Abstract: With the rapid development of mobile Internet technology,online health communities (OHCs) have emerged and quickly become an important complement to traditional offline healthcare.These platforms allow patients to access medical advice,share experiences and interact with healthcare professionals from the comfort of their own homes.Online healthcare has significantly changed the traditional doctor-patient communication model,moving from in-person consultations to communication via text,voice,and other digital media.This shift in communication methods has raised important questions about how physicians can improve the quality of their services and increase patient satisfaction after consultations,making it a major focus of healthcare research. This paper examines the factors that influence patients reciprocal behavior toward physicians,with a particular focus on the use of text and voice as communication media.Based on social support theory,a theoretical model is proposed to explore the determinants that drive patientsdecisions to reciprocate after a consultation.To analyze the voice data,the spectral centroid mean (SC) is used to measure the brightness of the sound,while the maximum consecutive voice messages are examined to assess the concentration and focus of the voice communication.In the case of text data,the number of emoticons is quantified as an indicator of the emotional expressiveness of the text,while the proportion of deterministic vocabulary is used to assess the degree of affirmation conveyed by the tone.In the empirical part,the research draws on a dataset that includes personal information and consultation data of doctors from a specific Online Health Community (OHC) platform,covering the period from January 2022 to June 2022.The dependent variable in this analysis is the patients decision to reciprocate,while the four aforementioned variables are treated as independent factors.In addition to the four independent variables mentioned above,we also introduce two types of control variables:one is the doctors personal information,and the other is the variable measuring the scale of doctor-patient interaction dialogues. A logistic regression model is constructed to examine the impact of these variables on the likelihood of patients engaging in reciprocal behaviors.The results show that when physicians communicate via text,a more positive tone and increased use of emoticons significantly increase the likelihood that patients will reciprocate.In addition,when physicians send voice messages,speech that is more focused and has a brighter tone correlates with a higher likelihood that patients will engage in reciprocal behavior.These findings provide important insights into how different modes of communication can influence the dynamics of doctor-patient interaction in online healthcare environments. From a theoretical perspective,this paper explores the various factors that influence both the transmission of information and the exchange of emotions in doctor-patient communication.By examining these dynamics,it aims to enrich and expand the scope of social support theory while uncovering the critical role and underlying influence mechanisms of communication media in online doctor-patient interactions.This research contributes to a better understanding of how digital platforms mediate the exchange of health information and emotional support and shape the overall experience.From a ctical management perspective,the findings of this study provide valuable insights and actionable guidance for physicians and online healthcare platforms.These conclusions can help optimize interaction strategies during consultations,fostering stronger and more positive doctor-patient relationships.Ultimately,such improvements will help improve overall service quality and patient satisfaction in the rapidly evolving online healthcare sector.