The Chinese government created specialty mediation committees to settle profession-based disputes, including medical disputes, in the 2010s. Using data on medical dispute resolution collected from fieldwork from 2016 to 2017, this article examines why (and how) mediators have addressed social grievances. It argues that the specialisation of mediation institutions and a series of politicisation measures, as well as affective and bargaining strategies employed in the mediation process, have jointly led to a high mediation rate. The findings also reveal that several factors could shape mediators' strategies, including timing, disputes that may lead to group petitioning, and disputants' level of bargaining power. This article enhances our understanding of the advent of the specialty mediation committees from an institutional perspective and enriches our knowledge of the mediators' role in the process.