What Makes a Good Doctor Response? A Study on Text-Based Telemedicine

Text-based telemedicine has become an increasingly used mode of care, requiring clinicians to deliver medical advice clearly and effectively in writing. As platforms increasingly rely on patient ratings and feedback, clinicians face growing pressure to maintain satisfaction scores, even though these evaluations often reflect communication quality more than clinical accuracy. We analyse patient satisfaction signals in Romanian text-based telemedicine. Using a sample of anonymised text-based telemedicine consultations, we model feedback as a binary outcome, treating thumbs-up responses as positive and grouping negative or absent feedback into the other class. We extract from doctor responses interpretable, predominantly language-agnostic features (e.g., length, structural characteristics, readability proxies), along with Romanian LIWC psycholinguistic features and politeness/hedging markers where available. We train a classifier with a time-based split and perform SHAP-based analyses, which indicate that metadata dominates prediction, functioning as a strong prior, while characteristics of the response text provide a smaller but actionable signal. In subgroup correlation analyses, politeness and hedging are consistently associated with positive patient feedback, whereas lexical diversity shows a negative association.