Health Care Industry Career Information

The following information is from the U.S. Department of Labor – Bureau of Labor Statistics Occupational Outlook Handbook.

Health Care Jobs

Nature of the Industry

Combining medical technology and the human touch, the health care industry administers care around the clock, responding to the needs of millions of people—from newborns to the critically ill.

About 545,000 establishments make up the health care industry all of which vary greatly in terms of size, staffing patterns, and organizational structures. About 76 percent of health care establishments are offices of physicians, dentists, or other health practitioners. Although hospitals constitute only 2 percent of all health care establishments, they employ 40 percent of all workers.

The health care industry includes establishments ranging from small-town private practices of physicians who employ only one medical assistant to busy inner-city hospitals that provide thousands of diverse jobs. In 2004, about half of non-hospital health care establishments employed fewer than 5 workers. By contrast, 7 out of 10 hospital employees were in establishments with more than 1,000 workers.

The health care industry consists of the some of the following segments:

Hospitals:provide complete medical care, ranging from diagnostic services, surgeries, and continuous nursing care. Some hospitals specialize in the treatment of the mentally ill, cancer patients, or children. Hospital-based care may be on an inpatient (overnight) or outpatient basis. The mix of workers needed varies depending on the size, geographic location, goals, philosophy, funding, organization, and management style of the institution. As hospitals work to improve efficiency, care continues to shift from an inpatient to outpatient basis whenever possible. Many hospitals have expanded into long-term and home health care services, providing a wide range of care for the communities they serve.

Nursing care facilities:provide inpatient nursing, rehabilitation, and health-related personal care to those who need continuous nursing care, but do not require hospital services. Nursing aides provide the vast majority of direct care. Other facilities, such as convalescent homes, help patients who need less assistance. Residential care facilities provide around-the-clock social and personal care to children, the elderly, and others who have limited ability to care for themselves. Workers care for residents of assisted-living facilities, alcohol and drug rehabilitation centers, group homes, and halfway houses. Nursing and medical care, however, are not the main functions of establishments providing residential care, as they are in nursing care facilities.

Physicians Offices:make up about 37 percent of all health care establishments in the industry. Physicians and surgeons practice privately or in groups of practitioners who have the same or different specialties. Many physicians and surgeons prefer to join group practices because they afford backup coverage, reduce overhead expenses, and facilitate consultation with peers. Physicians and surgeons are increasingly working as salaried employees of group medical practices, clinics, or integrated health systems.

Home health care services:Skilled nursing or medical care is sometimes provided in the home, under a physician’s supervision. Home health care services are provided mainly to the elderly. The development of in-home medical technologies, substantial cost savings, and patients’ preference for care in the home have helped change this once-small segment of the industry into one of the fastest growing parts of the economy.

Outpatient care centers:The diverse establishments in this group include kidney dialysis centers, outpatient mental health and substance abuse centers, health maintenance organization medical centers, and freestanding ambulatory surgical and emergency centers.

Medical and diagnostic laboratories:Medical and diagnostic laboratories provide analytic or diagnostic services to the medical profession or directly to patients following a physician’s prescription. Workers may analyze blood, take x rays and computerized tomography scans, or perform other clinical tests. Medical and diagnostic laboratories provide the fewest number of jobs in the health care industry.

In the rapidly changing health care industry, technological advances have made many new procedures and methods of diagnosis and treatment possible. Clinical developments, such as organ transplants, less invasive surgical techniques, skin grafts, and gene therapy for cancer treatment, continue to increase the longevity and improve the quality of life of many Americans. Advances in medical technology also have improved the survival rates of trauma victims and the severely ill, who need extensive care from therapists and social workers as well as other support personnel.

In addition, advances in information technology continue to improve patient care and worker efficiency with devices such as hand-held computers that record notes on each patient. Information on vital signs and orders for tests are transferred electronically to a main database; this process eliminates the need for paper and reduces recordkeeping errors.

Cost containment also is shaping the health care industry, as shown by the growing emphasis on providing services on an outpatient, ambulatory basis; limiting unnecessary or low-priority services; and stressing preventive care, which reduces the potential cost of undiagnosed, untreated medical conditions. Enrollment in managed care programs—predominantly preferred provider organizations, health maintenance organizations, and hybrid plans such as point-of-service programs—continues to grow. These prepaid plans provide comprehensive coverage to members and control health insurance costs by emphasizing preventive care. Cost effectiveness also is improved with the increased use of integrated delivery systems, which combine two or more segments of the industry to increase efficiency through the streamlining of functions, primarily financial and managerial. These changes will continue to reshape not only the nature of the health care workforce, but also the manner in which health care is provided.

Working Conditions

The average hours of non-supervisor workers in private health care vary among the different segments of the industry. Health care workers averaged 33.7 hours per week in 2004 for all private industry.

Many health care establishments operate around the clock and need staff at all hours. Shift work is common in some occupations, such as registered nurses. Numerous health care workers hold more than one job.

Employment

As the largest industry in 2004, health care careers provided 13.5 million jobs—13.1 million jobs for wage and salary workers and about 411,000 jobs for self-employed and unpaid family workers. Of the 13.1 million wage and salary jobs, 41 percent were in hospitals; another 22 percent were in nursing and residential care facilities; and 16 percent were in offices of physicians. About 92 percent of wage and salary jobs were in private industry; the rest were in State and local government hospitals. The majority of jobs for self-employed and unpaid family workers in health care were in offices of physicians, dentists, and other health practitioners—about 282,000 out of the 411,000 total self-employed.

