Abstract
A national chronic kidney disease (CKD) prevention system was established between 2001 and 2011 in Taiwan. Instead of following the theory of medicalization developed in the context of advanced countries, this paper draws on the perspective of technological governance from science, technology, and society studies and analyzes how a medical profession ＂promotes＂ the disease and transforms its status and the medical regime in a latecomer country. This study criticizes medicalization theory for ignoring this latecomer context. Since the millennium, the Taiwanese nephrological profession, faced with financial and professional pressure in the dialysis regime, has promoted a ＂new national disease＂ discourse on the basis of international statistics and the black-boxed clinical index of eGFR. The discourse and index facilitate the implementation of a CKD regime in a project-oriented policy-making mechanism at the expense of ignoring clinical, professional, and social complexities. This regime has the following consequences: It reverses the status of the nephrological profession but causes internal diversification; it worsens the imbalance between hospitals and local clinics; and its insufficient understanding of and support to diagnosed patients might cause iatrogenesis. In conclusion, this study specifies the ＂self-latecomerization＂ characteristics of the profession, knowledge, and policy-making mechanisms of latecomer medicalization.