| The
first public buildings erected in the American colonies
in the 1600s were churches and jails – emblems of both
the optimism and pragmatism of the settlers who determined
to convert a wilderness into a civilization. They might
also have erected hospitals - if there had be an alternative
to caring for the ill at home - but it would take another
two and a half centuries for medicine to move from pseudoscience
to science and for health care to be centralized in doctors'
offices, hospitals, and – now – in many other kinds of
facilities as well. In fact, we've come full circle: having
moved from home to hospital during much of the 20th century,
health care today is increasingly provided in facilities
other than hospitals, and even at home again – a trend
that reflects changes taking place in health care that
will fuel more changes, and more job opportunities, in
the years to come.
Today,
health services – an industry that comprises all health-related
workers from the most highly trained clinical professionals
to maintenance, repair, and service workers – constitutes
one of the nation's largest industries, employing more
than 11 million workers, or about 7% of the nation's
entire workforce.
It's
common knowledge that the dynamics of the industry –
particularly how we pay for health care – are changing
dramatically. More to the point, employment opportunities
in the industry are very good and will get better, at
least through the next decade and probably beyond.
WHAT'S
CHANGING?
Just
about everything: the population (it's aging); our knowledge
of pathology (it's expanding); the process of diagnosis
(it's more precise) and treatment (it's more complex);
and, of course, the way we pay for it all (away from
fee-for-service and toward managed care - PPOs, HMOs,
hybrids such as Point of Service programs, Integrated
Services Systems, and more). Technological advances,
clinical developments, new drugs, productive research,
a renewed focus on preventive care, and access to health
information have combined to reduce disease and increase
survival rates.
How
do these changes fuel employment in health services?
• The
elderly population, whose health needs exceed those
of younger folks, will increase at a rate greater than
the general population, which will drive the need for
facilities to house and care for the elderly as well
as for homecare, nursing, and personal care services.
•
New, sophisticated medical technology and improved medical
practices will increase survival rates of the ill and
injured, who will need extended care and a variety of
therapies.
•
Medical advances will make early diagnosis possible,
and pharmaceutical companies will produce drugs to prevent
certain illnesses and to treat them more successfully.
•
Accurate medical records will need to follow patients
as they move from general practitioners to specialists
and from one office or facility to another.
WHERE
WILL THE JOBS BE?
In
the decade between 2000 and 2010, the health services
industry will grow nearly 26%, from 11 million to 13.8
million employees. But the really good news for those
currently employed and for those who will enter the
industry soon is this: growth will be distributed across
all segments of the industry, though the need for some
particular specialties will exceed that of others.
The
health services industry is typically divided into several
segments: management, business, and financial positions;
professional/clinical positions; service positions;
office/administrative support positions; and maintenance/repair/production
positions.
The
Bureau of Labor Statistics (www.bls.gov)
projects growth in each segment of the industry; by
segment, the BLS projects growth in the 2000-2010 decade
as follows:
•
Management, business, and financial positions - 35%
(medical and health services managers, business operations
specialists)
•
Professional/clinical positions - 27% (physicians and
surgeons, dentists, medical and lab technicians and
technologists, and registered nurses)
•
Service positions, office/administrative support positions
- 30% (dental assistants, medical transcriptionists,
and food service workers)
•
Office/administrative support positions - 16% (medical
secretaries, receptionists, and billing/accounting clerks)
•
Maintenance/repair/production positions - 2%
Within
each segment, some specialties and job titles will experience
considerable growth, some moderate growth, and some
no growth at all. A few (but only a few) will decline.
Personal and home care aides, for example, will increase
67%; medical assistants, 60%; physician assistants,
50%; social workers and physical therapists will each
increase 37%; dental assistants, 30%; business operations
specialists, 19%; maids and housekeepers, 12%; dieticians
and nutritionists, no growth.
A
quick interpretive reminder for those who may be dazzled
by these percentages: dramatic percentage increases
in some segments or jobs/job titles – in home health
aides, for example – will yield fewer actual jobs in
the next decade than other specialties, such as nursing
aides and orderlies, that have smaller projected percentage
increases. Why? Because there are more of the latter
at work in the industry now.
Still,
to a greater extent than almost any other American industry,
health services offers positions that match a wide variety
of interests, skills, aspirations, and educational levels.
And more than most industries, health services rewards
a worker's investment in additional education, training,
and classroom or on-the-job experience. In fact, the
industry provides many job opportunities for workers
who have no specialized training beyond high school.
For example, 56% of workers in nursing- and personal
care facilities and 25% of hospital workers have a high
school diploma or less.
