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PaperclipPerfector  1d ago (text post)   6141 thread views

Culture War Roundup for the week of April 20, 2026

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There has, from time to time, been some discussion concerning doctor salaries. I don't personally care all that much about this. They're highly-trained professionals in an in-demand field, and doctor salaries probably aren't the main driver of overall healthcare costs.

Nevertheless, there's often some debate over what the numbers actually look like. I was just linked to this tweet in one of my econ link aggregators. (Yay, built-in browser translation!)

Their claim is that 84% of American physicians are in the top 10% of incomes, and 26% of American physicians are in the top 1%. Their paper makes comparisons to other countries. They also broke it down into primary care vs. specialists.

So, at least this is one snapshot view of the actual distribution of doctor salaries, which I hadn't really seen before in these discussions. Assuming, of course, that their methodology is sound, which I'm not qualified to assess.

Doctors are one of the only high status, high income, high volume jobs.

This is actually a great way to think about this wider issue. There are high status (meaning respect as a profession) and high volume jobs - like nurses and architects, but the pay is usually decent or below. There are high pay and marginally higher volume jobs - like some computer programmers, oil rig workers, successful salespeople - but they tend to have medium or lower social status (both prestige and occupational respect). And there are high status, high(ish) pay jobs (senior judge, Hollywood A/B lister, senator), but they’re very low volume. How many astronauts are there? (Apparently the most ‘prestigious’ profession). 50?

There are a million doctors in America. Doctors have very high social status / occupational prestige. Doctors have excellent job security and high pay. This unique combination exists for no other profession.

Sure, there are people who make more than doctors, like investment bankers, quant traders, senior executives at major corporations, but they are arguably widely reviled and in any case there aren’t many of them. And sure, there are the astronauts and noble prize winning scientists, but they almost all get paid less than doctors (according to Reddit the recent lunar astronauts probably make $150k a year). There are more ‘fun’ jobs like artists and creatives, but again, the trade off is that you’ll be poor unless you’re 99.9th percentile. There are schoolteachers, who also have relatively high social respect and good job security, but they make far less than doctors unless they’re in a top-10 paying nationwide school district (in which case the local doctors make much more too) and they’re still lower status than being a doctor.

The question is ‘are all three levers necessary here’? STEM adjuncts (who are often very smart) work for shitty pay and there are still tens of thousands more PhDs produced every year. In countries where doctors are paid much less (including relative to average salaries), medical school is still very competitive - suggesting that status (or more charitably healing the sick) is enough of a motivation, you don’t need to add ‘getting (moderately) rich’. Lastly, there are so many doctors relative to other very high pay professions that they cannot all or mostly or even to a large extent find other jobs - and since nowhere pays doctors more than America, they can’t emigrate either.

This suggests doctor pay can be reduced in the United States without major risks.

There are high pay and marginally higher volume jobs - like some computer programmers, oil rig workers, successful salespeople - but they tend to have medium or lower social status

Software development is higher status than nursing. Unless you're asking the bottom of society.

Unless you're asking the bottom of society? In other words, the people who become nurses?

Software development is higher status than nursing.

Was. The good times for status are over, I think.

Yeah, I'd agree. These days it looks like being a quant as well falls into the same category unless you're talking some very select elite groups. For the common person if a man says he's a nurse he'll get more respect than if he says he develops trading models for a living.

Sad times...

Where's it going, then?

Maybe in San Francisco. But here in my bubble in LA nursing is higher status. The only status conveyed by SWE is the status of money.

Even in San Francisco, I would bet that the average male nurse would get more opposite sex matches online than the average male SWE, which is as good a proxy for status as any. The only place that wouldn't hold is if you work for a number of prestige companies you could count on one hand (and, no, Meta and Google aren't there).

If we accept the premise that "the average male nurse would get more opposite sex matches online than the average male SWE," it'd only sound like Simpson's paradox.

I imagine the average male Californian nurse is whiter (less Asian), less foreign, and taller than the average male Californian SWE, correlated factors of which matter substantially in the domain of online dating where JBW ("Just Be White") and JBT ("Just Be Tall") reign supreme. An Asian American man may very well need a couple tens or thousands of $Ks (in 2004 or so Dollars) in annual income to be the equal of a white man in women's eyes. Furthermore, each inch of deficit in height adds another few $10Ks to make-up.

Suppose you ran an experiment with 100 trials each with 100 randomly selected young American women, where in each trial the woman is shown a randomly selected/generated white guy photo paired against a randomly selected/generated white guy photo where the only captions are "Profession: Nurse" for one and "Profession: Software Engineer" for the other and she has to choose one. I know which of the two professions I'd pick to crush the other like the Globetrotters crush the Generals. Even temporarily setting software engineer aside, the scent of "male nurse" smelling like "male bitch" for women is quite strong.

It's like the "Hello, Human Resources?!" combined with the older "When women say they do in fact like different kinds of guys" meme. Until proven otherwise, a 6'0" white male software engineer is smart and quirky. A 5'9" Asian male software engineer is geeky and weird.

Height doesn't predict sexual success.

The chart doesn't necessarily show that height doesn't predict sexual success.

It's totally possible that plenty of short men get married, just to less attractive women.

Likewise, plenty of ugly women have sex and marry. But we wouldn't say that 'female attractiveness doesn't predict sexual success' since they're not usually getting chad to commit, or getting sex on terms as favourable as their prettier peers.

Nursing seems really low status to me. It's a dirty job. Maybe status assessments vary so much, it's pointless to talk about The Status of X.

Nursing has the whole do gooder schtick attached to it; in the eyes of the normies that beats out the actual difficulty of breaking into the job (the job itself is not easy, I grant you, but then neither is being a janitor, and that's about as low status as you can get).

In San Francisco, people who aren't SWEs hate all the "techbros" and your average dead end L5 is hated, or at least considered uninteresting, by all the other average dead end L5s. You might get some respect if you work on something unusual (and you can feel smug around people who live on the peninsula), but converting your work to respect requires some cloutmaxxing (usually by poasting on Twitter, attending the right parties, and name-dropping). Even then, your status is limited to those who travel in the same cloutmaxxing circles. But if you do all this, carefully manage your bubble, and gas up your self conception, sometimes, just maybe, you can look in the mirror and convince yourself that you are high status.

Tough comment coming from someone who ostensibly thinks changing boomer diapers is high status. I've never considered before that nursing, of all things, could be high status. Sounds like self-serving nonsense from the median person, who could likely become a nurse. To me, investment banking, law, professors are all slightly higher status than doctors, who do a lot of filthy work.

Nurses do not do diaper changes, CNA’s do, and CNA’s have a weeks long training program at company expense for a very modest pay increase. They are not socially respected.

That's being a care worker, not a proper hospital nurse, and is a very different job which yes I'd agree is low status. I'm thinking more like ICU or Operating theatre helper as "nurse".

Nursing assistants do the diaper changes.

I don't really understand what you are trying to say.

I really don’t care about “status” so long as the pay is good. Nobody is fooled when an unemployed person refers to himself as an “entrepreneur.”

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