*5.1. Theoretical Implications*

Our findings have the following three theoretical implications:

First, this study extends existing studies on poor DPR by integrating both doctors' and users' perspectives. The majority of existing studies tend to investigate DPR only from users' perspectives, such as Um et al. (2018) [8] and Zhang et al. (2018) [12], ignoring the significance of interpreting DPR from dual perspectives of users and doctors. Mobile consultation transforms the traditional doctor-dominated relationship to a more equal and reciprocal relationship [36,54], which emphasizes the importance of taking doctors' experience into account to understand DPR. By discerning causes of poor DPR for both doctors and users, this study provides a more comprehensive understanding of DPR in the mobile context.

Second, this research contributes to existing knowledge on the causes of poor DPR in the mobile context by elaborating on both direct and underlying causes of poor DPR. Existing studies mainly ascribe poor DPR to observed behaviors, such as long waiting hours, no treatment plan and impatience [7,14], which fails to explore the underlying reasons for these behaviors. By drawing on the theoretical perspective of CMC and by conducting a qualitative study on a leading Chinese mobile medical platform, this study not only highlights representative misbehaviors of doctors and users as the direct causes of poor DPR but also identifies CMC limitations as the underlying reasons.

Last but not least, by comparing the traditional face-to-face consultation with CMC medical communication, this study extends the current mobile health studies by identifying the unique but dark side of mobile health services. Even though mobile health services are becoming extensively popular in recent years, the unique settings of mobile medical consultation make it difficult to further improve user satisfaction. By distinguishing the potential challenges of the mobile healthcare services, this study provides a brand-new perspective to explain user satisfaction, that is to explain user satisfaction from the mobile context itself, rather than from the interaction process.
