Programmers are the ones that spend hours upon hours writing code to make sure all these items, objects, and avatars interact with the world properly. They also build the physics systems, ensure the lighting in the game is working properly, and handle all other subsystem related duties. This is what takes up the majority of time when developing a new video game.
When people think of game design many of them think of computer labs and groups of people working feverishly through the night to finish them. While this is true for the later stages of game development it isn't always like this. In fact many games start out as a simple and crude characters sketch sometimes done on a napkin. This sketch can lay in an archive or simply sit at the back of a developers mind for years.
At some point or another whether it be due to funding availability or simply a technological advancement the idea will be resurrected. It's then brought to the attention of the workers at the development studio and if it sounds like a good idea development is started. The interesting thing about game development is that most studios start out as small work places.
Most development jobs and programming jobs are already taken when the company is founded due to its small size. However once the company has made its first game and they get more funding they will eventually expand their size. This means they will need more educated and capable people to work for them. Even after acquiring the needed people to make a game there are still hurdles that many companies have to overcome.
One of these problems is product distribution. Most games that are made usually come in a cardboard box or DVD case. Most game developers don't market their own games and need a third party company to literally make the discs, box them, and then market them to stores. Some game companies that have been around for a while are big enough to do this on their own but most are not.
Usually a manufacturer and distributor are looked at before people are hired for the design jobs or the programming jobs. After all if there's no way to market the game then there will be no reason for people to make it. Keep in mind the game studio also has to pay the manufacturer and distributor for their services. This is usually taken out as a cut of money earned off of the game.
If the game does well then everyone is happy. If the game doesn't do well then chances are the studio will go bankrupt. If the game studio is part of a larger company then the financial responsibility falls to the parent company. In that case the company takes the hit and may close down the studio due to poor performance.