Health care jobs are found throughout the country, but they are concentrated in the larger States—in particular, California, New York, Florida, Texas, and Pennsylvania.

Workers in health care tend to be older than workers in other industries. Health care workers also are more likely to remain employed in the same occupation, due in part to the high level of education and training required for many health occupations.

Occupations in the Industry

Health care firms employ large numbers of workers in professional and service occupations. Together, these two occupational groups account for 3 out of 4 jobs in the industry. The next largest share of jobs, 18 percent, is in office and administrative support. Management, business, and financial operations occupations account for only 4 percent of employment. Other occupations in health care made up only 3 percent of the total.

Health care professionals and technicians work in many fast growing occupations. Health care workers may operate technical equipment and assist health diagnosing and treating practitioners.

Most workers in health care jobs provide clinical services, but many also are employed in occupations with other functions. Numerous workers in management and administrative support jobs keep organizations running smoothly.

Hospitals:Hospitals employ health care and medical workers with all levels of education and training, thereby providing a wider variety of services than is offered by other segments of the health care industry. About 3 in 10 hospital workers is a registered nurse. Hospitals also employ many physicians and surgeons, therapists, and social workers. About 1 in 5 hospital jobs are in a service occupation, such as nursing, psychiatric, and home health aides, or building cleaning workers. Hospitals also employ large numbers of office and administrative support workers.

Nursing and residential care facilities:About 2 out of 3 nursing and residential care facility jobs are in service occupations, primarily nursing, psychiatric, and home health aides. Professional and administrative support occupations make up a much smaller percentage of employment in this segment, compared to other parts of the health care industry. Federal law requires nursing facilities to have licensed personnel on hand 24 hours a day and to maintain an appropriate level of care.

Offices of physicians:Many of the jobs in offices of physicians are in professional and related occupations, such as medical assistants and x-ray technicians. About two-fifths of all jobs, however, are in office and administrative support occupations, such as receptionists and information clerks.

Home health care services:About 57 percent of all jobs in this segment are in service occupations, mostly home health aides and personal and home care aides. Nursing and therapist jobs also account for substantial shares of employment in this segment.

Offices of other health practitioners:Professional and related occupations account for about 2 in 5 jobs in this segment. Office and administrative support occupations and healthcare practitioners and technical occupations also account for a significant portion of all jobs—about 33 percent each.

Outpatient care centers:This segment of the health care industry employs a high percentage of professional and related workers, including counselors, social workers, and registered nurses.

Medical and diagnostic laboratories:Professional and related workers, primarily clinical laboratory and radiological technologists and x-ray technicians, make up about 43% of all jobs in this industry segment. Service workers employed in this segment include medical assistants, medical equipment preparers, and medical transcriptionists.

Outlook

Job opportunities for health care careers should be excellent in all employment settings because of high job turnover, particularly from the large number of expected retirements and tougher immigration rules that are slowing the numbers of foreign health care workers entering the U.S. Wage and salary employment in the health care industry is projected to increase 27% through 2014, compared with 14% for all industries combined. Health care employment growth is expected to account for about 3.6 million new wage and salary jobs—19% of all wage and salary jobs added to the economy over the 2004–14 period. Projected rates of health care employment growth for the various segments of the industry range from 13% in hospitals, the largest and slowest growing industry segment, to 69% in the much smaller home health care services.

Many of the occupations fastest growth projection are concentrated in the health care industry. For example, over the 10 yr period of 2004–14, total employment of medical assistants is supposed to increase by 52%.

Employment in health care will continue to grow for several reasons. The number of people in older age groups, with much greater than average health care needs, will grow faster than the total population between 2004 and 2014; as a result, the demand for health care will increase. Employment in home health care and nursing and residential care should increase rapidly as life expectancies rise, and as aging children are less able to care for their parents and rely more on long-term care facilities. Advances in medical technology will continue to improve the survival rate of severely ill and injured patients, who will then need extensive therapy and care. New technologies will make it possible to identify and treat conditions that were previously not treatable. Medical group practices and integrated health systems will become larger and more complex, increasing the need for office and administrative support workers. Health care industry growth also will occur as a result of the shift from inpatient to less expensive outpatient and home health care because of improvements in diagnostic tests and surgical procedures, along with patients’ desires to be treated at home.

Many job openings will result from a need to replace workers due to retirements and high job turnover. Fast growth is expected for workers in occupations concentrated outside the inpatient hospital sector, such as medical assistants. Because of cost pressures, many health care facilities will adjust their staffing patterns to reduce labor costs. Where patient care demands and regulations allow, health care facilities will substitute lower paid providers and will cross-train their workforces. Many facilities have cut the number of middle managers, while simultaneously creating new managerial positions as the facilities diversify. Traditional inpatient hospital positions are no longer the only option for many future health care workers; persons seeking a career in the field must be willing to work in various employment settings. Employment growth in hospitals will be the slowest within the health care industry because of efforts to control hospital costs and the increasing use of outpatient clinics and other alternative care sites.

Health care workers at all levels of education and training will continue to be in demand. In many cases, it may be easier for jobseekers with health-specific training to obtain jobs and advance in their careers. Specialized clinical training is a requirement for many jobs in health care and is an asset even for many health administrative jobs that do not specifically require it.