Writing in the Chronicle Review of the Chronicle of Higher Education, Jeffery J. Williams contrasts the structure of the academic labor market with that of medicine:
Given that there are more than 1.4 million college faculty members in the United States, it is clear that they are not disappearing. But the all-purpose professor has faded. We have tended to see the professor as a single figure, but he is now a multiple being, of many types, tasks, and positions. And instead of the traditional idea of a community of scholars, all roughly equivalent, we now have a distended pyramid, with a huge base of people whose primary job is teaching, often entry-level courses; a layer of specialists in particular fields and researchers who may hardly even teach above them; and a thin spire of administrators commanding the peak.
The spread of academic labor follows the trend of other professions. The idea of the professional usually evokes a generic image—the old-fashioned family doctor, for instance, who hung out his shingle—but now we have a much more variegated system of alpha and beta practitioners. And … most professionals now work in hierarchical bureaucratic structures.
Along with the greater differentiation of tasks over the past 50 years, we have experienced a progressively steeper stratification of academic workers.
The comparison with medicine, however inexact, suggests a few ideas that we might be able to use. …[H]ealth-care professionals maintain their employment conditions in part through their professional organization, and particularly for nurses, unionization.