Legitimating the Role of a New Profession in a Marketised Healthcare System: The Emergence of Medical Social Work in China

ABSTRACT

This article examines the emergence and legitimation of medical social work (MSW) within China's recently marketised healthcare system, building on longstanding sociological debates about professional formation and authority. Drawing from qualitative interviews with medical social workers, doctors and patients across diverse hospital settings, the study compares two organisational models—internal embedding of MSW within hospitals and external collaboration via government agencies—to analyse strategies for gaining professional legitimacy. Three key strategies are identified: external manifestation through symbolic markers (white coat, blue vest), alignment with political imperatives for mediating doctor–patient disputes and resource mobilisation to support vulnerable patients. Findings consider how these three legitimation strategies are enacted in the two organisational contexts and infrastructural access, while externally affiliated strategies enable flexibility, perceived independence and community linkage. The article argues that MSW legitimacy in China emerges not from seeking exclusive control of specialised knowledge but through dynamic negotiation of identity, symbolic authority and responsiveness to policy priorities, providing an empirical case of post‐professionalism under conditions of market reform. These insights contribute to the sociology of health and illness by highlighting context‐sensitive processes of professional formation in transitional healthcare systems in the Global South.