Voluntarily Burning Out/Uberization in Medicine: Chinese Doctors’ Platform Gig Work as Active Patient-Management and Career-Development Tools

• In Event: Organizations, Occupations, and Work Section Roundtables
  In Refereed Roundtable (90 minute): Table 24: High-status Occupations and Technological Change

Abstract

Platform gig workers are usually portrayed as either (1) precarious, low-skill laborers working in atomized conditions under platform control without formal contracts or benefits, or (2) creative freelancers who adapt to algorithmic management in pursuit of unrealized autonomy or flexibility. My study complicates these dominant portrayals by examining the online gig work of Chinese doctors, a profession characterized by high skill, high social status, and stable affiliation with traditional medical institutions. Despite widespread burnout in hospital jobs already, nearly half a million Chinese doctors voluntarily further exhaust themselves by engaging in online medical platforms (OMPs) during leisure time. This unique phenomenon of extra self-exploitation without mandatory obligations remarkably challenges current theories on (1) gig worker precarity and (2) platform control and management. Drawing on multiple data sources, I find that doctors actively use OMPs as patient-management and career-development tools, rather than merely as sources of supplementary income. They retain substantial discretion over platform services, while temporarily circumventing the most notable constraints of traditional medical institutions: geographically uneven distribution of medical resources nationwide, and rigid bureaucratic hierarchy within public hospitals. OMPs therefore serve as an expedient, though probably unsustainable, remedy for the pitfalls of China’s current healthcare system after marketization reforms that have posed crucial challenges to medical institutions.

Author

• Yingzhe Zhu, Northwestern University