The influence of physicians' knowledge sharing on patient satisfaction in online medical consultations (OMCs) has received extensive attention in recent years. However, patient gratitude in OMCs, another crucial outcome for physicians' knowledge sharing, has largely been overlooked. To address this gap, this study attempts to distinguish patient satisfaction from gratitude in OMCs and elucidate the relationship between the sharing process and outcomes. Drawing on the affect theory of social exchange, this study proposes a model that investigates the relative effects of physicians' informational and emotional support during the knowledge‐sharing process on patient satisfaction and gratitude, as well as the contingent roles of physicians' professional seniority and patients' disease severity. The research model is tested by using data from a well‐known online health platform in China. The results indicate that patient gratitude is associated with a more favourable service evaluation than satisfaction in OMCs. Physicians' informational support has a greater effect on patient satisfaction than emotional support, while emotional support has a greater effect on patient gratitude than informational support. Moreover, professional seniority and disease severity positively and negatively moderate the relationship between emotional support and patient gratitude, respectively. A survey‐based experiment is also adopted to validate the research model with self‐reported perceptual measures. This study contributes to the literature on patient gratitude, online healthcare service evaluation, knowledge sharing, and the affect theory of social exchange.