How Were Neo-Weberian Closure Gradually Formatted in the Linked Ecologies of Profession: The Case of Taiwanese Medical Professional Governance Act

In modern society, professions maintain autonomy or professional authority through their knowledge dominance. However, over the past half-century, the differentiation and collaboration between various professions have brought challenges. As a result, researchers have begun to focus on the ecological systems that emerge among different professions, allowing sociologists to better describe the various forms of “social closure” encountered by the public. This paper adopts Abbott's (1988) ecological framework and neo-Weberian approach to explore how the jurisdictional relationships among medical professionals in Taiwan, such as physicians, nurses, pharmacists, and therapists, were formatted gradually during the development of the medical profession. Methodologically, this study employs secondary data analysis, examining materials in the legislative processes and news reports to clarify how various "jurisdictional settlements" are formed as occupational and social closure within the system of medical profession. The preliminary findings of this paper are threefold: (1) Isomorphic trends, which can be subdivided into two forms: diachronically occurring the delineation of practice scope and synchronically emerging the administrative supervisory bodies; (2) Differentiation trends, among the ecologies of medical/health professionals existed the physician-dominant as the regular principle, while emergencies or spatial-separation serve as exceptions; (3) Emerging trends, which can be further categorized into the competition over professional practice and the differentiation of organizational arenas, which were shown in the legislative amendments followed with controversies in societal level. In this regard, Taiwan's regulation of medical professionals operates as a dual-layered system: the state first exerts strict control over the physician in terms of laws, finances, education, then physicians themselves regulate rigidly the scope of practice for other medical professionals. This paper argues that Abbott’s “linked ecologies” perspective contributes significantly to neo-Weberian analysis of the medical professional system, though there are several aspects that warrant further refinement.