Promotion or suppression? Does internet use by the Chinese public affect physician trust?

Objective: This study aims to explore the causal relationship between internet use and the level of physician trust among Chinese residents, providing rigorous empirical evidence for understanding the changes in doctor-patient relationships in the digital era. Methods: Using four waves of panel data from the China Family Panel Studies (CFPS) spanning 2016 to 2022, we construct a two-way fixed effects model to control for individual and time heterogeneity. We further employ propensity score matching (PSM) to alleviate sample selection bias, thereby robustly examining the relationship between internet use and residents' physician trust. Results: Internet use is significantly associated with a lower level of residents' trust in physicians, and this conclusion remains consistent across multiple robustness tests. Heterogeneity analysis reveals that physician trust among individuals with poorer health, lower social status, and no medical insurance is more susceptible to the impact of internet information. Conclusion: When understanding the relationship between the internet and physician trust, one cannot generalize; instead, refined policy design should be implemented by considering individuals' health status, social position, and institutional participation. Particularly for groups with high information sensitivity and vulnerable trust, efforts should be made to strengthen online information guidance and health education to prevent them from falling into information cocoons and cognitive polarization.