Re: National Sign-On Letter to House on H-1Bs, U.S. Immigration

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From: Stephen D. Williams (
Date: Sun Jun 11 2000 - 13:03:03 PDT

Linda wrote:

> Stephen D. Williams wrote:
> << If you don't like it, go study something that changes slowly, like
> medicine!>>
> Not sure I agree with that!!! There is a lot of change, if one looks for
> it, and a shift towards evidence-based and cost-effective medical practice
> which requires constant study. We have to keep up with the reading.

Especially lately, but the argument has been made that the basics change
infrequently and most methods from the previous decade are still at least somewhat
relevant. Technology can completely transform itself in certain major ways in a
very short time causing serious practioners to relearn all the details and often
enough even the principles and paradigms. Analysis, design, languages, programming
paradigms, communication methods, application and computer organization, security,
delivery, application lifecycle, scope of usability, all hardware details and
capabilities, etc. have changed several times in the 18 years since I was first a
professional participant.

Although it's interesting to contrast high-knowledge professions like medicine,
law, and serious engineers and scientists, the differences are rational and
difficulties with each profession are caused by different aspects. Software
engineers screw up constantly. The most efficient way to proceed is to screw up as
fast as possible and be good at testing, finding, and fixing the problems. One
visible screwup in medicine has amplified consequences. There was a sad case of a
7 year old boy in my county that was given 2 teaspoons of anti-bedwetting medicine
at bedtime and was found dead the next morning because the pharmacist had mixed the
dosage at 5 times the prescribed amount. Needless to say, I'm shocked that such a
medicine would have such a low terminal-toxicity multiple.

> I find it incredible that there might be age discrimination amongst
> programmers. In medicine, experience is usually considered an asset.
> Much of the training in medical school is irrelevant, and Residency training
> does little to prepare for real-world medicine. Experience is the greatest
> teacher. In fact, some believe it is desirable to find a physician with around
> 10 years experience - apparently that is the point where clinical knowledge and
> experience are optimal. (Of course, I have been in practice for just over 10
> years; otherwise I wouldn't be writing this ;)) So it seems unusual that age
> and experience would not be considered valuable in your field.

Because the knowledge base changes and grows so quickly, anyone who is not actively
self-renewing falls behind quickly. This is very clearly a problem for developers
moving to management. You are very effective for a couple years but if you aren't
actively participating in development activities, by maintaining some code, as a
hobbyist, or being a tech lead, then after 3-5 years you are effectively outdated
in your knowledge of the field. Programmers end up spending significant time
explaining their perception of something so that you can make decisions, etc. One
main effect is that most interviewing is delegated to the senior future peers in an
organization rather than just the manager. All this also applies when you have
spent too much time in a stagnating job.

My impression is that physicians at all levels participate in their practice in an
material way including: consulting with other physicians, observing the
effectiveness of treatments, conferences, continued education, journals, etc.
Those that become non-practicing administrators (a few in hospitals?) will have the
knowledge decay, but very slowly. Imagine that you are looking for a new partner
in your practice. Would you consider a physician that has not practiced actively
for 20 years? What about one that has been practicing in third world countries for
30 years? Would you want someone up to date on the latest methods, discoveries,
drugs, machines, procedures, legal, and regulatory guidelines? Or would you be
willing to bring someone in who had done similar but limited work and provide
training to get them up to speed?

It's no surprise that significant numbers of both attorneys and physicians work in
small independant groups rather than in giant corporations. Computer consultants
are following this pattern.

Some have suggested that certification and standardization of IT is the answer, or
maybe unions. None of that will work for various reasons that don't need to be
rehashed here. Primarily it boils down to the lack of a need for uniformity and
the benefit of constant and pervasive choices and innovation. It's beneficial to
have people with all ranges of skills and experience to allow the market to pay
more or less appropriately for what is needed. While there are arguably only a few
medical and legal field aspects that parallel IT, some would be: medical field:
nurses, midwives, nurse practioners, paramedics, and law field: paralegals,
accountants (who routinely give what amounts to legal advise).

Getting up to speed in IT is another problem, but frequently newcomers have a much
easier time learning the current stuff than busy practioners have taking time to do
the same. While the experience is valuable and sometimes critical, sometimes the
paradigm changes make it harder to apply without relearning time.

> <<Of course there is a big difference between the tiny percentage that
> are really into learning, curiosity, and self-improvement that read and
> learn constantly.>>
> Yup, that probably applies to every profession. Attitude is everything.

Yes. It is amplied more in some professions than others. There should be an
'Index of Change' for each profession.

> --Linda


-- - Revolutionary E-Business Communication Stephen D. Williams  Senior Consultant/Architect
43392 Wayside Cir,Ashburn,VA 20147-4622 703-724-0118W 703-995-0407Fax  Jan2000

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