5 ms·

Programmers don’t unionize because they are well paid, and there is no structural barrier stopping people who gain skills and experience from getting better pai

Programmers don’t unionize because they are well paid, and there is no structural barrier stopping people who gain skills and experience from getting better paid in the future. To contrast that look at medicine. Doctors have no union. They have a huge barrier to entry but once you are already a doctor then how much you get paid is determined by your skills and where you work. Doctors can get paid millions with enough prestige on them. Nurses on the other hand have a terminal limit. Every pay increase is gated by another nursing exam giving an additional certificate. Then in the end, the only upgrade is to doctor. However that means losing all benefits, retraining, and starting in a new track despite both professions being medical. Nurses therefore need a union. Another thing that stops unionization is the ability to work on your own. Nurses with high enough qualifications can work on their own, but in most cases they still need a supervising doctor even if that doctor is only a warm body. VFX pros are much the same. They need a team with them to work on a big budget movie. Programmers and doctors though can break away and start their own practice, serving the public directly and no one can stop them. With a little business savvy they can even rival the agencies that would have hired them as employees. If your profession can double as a stand-alone business then you rarely get a proper union. Even in cases (e.g. electricians) where a union is formed, it will still conduct training and certification which positions it somewhat like a guild.

closewith 4y ago
> Doctors have no union. Citation needed.
- dsr_ 4y ago
  The AMA controls medical school certification, and size, and therefore controls the number of new entrants, keeping earnings high. It doesn't organize medical doctors for working conditions, salary and benefits negotiation, insurance, or most of the other features of a union. A hospital chain doesn't negotiate with the AMA on behalf of their surgeons and hospitalists. (It would probably be a very good thing if interns and early residents had a union supervising working conditions.)
  - closewith 4y ago
    Ah, so doctors in the US aren't unionised at all? If so, they're a global outlier.
classichasclass 4y ago
There are most definitely physician unions, especially in government-operated clinics which are often union shops. I was involuntarily in SEIU for a number of years as a result, though I thought striking was unethical for a doctor myself. See also UAPD and NAVAPD.
ravenstine 4y ago
In addition, programmers have a decent shot at striking it out on their own if they can't stand W2 employment or if they think they can make more money starting a business. That's one big reason why I am unlikely to support unionization for the foreseeable future. If an employer treats us like crap, we just leave and either find a better opportunity or start our own business with blackjack and hookers. As a programmer, you can start your own business today by simply offering your services and looking for clients. We aren't nearly as enslaved to our companies as many other professions are.
imglorp 4y ago
> they still need a supervising doctor even if that doctor is only a warm body. This is a good thing for standard of care: it's a chain of accountability. Medical supervision is supposed to set local policies and quality gates across a range of different providers. This also extends to EMT's in the field, for example: their supervision says what drugs or procedures they can use, which affects what the ER is expecting when patients arrive.
- barry-cotter 4y ago
  > This is a good thing for standard of care: it's a chain of accountability. This is classism in action. There’s no reason a nurse practitioner can’t bear legal responsibility for their actions. As long as it’s unambiguous who is the responsible party whether they are a physician, nurse or physiotherapist there’s a chain of accountability.
  - imglorp 4y ago
    Not disagreeing that you need to enable all levels of provider, that's not what I'm saying. I also agree all levels of provider should have an easy career path to the top. The point is there's a system requirement for interfacing one provider to the next, so that if you're receiving a handoff from someone else you know they prepared the patient for the next guy. There's also a malpractice/liability component.
  - kurupt213 4y ago
    NPs don’t have near the experience of a doctor (who needs something like 8,000+ hours of supervised experience before they can practice unsupervised). You are saying a NP is the equivalent of an attending physician, which is absurd.
    - barry-cotter 4y ago
      Saying an attending physician and a nurse practitioner are in every way similar would seem unlikely, given the radically different environments they work in. When we compare outcomes they look as good or better than physicians but that’s not to say they can completely replace them. > A meta-analysis of nurse practitioners and nurse midwives in primary care > This meta-analysis was an evaluation of patient outcomes of nurse practitioners (NPs) and nurse midwives (NMs), compared with those of physicians, in primary care. The sample included 38 NP and 15 NM studies. Thirty-three outcomes were analyzed. In studies that employed randomization to provider, greater patient compliance with treatment recommendations was shown with NPs than with physicians. In studies that controlled for patient risk in ways other than randomization, patient satisfaction and resolution of pathological conditions were greater for NP patients. NPs were equivalent to MDs on most other variables in controlled studies. In studies that controlled for patient risk, NMs used less technology and analgesia than did physicians in intrapartum care of obstetric patients. NMs achieved neonatal outcomes equivalent to those of physicians. Limitations in data from primary studies precluded answering questions of why and under what conditions these outcomes apply and whether these services are cost-effective. https://pubmed.ncbi.nlm.nih.gov/7501486/ https://pubmed.ncbi.nlm.nih.gov/7501486/
mountainb 4y ago
Doctors have a guild: the AMA. Lawyers have a guild: the ABA. Neither are the same things as unions but they have similar effects. The ABA and AMA also have large roles in professional education. Both also have major roles in accreditation and regulation of the profession. Unlike unions, they do not collectively bargain on behalf of individual workers. They aren't subject to the many regulations associated with organized labor. They also enjoy broad exemptions to antitrust law which would otherwise apply. It's why other classes of worker cannot have the same type of protective guild -- it's legal when the ABA or AMA do it and illegal when someone else does it.
- ghaff 4y ago
  The situation with doctors and lawyers is considerably different however. Doctors, whether MDs or otherwise, tend to be pretty well-compensated in US broadly. Lawyers are much more of a mixed bag. White shoe law firms--mostly hiring students from top-tier schools with prestigious clerkships? Big bucks though either make partner or are mostly eased out. Some decent corporate law and successful private practices. But it's generally not a particularly well-compensated profession for someone from a mid to low-tier law school. And lots of people who graduate law school and even pass the bar don't actually end up practicing law.
  - cma 4y ago
    Doctors are well compensated in large part because their unions (professional associations) restricts the number of new doctors unreasonably and advocates against certifying foreign doctors to practice in the US.
- pclmulqdq 4y ago
  My understanding is that in many places, the trade unions (electricians, plumbers, etc.) operate more like the AMA than the UAW. There is a spectrum of unionization.
Archelaos 4y ago
> Doctors have no union. In Germany doctors are heavily unionized. The largest union, Marburger Bund has 131.000 members.[1] The second largest, Hartmannbund has 70.000 members.[2] For comparision: At the end of 2020, there were 409,121 practising doctors (not including dentists) in Germany.[3] [1] Source: https://de.wikipedia.org/wiki/Marburger_Bund https://de.wikipedia.org/wiki/Marburger_Bund [2] Source: https://de.wikipedia.org/wiki/Hartmannbund https://de.wikipedia.org/wiki/Hartmannbund [3] Source: https://www.bundesaerztekammer.de/baek/ueber-uns/aerztestatistik/aerztestatistik-2020/ergebnisse-der-aerztestatistik-zum-31122020/berufstaetige-aerzte https://www.bundesaerztekammer.de/baek/ueber-uns/aerztestati...
kurupt213 4y ago
You are sadly mistaken if you think nursing is even close to what being a doctor is.

