The Role of Medical Word-of-Mouth on Sport Therapists: A Patient Psychological Perspectives

doi:10.4236/ojmp.2013.24B002

Paper Menu >>

Journal Menu >>

Open Journal of Medical Psychology, 2013, 2, 7-10

doi:10.4236/ojmp.2013.24B002 Published Online October 2013 (http://www.scirp.org/journal/ojmp)

The Role of Medical Wor d-of-Mouth on Sport Therapists:

A Patient Psychological Perspectives

Fangyi Liu1, Ming-Yu Chou1*,Yung-Lun Liu1, Hong-Zhou Chen2

1Department of Leisure Recreation & Travel Management, Toko University, Chiayi County, Chinese Taipei.

2Department of Animation & Game Design, Toko University, Chiayi County, Chinese Taipei.

Email: *[email protected]

Received June, 2013

ABSTRACT

In 21st century, more and more people see medical services of sport therapists as a promising industry due to global

aging population and high biotechnology development. Hence, understanding medical word-of-mouth (WOM) process

among patients in medical services of sport therapists could be interesting and useful. This study would find out the role

of WOM on patients psychology when choosing the sport therapists, understand how patients look for sport therapists’

information and which information source is important to them. As a pioneer, this study would like to improve medical

WOM marketing of sport therapists. The authors designed a questionnaire based on how patients choosing sport therap-

ists, including questions search importance of different information sources of sport therapists with medical service de-

cision, and respondents’ psychological demographics. We released 253 questionnaires of judo therapy clinics in Taiwan.

More than half of the respondents see sport therapists due to others’ recommendations (referral of family, friends and

professionals）. Women are more likely to seek medical word-of-mouth information than men; and respondents who

think choosing sport therapists are important tend to seek medical word-of-mouth information. Further, patients focus

on “therapist’s behavior”, “therapist’s skills”, and “therapist’s ethic”.

Keywords: Medical Word-of-Mo uth; Sport Therapist; Patient Psychology

1. Introduction

Medical worth-of-mouth (WOM) of doctors or therap ists

reviews commonly circulate in conversations, such as

chats, experience sharing, or when people ask their

friends to recommend a sport therapists For example,

people often make statements like “Dr. Liu is the best

judo therapist in the country!” “Nobody can diagnose my

problem. Do you know which therapist is an expert on

this?” When people are asked about famous cardiologists,

several names may enter their minds, and their i mpress-

sions usually come from hearing the discussions of oth-

ers. When people cannot determine which therapis t to

visit, they are commonly influenced by WOM reviews,

deciding to try the recommended therapist s. WOM re-

views are especially convincing when the receiver has

heard the same WOM review regarding the same sport

therapist many times, or when the spreader has substan-

tial knowledge of sport health care, for example, people

working at sport therapy clinics.

Although the phenomena of sport therapy medical

WOM reviews exist, very few sport health care-related

studies have explored this issue. In the field of sport

health care management, most of the studies on patients’

psychology have enabled medical institutions to improve

sport health care information communication by focusing

on patients’ psychological behaviors of seeking informa-

tion regarding their symptoms and self-care after visiting

doctors and therapists [1]. A significant number of stu-

dies on health care management focused on issues such

as the quality of medical services, doctor-patient or the-

rapi st-patient relationships, and patients’ psychological

satisfaction of medical services [2]. Most of these studies

focused on patients’ behaviors during or after medical

treatments, whereas in this study, we investigated pa-

tients’ psychological behavior prior to medical treatment.

After reviewing literature on WOM, we explored the

influence medical WOM reviews had on patients’ sport

therapist selection decisions. The literature we reviewed

included that on the definition of WOM, the influence of

WOM on receivers’ psychological decisions, and the

influence of WOM on professional services.

*Corresponding author.

F. LIU ET AL.

In addition, we limited the discussion to “the influence

of medical WOM on patients’ sport therapist selection”

for a more focused study. We conducted surveys and

interviewed patients to increase the credibility of the re-

sults. The research questions were as follows:

1) What is the significance of medical WOM on pa-

tients’ sport therapist selectio n ?

2) What are the traits of the people actively seeking

medical WOM of sport therapists?

3) What are the traits of the people spreading medical

WOM of sport therapist?

4) What types of WOM do patients value when they

select sport therapists?

2. Literature Review

2.1. Medical WOM in Health Care

Many studies have been conducted on the WOM of service

products and manufactured products, whereas few

studies have been conducted on the WOM of health care

services. Numerous scholars have indicated that the

WOM for service products had more influence on the

consumers than the WOM for manufactured products [3].

