Two to tango: Physician linguistic style matching and patient revisits in online mental healthcare consultations

Effective mental healthcare typically evolves through an ongoing therapeutic process grounded in sustained physician-patient interactions, where patient revisits play a key role in maintaining such continuity. Nevertheless, empirical research on patient revisits in online mental healthcare settings remains limited. Drawing upon interpersonal trust theory, this study examines whether and how initial physician linguistic style matching (LSM) influences patient revisits in online mental healthcare consultations. Analyzing a large-scale dataset of over 227 thousand real-world consultations from a leading Chinese online healthcare platform, we find a robust, positive association between initial physician LSM and patient revisits. Bootstrapped mediation analysis suggests that this effect operates through a dual trust-building mechanism that fosters both patient affective and cognitive trust. We also observe suggestive evidence of a potential expectation-violation pattern, whereby the positive effect of physician LSM on patient cognitive trust may attenuate at very high levels. Further analyses show that the positive effect of physician LSM is more pronounced when physician responses are more topic-relevant and among patients with milder emotional distress. Finally, the observed effect persists among returning patients and those with chronic physical conditions (e.g., hypertension and diabetes), and physician LSM in publicly visible consultations also serves as a diagnostic signal influencing third-party patient selection. Collectively, our findings advance understanding of patient revisits, physician-patient interactions, and linguistic accommodation in online mental healthcare consultations and provide practical implications to promote effective, patient-centered healthcare.