Abstract Physicians' active engagement is a critical part of sustaining online health communities (OHCs) development. Gamification design can be leveraged to invoke physicians' gameful experience, better motivating their engagement in OHCs. However, it can also create inequality of economic returns among physicians, causing harm to these communities. Drawing on this operational paradox, this paper empirically examines both positive and negative effects of gamification on physicians and the contingent role of disparity in professional seniority on their engagement and inequality of economic returns, to advance knowledge of such practices. Although gamification design engages physicians and increases their income, the results indicate increased economic inequality among the physicians as a consequence. Considering physician's higher professional seniority in the same department, it weakens the positive effect of gamification design on their engagements but strengthens such effect on economic inequality. Managers are advised to carefully plan their gamification design in order to promote physician engagement in OHCs and avoid the related paradoxes.

中文翻译：

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部署游戏化让医生参与在线健康社区：一个操作悖论

摘要 医生的积极参与是维持在线健康社区 (OHC) 发展的关键部分。可以利用游戏化设计来唤起医生的游戏体验，更好地激励他们参与 OHC。然而，它也可能造成医生之间经济回报的不平等，对这些社区造成伤害。利用这一操作悖论，本文实证研究了游戏化对医生的积极和消极影响，以及专业资历差异对其参与和经济回报不平等的偶然作用，以促进对此类实践的了解。尽管游戏化设计吸引了医生并增加了他们的收入，但结果表明医生之间的经济不平等加剧。考虑到医生' 同一部门的更高专业资历，削弱了游戏化设计对其参与的积极影响，但加强了这种对经济不平等的影响。建议管理者仔细规划他们的游戏化设计，以促进医生参与 OHC 并避免相关悖论。