Hospitals
and other facilities often provide in-service training
– often toward higher certification – for employers,
and some hospitals provide training and/or tuition assistance
in return for service commitments from employees. And
increasingly, to contain costs, anticipate staff turnover,
and minimize staffing needs, hospitals and other facilities
cross-train employees to perform duties outside their
specialties or primary assignments. Often cross-trained
employees – those with two or three job competencies
– are paid more, hove more opportunities for overtime
work, and have more job security.
WHAT
JOBS ARE – OR WILL BE – REALLY HOT?
If
all segments of health services will grow in the coming
decade, where will the greatest growth opportunities
be? The single greatest area of growth will be in what
is already the largest health care occupation: registered
nursing.
In
November 2001, the BLS revised the projected need for
new and replacement registered nurses by 2010 to one
million! That projection has alarmed the industry, however,
because enrollment in nursing programs declined steadily
throughout the 1990s. In fact, fall 2001 enrollments
in baccalaureate nursing programs increased for the
first time in six years, and yet even if enrollment
increases continue, it's unlikely that supply will meet
demand by 2010. Even now, there are 126,000 current,
budgeted, funded but unfilled nursing positions in American
hospitals, according to The American Hospital Association
(www.aha.org).
Too
few new nurses entering the profession, wages that have
barely kept up with inflation in the past decade, too
little support, too much overtime, the 'flight' from
hospitals to other care facilities, and an aging nurse
population has all contributed to the nursing shortage.
But the degree of alarm over the shortage – and the
remedies being suggested to recruit nurses, improve
conditions, provide support, and increase wages – should
make it an attractive career for those whose interest
is in patient care. The BLS provides a clear, comprehensive
description of the roles and responsibilities of registered
nurses at http://stats.bls.gov/oco/oco20016.htm.
Projections
for growth by 2010 in many other patient-centered jobs
in the health services make them attractive career options
as well:
Management/business/financial:
•
Medical and health services managers - 35%
Professional/Clinical:
•
Dentists - 13.7%
•
Physicians/surgeons - 28%
•
Pharmacists - 30%
•
Physical Therapists - 36.7%
• Aides,
assistants, technicians - from 12% to nearly 70%
Service
Workers:
•
Food and beverage workers - 4%
•
Janitors/cleaners - 22%
•
Medical transcrtiptionists - 30%
Office/Support:
•
Billing/posting clerks - 29%
•
Receptionists - 27%
•
Medical secretaries - 20%
Some
jobs, such as P.T. Assistants, Medical Record Administrators,
Chiropractors, Occupational Therapists, and others have
"excellent" growth projections (36% growth
overall). Many, such as biomedical photographers, dental
assistants, surgical technicians, physician assistants,
athletic trainers, rehabilitation counselors, and others
have "very good" growth projections 21-35%
growth). Some, such as medical and lab technologists/technicians,
optometrists, environmental health technicians, ophthalmic
lab technicians, and others have "good" or
"less good" growth projections (0 to 20% growth).
An
abbreviated list of job titles, growth projections,
worksite descriptions, and wage/salary information is
provided by the BLS at www.bls.gov/oco/cg/cgs035.htm.
WHERE
TO GO FROM HERE?
For
younger people just choosing a profession, as well as
for those making a mid-career change and considering
the health services, what's more important than lists
and percentages and projections is this: the health
services generally are comprised of a large and diverse
set of jobs with equally diverse responsibilities and
education requirements and wage scales, and levels of
patient contact. To a greater extent than any other
American industry, it's possible for a worker to choose
a job or career that matches his/her interests, educational
achievement or aspiration, people skills, research interest,
technological understanding, passion, or compassion.
Beyond that, after having chosen a career or career
path, it's possible to change or alter the path, get
additional training or experience, move from one worksite
or facility to another and have those changes and/or
added experience reflected in higher wages and in greater
responsibility and job satisfaction.
Resources
for current or prospective health professionals abound,
on-line and in print. Important on-line resources include...
•
The American Medical Association's Health Professions
Directory (www.ama-assn.org/ama/pub/category/2322.html)
•
The Occupational Handbook of the Bureau of Labor Statistics
(www.bls.gov/oco)
•
Pam Pohly's Net Guide to Health Professional Associations,
Academies, and Organizations
(www.pohly.com/assoc2.html)
•
The National Association of Colleges of Nursing (www.aacn.edu)
Print
materials include
•
'Chicken Soup for the Nurse's Soul,' Jack Canfield
•
'From Silence to Voice: What Nurses Know and Must Communicate
to the Public,' Bernice Buresh and Suzanne Gordon
•
Goodman and Gilman's 'The Pharmacological Basis of Theraputics,'
Joel G. Hardman (ed), and many others. Check Amazon.com
for an abundance of current books on medical topics.
Paul
Adams is Director of Communications at Recruitment Marketplace.
He can be reached at adamslmg@tiac.net.
Copyright
@2002 Landon Media Group, LLC
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