closewith 4y ago

> Doctors have no union. Citation needed.

dsr_ 4y ago
The AMA controls medical school certification, and size, and therefore controls the number of new entrants, keeping earnings high. It doesn't organize medical doctors for working conditions, salary and benefits negotiation, insurance, or most of the other features of a union. A hospital chain doesn't negotiate with the AMA on behalf of their surgeons and hospitalists. (It would probably be a very good thing if interns and early residents had a union supervising working conditions.)
- closewith 4y ago
  Ah, so doctors in the US aren't unionised at all? If so, they're a global outlier.

classichasclass 4y ago

There are most definitely physician unions, especially in government-operated clinics which are often union shops. I was involuntarily in SEIU for a number of years as a result, though I thought striking was unethical for a doctor myself. See also UAPD and NAVAPD.

ravenstine 4y ago

In addition, programmers have a decent shot at striking it out on their own if they can't stand W2 employment or if they think they can make more money starting a business. That's one big reason why I am unlikely to support unionization for the foreseeable future. If an employer treats us like crap, we just leave and either find a better opportunity or start our own business with blackjack and hookers. As a programmer, you can start your own business today by simply offering your services and looking for clients. We aren't nearly as enslaved to our companies as many other professions are.

imglorp 4y ago

> they still need a supervising doctor even if that doctor is only a warm body. This is a good thing for standard of care: it's a chain of accountability. Medical supervision is supposed to set local policies and quality gates across a range of different providers. This also extends to EMT's in the field, for example: their supervision says what drugs or procedures they can use, which affects what the ER is expecting when patients arrive.

