Effects of Agent Identity on Patients’ Intention to Comply in Online Medical Consultations: The Mediating Role of Perceived Decision-Maker Autonomy

As AI technologies become increasingly integrated into online medical consultations, understanding patient responses to different forms of AI involvement is crucial. However, limited research has examined how patients’ perceptions of AI involvement affect their intention to comply with medical advice. Drawing on the heuristic–systematic model, this study examines how agent identity (human, AI, or AI-assisted human) influences patients’ intention to comply with medical advice. Across four scenario-based experiments, results show that patients are more likely to comply with advice from AI-assisted human agents than from AI agents, but less likely than with human agents. Perceived decision-maker autonomy mediates this effect. Moreover, we identify two boundary conditions: the effect of perceived decision-maker autonomy is weakened when decision transparency is high but strengthened when disease severity is high. These findings advance understanding of human–AI collaboration and offer practical insights to enhance patient acceptance of AI in online consultations.