Preamble:
A mailing list for Technical Communicators (i.e., techwriters and trainers and related folks) was having an oft-rehashed discussion about how their main organization/association in the USA and Canada, called the STC (Society for Technical Communication), wasn’t doing all that much for them, and they should consider turning it into a union.

I responded by pointing out that a union doesn’t work for that kind of widely-scattered membership (working in onesies and twosies at tens of thousands of separate companies and government branches), and maybe the model they wanted was a guild. Modern guilds are pretty much the American Medical Association (AMA), the Canadian Medical Association (CMA) and similar. I pointed out some characteristics and inevitable trends when guilds come to power, using the medical associations as examples, particularly the ones that I know, here in Ontario, Canada. An American techwriter, took offense, because his dad had been a doctor, and he felt that by “attacking” guilds like the CMA and AMA (pointing out some flaws), I was attacking dear old Dad. Of course, he couched it in terms of “worrying” that I’d laid myself open to legal retaliation by the mighty power of the AMA, even though I don’t live in the Litigious States of America, but nobody on the list was fooled.
So, I replied more comprehensively as follows… (with some extraneous bits snipped, and some explications added for readers who were not privy to the original discussion.

The content:
[...]

My points were observations about THE GUILD (into which you can read Ontario Medical Association, and by extension, Canadian Medical Association, and by further extension-due-to-similarity the AMA).

As with any guild, members are not the executive [council]. All members are members because they must be. Only some members are members because they wish to be. Because the guild has disciplinary powers and great latitude, members must be very careful what they say and do. If they offend the wrong people in the positions of power - those whose primary skill and motivation is political (the ability to further themselves in organizations) rather than technical (the science and practice of medicine and direct health care, in this example) - then their careers and livelihoods are at risk.

My own doctor agrees with me - as does my wife’s doctor. They are both overworked and underpaid, as doctors and as mothers. They will both be retiring sooner than has been traditional for male doctors… because female doctors traditionally just have more sense in that respect (yes, that observation is also a generalization which you or somebody are free to misinterpret as a precise rock-hard claim to which you can object and take offense…..go nuts.).

It is a fact, well documented in the press in Canada, and especially in the province of Ontario, that:

a) there is a critical shortage of doctors - long evident in remote and non-urban areas, and growing more critical day-by-day in the cities.

b) it’s going to get more critical as the existing doctors retire (many are Baby Boomers who are retiring as their patients do; however not only the patients but also the doctors are just entering the years when they will need ever-increasing medical services from the remaining practicing doctors), and as newly minted doctors take a more sensible approach to work-life balance — meaning they won’t willingly work the 60-to-90 hour weeks at multiple clinics and hospitals that past (mostly male) doctors have traditionally done. [So, as with other bastions of baby-boomer employment that kept going because so many boomers were workaholics, medicine is going to need greater numbers of replacement doctors than are retiring. Simply, the next generation of doctors is going to want "a life", so they'll restrict themselves to 40- or 50-hour weeks to allow them time for family, hobbies, etc. That will mean every two retiring boomer physicians will need to be replaced by three gen-Y and newer physicians to fill the same number of clinic and office hours.]

It’s also a fact that the medical association controls what medical teaching establishments are allowed to come into existence, and which new doctors are allowed to be accredited, and what hoops foreign-trained doctors must jump through to achieve accreditation, despite having graduated well from fine schools and despite having practiced successfully in their countries of origin.

Rank-and-file doctors [in the guild/association] not only disagree with the restrictiveness, they’ve been raising the alarm for some time. Their leaders/masters in the upper hierarchy of the associations are only lately coming round and loosening the reins a little, even though the writing on the wall was obvious more than a decade ago. . . when they were _lowering_ the quotas and class sizes at medical schools, citing an ostensible oversupply of physicians that wasn’t even true then and is laughably untrue now. The pipe-line is not a fraction as full as it needs to be. [Because doctors take many years to train, in order to have enough doctors graduate this year, you had to stuff X-many medical students into the beginning of that pipeline six or seven years ago. They didn't. They allowed far fewer med-school positions to exist than would have produced the doctors that we need today. Any increases now in med-school enrollments will be felt only six or seven years from today... if those increases happen today, which they aren't really -- such changes (including planning, finding space, finding additional instructors, etc.) take years to ramp up.]