barry-cotter 4y ago
> This is a good thing for standard of care: it's a chain of accountability. This is classism in action. There’s no reason a nurse practitioner can’t bear legal responsibility for their actions. As long as it’s unambiguous who is the responsible party whether they are a physician, nurse or physiotherapist there’s a chain of accountability.
- imglorp 4y ago
  Not disagreeing that you need to enable all levels of provider, that's not what I'm saying. I also agree all levels of provider should have an easy career path to the top. The point is there's a system requirement for interfacing one provider to the next, so that if you're receiving a handoff from someone else you know they prepared the patient for the next guy. There's also a malpractice/liability component.
- kurupt213 4y ago
  NPs don’t have near the experience of a doctor (who needs something like 8,000+ hours of supervised experience before they can practice unsupervised). You are saying a NP is the equivalent of an attending physician, which is absurd.
  - barry-cotter 4y ago
    Saying an attending physician and a nurse practitioner are in every way similar would seem unlikely, given the radically different environments they work in. When we compare outcomes they look as good or better than physicians but that’s not to say they can completely replace them. > A meta-analysis of nurse practitioners and nurse midwives in primary care > This meta-analysis was an evaluation of patient outcomes of nurse practitioners (NPs) and nurse midwives (NMs), compared with those of physicians, in primary care. The sample included 38 NP and 15 NM studies. Thirty-three outcomes were analyzed. In studies that employed randomization to provider, greater patient compliance with treatment recommendations was shown with NPs than with physicians. In studies that controlled for patient risk in ways other than randomization, patient satisfaction and resolution of pathological conditions were greater for NP patients. NPs were equivalent to MDs on most other variables in controlled studies. In studies that controlled for patient risk, NMs used less technology and analgesia than did physicians in intrapartum care of obstetric patients. NMs achieved neonatal outcomes equivalent to those of physicians. Limitations in data from primary studies precluded answering questions of why and under what conditions these outcomes apply and whether these services are cost-effective. https://pubmed.ncbi.nlm.nih.gov/7501486/ https://pubmed.ncbi.nlm.nih.gov/7501486/

mountainb 4y ago

Doctors have a guild: the AMA. Lawyers have a guild: the ABA. Neither are the same things as unions but they have similar effects. The ABA and AMA also have large roles in professional education. Both also have major roles in accreditation and regulation of the profession. Unlike unions, they do not collectively bargain on behalf of individual workers. They aren't subject to the many regulations associated with organized labor. They also enjoy broad exemptions to antitrust law which would otherwise apply. It's why other classes of worker cannot have the same type of protective guild -- it's legal when the ABA or AMA do it and illegal when someone else does it.

ghaff 4y ago
The situation with doctors and lawyers is considerably different however. Doctors, whether MDs or otherwise, tend to be pretty well-compensated in US broadly. Lawyers are much more of a mixed bag. White shoe law firms--mostly hiring students from top-tier schools with prestigious clerkships? Big bucks though either make partner or are mostly eased out. Some decent corporate law and successful private practices. But it's generally not a particularly well-compensated profession for someone from a mid to low-tier law school. And lots of people who graduate law school and even pass the bar don't actually end up practicing law.
- cma 4y ago
  Doctors are well compensated in large part because their unions (professional associations) restricts the number of new doctors unreasonably and advocates against certifying foreign doctors to practice in the US.
pclmulqdq 4y ago
My understanding is that in many places, the trade unions (electricians, plumbers, etc.) operate more like the AMA than the UAW. There is a spectrum of unionization.

Archelaos 4y ago

> Doctors have no union. In Germany doctors are heavily unionized. The largest union, Marburger Bund has 131.000 members.[1] The second largest, Hartmannbund has 70.000 members.[2] For comparision: At the end of 2020, there were 409,121 practising doctors (not including dentists) in Germany.[3] [1] Source: https://de.wikipedia.org/wiki/Marburger_Bund https://de.wikipedia.org/wiki/Marburger_Bund [2] Source: https://de.wikipedia.org/wiki/Hartmannbund https://de.wikipedia.org/wiki/Hartmannbund [3] Source: https://www.bundesaerztekammer.de/baek/ueber-uns/aerztestatistik/aerztestatistik-2020/ergebnisse-der-aerztestatistik-zum-31122020/berufstaetige-aerzte https://www.bundesaerztekammer.de/baek/ueber-uns/aerztestati...

kurupt213 4y ago

You are sadly mistaken if you think nursing is even close to what being a doctor is.