The changing relationship between the Chinese urban medical profession and the state since the republican period: the perspective of the sociology of professions

The relationship between professions and the state is one of the most important issues in the sociology of professions. Using the analysis framework of the corporate-clinical autonomy dynamic relationship, this article delineates and analyzes the changing relationship between the (Western) medical profession and the Chinese state since the Republican period. Before 1949, the relationship between the growing medical profession and the newborn state was characterized by mutual construction. Beginning in 1949, the communist regime successfully transformed medical professionals into members of work units. The profession was tamed and became the functionary of the state. Although China began its reform in 1978, public healthcare institutions still dominate the delivery of healthcare services. Practitioners are thus still dependent upon work units. They hold dominance over both patients and medical enterprises, through which the profession gains economic interests from the market. However, one cost is that the profession serves as the buffer between patients and the government. Further reform of the healthcare system should reconstruct the relationship between the profession and the state.