[4] also indicated that because services were intangible,

consumers typically asked people with experience for

information to determine whether the services met their

demands and to evaluate the quality of the service. [5]

emphasized the risks of service products to consumers;

they argued that the purchase of service products was more

risky because services were intangible, no standards

could be applied, and service providers rarely offer

guarantees to customers [6].

A number of scholars examine WOM in professional

service sectors. For example, [7] indicated that in high-

risk and highly invasive professional services, WOM was

extremely significant to consumers. [8] Found that the

value of WOM increased when consumers were planning

to purchase service products that were complex, highly

invasive, expensive, risky, and significant, such as health

care services. Health care services were credence goods,

which differed from search goods and experience goods.

Search goods are products whose quality consumers can

discern prior to the purchase; for example, consumers

can try on clothing to determine whether it fits prior to

purchasing. Experience goods are products whose quality

consumers can judge after purchasing [9]; for example,

they can determine whether the canned goods they pur-

chase are tasty. By contrast, credence goods are products

whose quality consumers have no way of judging before

or after purchasing. Therefore, WOM played a signi fi-

cant role in the purchase of credence goods [10].

2.2. Seeking Medical Treatment and Information

Seeking medical treatment is a purchase psychological

behavior. When patients evaluate their decisions regarding

medical treatments, they use a psychological decision

model similar to that of purchase behaviors, which is a

series of psychological processes from demand evaluation

to result evaluation after the purchase, including demand

confirmation, information seeking, evaluation of alternatives,

purchase psychological decision making, and after-

purchase psychological behaviors [11]. The purpose of

information seeking is to obtain and compare options.

Thi s psychological process comprised internal seeking,

where the consumers make judgments based on their

experience and knowledge, and external search, where

consumers seek external information, such as actively

seeking WOM [9]. According to [12], because most

patients did not understand their own psychological

illnesses, they tended to seek information regarding

doctors, sport therapists, clinics or hospitals from friends

or relatives with a similar experience (actively seeking

WOM) to save them the trouble of blind searching and to

overcome their lack of sport health care information.

Several studies regarding sport health care manage-

ment have been conducted on health information seeking

psychological behaviors. However, these studies primar-

ily focused on patients’ psychological behaviors of seek-

ing information on disease diagnosis and care [13]. The

study by Lambert differed from this study on the point in

time that was discussed: Those scholars examined how

patients sought external health care information to better

understand their illnesses and prepare for self-care after

they had visited the sport therapists, whereas we explored

how patients sought sport therapist information to deter-

mine which sport therapist to visit, that is, a pre-purchase

search.

3. Methodology and Design

This study was conducted in cooperation with the Toko

University and judo therapy clinics in Taiwan. A quantita-

tive study was conducted at the Taiwan judo therapy clinics,

where questionnaires were administered and analyzed. We

selected judo therapy clinics to distribute the question-

naire and explore residents’ behaviors of seeking sport

medical treatment.

We distributed the questionnaires in the waiting area

of the judo therapy clinics in Taiwan. Over a week, six

researchers distributed questionnaires during the morning,

afternoon, and evening clinic hours. The participants

were randomly selected patients or the friends and

families of patients. After the researchers obtained the

participants’ consent, the participants completed the

questionnaires anonymously. The researchers assisted the

elderly and visually impaired participants in completing

the questionnaires.

The questionnaires were designed to study the

significance of doctor WOM, who was more likely to

F. LIU ET AL.

actively seek medical WOM of sport therapist, whose

recommendation and medical WOM were effective, and

what information patients valued most when selecting

sport therapists. We conducted numerous discussions,

revisions, and pre-tests to obtain the final version of the

questionnaire. To design the question for identifying

what information patients valued the most when selecting

sport therapists, we posted an open-ended question

(“What do you value most when selecting sport therapists?”)

on social networking sites and asked internet users to

nominate the top three factors they considered. We

collected 125 samples and summarized the top 12 factors

as follows: sport therapist’s medical skills, sport therapist’s

attitudes, sport therapist’s medical ethics, whether the

sport therapists were well-known, whether the sport

therapists had been involved in medical disputes, medical

expenses, sport therapists’ appearances, experience,

education, the clinics of the sport therapist had worked at,

sport therapist s’ gender, and reputation.

We employed SPSS 17.0 to analyze the data, and used

descriptive statistics to describe the information collected

in the survey to gain an initial understanding of the in-

fluence medical WOM had on sport therapists’ selection.

