From Grace to Violence: Stigmatizing the Medical Profession in China

Abstract

This study examines how the once prestigious medical profession in China has become criticized to the point of inducing widespread violence by patients. Drawing on archival documents, media articles, interviews, and secondary sources, we trace the lengthy and uneven trajectory by which the profession moved from collective approval through ambivalence towards stigmatization. We develop a process model of professional stigmatization that identifies dynamics that precipitate and then catalyze that trajectory; and highlight the underpinning mechanisms. By unpacking the complex process of stigmatization, the study extends understanding of how aspects of stigma emerge, and are attached by different stakeholders to a profession, and the consequences that follow. We conclude by highlighting implications for research on stigma and the challenge of stigma containment.

Stigma Beyond Levels: Advancing Research on Stigmatization

“…Similar to studies at the individual level, studies of occupational stigma have largely left processes of stigmatization unexamined or treated them as implicit. Two forthcoming papers are exceptions: one discusses how coping may inadvertently maintain stigmatization for occupational members (Mikolon, Alavi, & Reynders, 2020), and the other examines the emergence of professional stigma after ethical transgression (Wang, Raynard, & Greenwood, 2020).…”

“…An excellent example of the type of work we imagine is a paper by Wang and colleagues (2020). In the paper they discovered that in China while the government attempted to publically shame individual physicians for profitseeking behaviors, it unintentionally catalyzed stigmatization at the profession level as a whole leading to occupational and categorical stigma (Wang et al, 2020).…”

My Work Is Meaningless: The Consequences of Perceived Occupational Stigma for Employees in High-Prestige Occupations

“…First, the sample comprised preschool teachers, which constrains the generalizability of the findings. Thus, whether these findings apply to other high-prestige occupations, such as physicians, which is another stigmatized high-prestige profession, remains to be tested ( Wang et al, 2021 ). We encourage future studies to replicate our research across more occupations.…”

“…In other words, they may not believe other people appreciate their work. Indeed, recipients may not only be ungrateful for their work but may be hostile or aggressive (e.g., Zapf, 2002 ), and can even seek to hurt them, especially under the influence of occupational stigma (e.g., Wang et al, 2021 ). Therefore, when employees of high-prestige occupations perceive their job to be subject to occupational stigma, they may perceive information or cues that the recipients of their work do not appreciate their efforts, which makes it more difficult for them to perceive task significance, and in turn reduces their perceived meaningfulness.…”

“…When negative press builds over time, the profession is likely to become stigmatized in the eyes of the public and viewed as sinful or deceptive ( Hughes, 1951 ; Ashforth and Kreiner, 1999 , 2014 ). Occupational stigmatization has become an increasing problem, with a constant rise in violence against workers whose occupations have become stigmatized ( Wang et al, 2021 ) and a consequent negative impact on perceptions of the industry as a whole industry ( Brien et al, 2017 ). When employees are aware that their work has become stigmatized and believe others view them negatively because of the work they do, this is referred to as occupational stigma consciousness ( Pinel, 1999 ; Pinel and Paulin, 2005 ; Shantz and Booth, 2014 ).…”