Public pressure is mounting, and even politicians are starting to wake up and jump out in front - now that they see which way the wind blows.
So what will happen is that the medical establishment (not my GP nor the dermatologist I saw last month after 7 months of waiting, but the upper political echelons of their association leadership) and the government that supplies their clout will “reconsider” and suddenly find that most of those icky foreign-trained doctors are actually fine physicians. Instead of remedial (repeat) med-school and three or four years of supervised OJT, those foreign-trained physicians actually need only a quick-and-dirty orientation and maybe a few English (or French) lessons and they can hit the ground running. Of course, this will still take a few more years to even begin.

Rank and file doctors - the non-political ones who are still in practice and haven’t saved their health and sanity by retiring - will heave a sigh of relief as newcomers begin to take up some of the enormous burden.

A glance at history and at human psychology shows that the conservative, protectionist, pull-up-the-ladder-of-the-treehouse worldview is the normal outcome of guilds.

The people who argue to start one - whether based on the STC or some other foundation - all assume that they will be insiders, or “grandfathered”.

The key would be to get the government clout. Otherwise, you can’t implement the controls that make it worthwhile. Being able to exclude people is valuable only if by doing so you keep them from legally being employed in your/their field, or at least make it unlikely, difficult and marginal for them. Make no mistake; you have to exclude people, a lot of them. Setting the bar too low dilutes the brand, the cachet. On the other hand, setting it too high makes for great exclusivity, but not enough dues-paying fodder… er… members to be attractive. [But as we've seen with the actions of the doctor guild, there are consequences of either choice that can come back and bite.]

[This next bit is in answer to the other writer feeling that, because I'd "attacked" the AMA (very indirectly), I had therefore attacked its rank-and-file members, and had therefore attacked all doctors... notably his sainted father. It's a bit of further digression, but I'll leave it in.]

If you and I lived in China, and foreigners complained about what China-the-government/regime was doing, you would understand yourself and your father and all your neighbors to have been maligned. That’s a cultural thing that has a lot to do with the fact that they’ve had only one government for a few successive generations. We’re seeing that sociological quirk in the counter-protests to the Olympic-torch protests. We in the west like to change our governments (at least the overtly political, elected portions) whenever we get tired of them, so we don’t identify government with country with “me”. Similarly, people who are members of the AMA, the CMA, the OMA, etc are members, not because it-is-I-and-I-am-it, but because it was a requirement of working in their chosen field. Only _some_ of those members have the political gene and are compelled to become insiders and seekers after higher echelons and positions of power. Those are the members who begin to think “organization-equals-me” and you insult my gang, you insult me (or vice versa).

“Attacking” the organization (in this case as an example of a type to which we might aspire if we are collectively bent that way) is not the same as attacking the profession or the calling. Nor is it the same as attacking the ordinary members who have little choice but to be members (according to the law of your country, as well as the law of mine), and who don’t necessarily agree with some/many of the guild’s policies. [Snip gratuitous poke at the other guy.]

By the way, [...] I said nothing about the doctors in Canada disobeying the laws of our country. I didn’t even say it about the senior CMA and OMA people. What I said is that by them colluding with government, they (their policies) _become_ the law.

I think it’s the same in the US as in Canada, that you can’t legally practice medicine if you are not a accredited member of the guild? Is that not so? If you try to practice anything that even smells like medicine without their blessing, not only are you open to lawsuits just for the lack of that accreditation, but you are open for criminal prosecution, isn’t that true?

Getting back to our group forming some sort of guild : We’d already established that a union is not going to do much for our widely scattered membership of techwriters, but that if we want collective clout, the next closest thing is a guild. A guild that doesn’t have government sanction is just a club with no power to enforce its edicts. But gaining that government sanction is not without costs. The costs might not be the same as those brought on by the CMA (and the Ontario Medical Association) in Canada, but they’ll happen as a direct consequence of the guild exercising its mandate. If you must do it, do it with your eyes open.

The Law of Unintended Consequences is always in force.

That’s the way I see it, anyway.

Copyright 2008