4. Results and Analysis

We administered the questionnaires outside the waiting

area of judo therapy clinics in Taiwan and recovered 253

effective questionnaires. We analyzed the data using

SPSS 17.0 and the results were as follows:

The age of the participants was evenly distributed,

with an average of 48 years; 48.2% of the participants

were male, and 51.8% were female.

Of the participants, 92.5% were local judo therapy

clinics’ counties, and only 7.5% were from other coun-

ties. Additionally, most of the participants (34.2%) were

college graduates.

4.1. The Significance of WOM on Patients’ Sport

Therapists Selection

WOM was significant to patients’ sport therapists’ selec-

tion. The patients that selected the sport therapists they

would visit based on medical WOM accounted for

48.02% of the participants. Among them, 32.40% used

walk -in registration, and 19.58% used online registration.

These results confirmed that reported in numerous pre-

vious studies and provided data for this study. According

to [4], because service products are invisible and intangi-

ble, consumers typically ask people with experience for

information regarding the products prior to the purchase,

to determine whether the service suits their needs and

evaluate the quality of the service. [10] Also indicated

that the value of WOM increased when consumers were

planning to purchase service products that were complex,

highly invasive, expensive, risky, and significant, such as

health care services. [14] Found that medical WOM ac-

counted for highest percentage of American patients’

pre-treatment information searching. In addition, older

patients were more likely to be influenced by medical

WOM when making health care decisions, because they

cannot search the information on the Internet.

4.2. The Traits the Spreaders of Sport Therapist

WOM

Recommendations from families, friends, and profess-

sionals were the most useful. More than 70% of the par-

ticipants considered recommendations from families and

friends crucial, and 80% of the participants considered

recommendations from medical professionals crucial,

which indicated that the tie strength between the receiv-

ers and the spreaders and the professionalism of the

spreaders had a significant influence on the patients [4].

4.3. The Most Valued Factor in Patients’ Sport

Therapis t s Selection

The most valued factor in patients’ sport therapist selec -

tion was sport therapist’s attitudes (82.99%), followed by

sport therapist’s skills (71.16%), medical ethics (67.19%),

reputation (35.58%), experience (33.20%), whether the

sport therapists had been involved in medical disputes

(26.01%), the therapy clinics the sport therapists were

working at (23.71%), sport therapists’ education (11.86%),

whether the doctors were well-known (9.88%), medical

expenses (9.49%), sport therapists’ gender (2.37%), and

sport therapists’ appearance (0.79%). A comparison be-

tween the answers from the participants who selected the

doctors based on WOM and those who randomly se-

lected doctors during walk-in registration showed that no

significant differences in the factors they valued during

sport therapists selection.

5. Discussion and Implications

In general purchase behaviors, when consumers considered

the purchase decisions significant, they usually sought

relevant information and WOM prior to the purchase

[15]. However, in this study, we found that although

most of the patients considered sport therapists selection

crucial (74%), only 41.5% of them actively sought WOM,

whereas 59.5% of them did not. We concluded that the

patients in this study tended not to actively seek medical

WOM because most of them had relatively easy-to-treat

illnesses (they were outpatients recruited from a clinic)

and the risks were relatively low [5]; for example,

patients with a cold do not need to visit a specific sport

therapist. Additionally, a number of patients were

unaware of the severity of their illnesses. Equally

possible was that the patients had passively received

F. LIU ET AL.

WOM regarding the sport therapists or the patients had

heard about the sport therapists from another sport

therapist when the patients were transferred from one

clinic to another. In both cases, the patients did not

actively seek medical WOM. Patients might have also

failed to actively seek medical WOM because of the lack

of health care information or channels.

In this study, we enabled medical staff to understand

why the patients selected them and where the patients

acquired sport therapists information from. We also

found that patients’ behaviors of seeking medical treat-

ment enabled the health care system and doctors to un-

derstand the sources of patients’ health care information.

We concluded that patients with higher levels of med-

ical professionalism were more likely to actively seek

medical WOM. We suggest that the health care system

provide additional health care education to the public to

enhance their knowledge of health care. This health care

system should also create more platforms for the public

to exchange sport therapists’ information (e.g., health

care websites and forums) to improve the information

flow of health care.

Most of the participants obtained information about

the doctors through walk-in registration or the official

Web site of the hospital, indicating that the patients had

substantial trust in medical institutions in Taiwan. During

the interviews, numerous participants expressed their

faith in the sport therapists at clinics. Therefore, medical

institutions should make it their responsibility to provide

more reliable health care information to the public. We

also found that the families of the patients were more

active than the patients themselves in seeking medical

WOM. Therefore, the sport therapists system should tar-

get their health care publicity at the families of patients.

For example, many public service announcements should

be designed to communicate with the families of patients.

6. Acknow l edgements

We would like to thank the anonymous referees for their

valuable comments and suggestions. The first author

Fangyi Liu can be contacted at [email protected],

and the corresponding author Ming-Yu Chou can be

contacted at [email protected].

REFERENCES

[1] J. Weaver, D. Mays, S. S. Weaver, G. Hopkins, D. Eroglu

and J. Bernhardt, “Health Information-Seeking Behaviors,

Health Indicators, and Health Risks,” American Journal

of Public Health, Vol. 100, No. 8, 2010, pp.

1520-1525. doi:10.2105/AJPH.2009.180521

[2] S. Shabbir, H. R. Kaufmann and M. Shehzad, “Service

quality, word of mouth and trust: Drivers to achieve pa-

tient satisfaction,” Scientific Research and Essays, Vol. 5,

No. 17, 2010, pp. 2457-2462.

[3] Y. Chen, F. Liu, C. H. Fang and T. M. Y. Lin, “Under-

standing the Effectiveness of Word-of Mouth: An Elastic-

ity Perspective,” Journal of Research in Interactive Mar-

keting, Vol. 7, No. 1, 2013, pp.

57-77. doi:10.1108/17505931311316743

[4] J. Bristor “Enhanced Explanations of Word of Mouth

Communications: The Power of Relationships,” Research

in Consumer Behavior, Vol. 4, 1990, pp. 51-83.

[5] C. H. Fang, T. M. Y. Lin, F. Liu and Y. H. Lin, “Product

Type and Word of Mouth: A Dyadic Perspective,” Jour-

nal of Research in Interactive Marketing, Vol. 5, No. 2/3,

2011, pp. 189-202. doi:10.1108/17505931111187802

[6] F. Liu, C. H. Fang, T. M. Y. Lin and S. Chung,

“Word-of-Mouth Effect of Aboriginal Cultural Products

Purchase Behavior in Taiwan,” International Journal of

Psychology, Vol. 47, 2012, pp. 178-178.

[7] F. Liu, I. L. Chien, M. Y. Lan and S. M. Chien, “Devel-

opment The Theme Park Brand Equity Model of Tai-

wan,” International Journal of Psychology, Vol. 47, 2012,

pp. 174-174.

[8] Y. Chen, F. Liu, L. M. Ho and T. M. Y. Lin, “Develop-

ment of Word-of-Mouth Elasticity Measures for Tourism

Product Categories,” Psychology, Vol. 3, No. 9, 2012, pp.

722-728. doi:10.4236/psych.2012.39109

[9] M. Y. Lan, F. Liu, C. H. Fang and T. M. Y. Lin, “Under-

standing Word-of-Mouth in Counterfeiting,” Psychology,

Vol. 3, No. 3, 2012, pp. 289-295.

doi:10.4236/psych.2012.33041

[10] J. Sweeney, G. Soutar and T. Mazzarol, “Factors Influen-

cing Word of Mouth Effectiveness: Receiver Perspec-

tives,” European Journal of Marketing, Vol. 42, No. 3,

2008, pp. 344-364. doi:10.1108/03090560810852977

[11] J. Engel, R. Blackwell and P. Miniard, Consumer Beha-

vior, 8th Ed., Dryden Press, New York, 1993.

[12] H. Bansal and P. Voyer, “Word-of-Mouth Processes

within a Service Purchase Decision Context,” Journal of

Service Research, Vol. 3, No. 2, 2000, pp.

166-177. doi:10.1177/109467050032005

[13] S. Lambert and C. Loiselle, “Health information seeking

behavior,” Qualitative Health Research, Vol. 17, No. 8,

2007, pp. 1006-1019. doi:10.1177/1049732307305199

[14] S. A. Nasco and D. Hale, “Information Search for Home,

Medical, and Financial Services by Mature Consumers,”

Journal of Services Marketing, Vol. 23, No. 4, 2009, pp.

226-235. doi:10.1108/08876040910965566

[15] F. Liu and M. J. Lee, “Understanding the Island

Tourism Image Formation in Taiwan: via Fuzzy

Preference Relati o ns,” International Journal of

Psychology, Vol. 47, 2012, p. 174.