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Jobs available in nine employment segments of health care field

You’ve heard it and read it everywhere: Health care is where the greatest job growth is, health care has created jobs every month for 20 consecutive years , health care has many of the fastest-growing occupations in America (registered nurses, home health aides and personal care aides, to name three).

All true, and much more. In fact, health care is seeing and will continue to see a sustained annual employment growth rate of 3 percent in the 2010- 20 decade (that’s 34 percent in 10 years), the fastest of all sectors, according to the Bureau of Labor Statistics. Health care, which employs slightly more than 17 million Americans, will balloon to more than 22 million by the end of the decade.

There will be more workers in health care than there will be in state and local governments combined. And, if the picture isn’t clear enough, understanding the drivers of health care growth (no matter what happens or doesn’t happen regarding reform) will help define the situation.

Americans spend 18 percent of the gross domestic product on health care. Simply put, that’s more than one of every $6 we have — $3 trillion — more than any other country in the world spends on everything combined, with the exception of China, Japan and Germany. Three trillion dollars, by the way, looks like this: $3,000,000,000,000. (Just wanted to make the point a little clearer.)

We have a consistently growing population — 315 million right now and growing by 3.1 million per year (U.S. Census) — and an aging population, with the 38th highest median age, 37.1, in the world (CIA — The World Factbook). The projected change in demographics is driving the growth in the number of jobs being added in the sector.

The number of people 65 years and older is projected to increase from 40.2 million in 2010 to 54.8 in 2020, accounting for 16.1 percent of the population in 2020, up from 13 percent in 2010. The older we get, the more health care dollars we spend and the more dollars we spend, the more health care professionals we employ.

So with more of us, and more of us getting older, it stands to reason that we spend so much on health care, especially long-term care, acute care and chronic care. And that, in a nutshell, is why health care is creating all those jobs.

It makes sense, then to delve into this, not as a societal issue, but purely as an employment issue, and to do so by exploring the different regions of this vast universe we call health care. We’ll define the segments of the health care industry, showing what actually makes up the industry we talk about in such glowing terms of employment growth. In other words, yes, there is robust growth in the health care field, and here’s where it is.

The health care industry is comprised of nine segments, as described by the Bureau of Labor Statistics: hospitals, nursing and residential care facilities, physicians’ offices, other practitioners’ offices, dentists’ offices, home health care services, outpatient care centers, other ambulatory health care services, and medical and diagnostic laboratories.

Clearly the dominant segment is hospitals. Approximately 35 percent of all health care workers work in hospitals, with the rest in the other eight segments combined. With about 16.5 million jobs in the health care field nationwide, that equates to slightly less than 6 million Americans working in hospitals, although hospitals represent less than 2 percent of all health care establishments. Yet only three of every 10 hospital workers are nurses, the first job that comes to mind when we visualize a hospital.

Although many other hospital jobs involve actual care giving, hospitals employ workers in more different occupations than any other type of employer in the American workplace. The list includes jobs in finance and accounting, marketing and public relations, human resources, information technology, building maintenance, transportation, telecommunications, food services, fund raising and operations. Hospitals employ large numbers of administrative and support personnel.

Further, more than 70 percent of hospital jobs are in establishments with more than 1,000 workers.

In other words, the approximately 6 million hospital jobs are highly concentrated in relatively few but easily recognizable places.

Hospitals provide complete medical care ranging from diagnostic services to surgery to nursing care. Some hospitals are specialized, treating the mentally ill, cancer patients or children. Hospital-based care may be on an inpatient (overnight) or outpatient basis. With a focus on efficiency and cost containment, outpatient care is growing rapidly.

Different hospitals require different mixes of workers, determined by the “size, geographic location, goals, philosophy, funding, organization, and management style of the institution.” Many hospitals have expanded the scope and spectrum of the services they provide to the communities they serve. Included in these services are long-term and home health care.

Nursing and residential care facilities make up the second largest segment, in terms of numbers of workers employed, with approximately 24 percent of all health care employees. More than 4 million workers work in 12 percent of all health care establishments, obviously smaller in size than the average hospital.

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. The vast majority of the direct care offered by these institutions is provided by nursing aides. Patients requiring less assistance are served by other facilities such as convalescent homes.

Residential care facilities provide 24-hour social and personal care — but not medical and nursing care — to children, the elderly and others who have limited ability to care for themselves. These facilities include alcohol and drug rehab centers, group homes, halfway houses and assisted living facilities.

These segments will add 822,000 jobs to reach a level of almost 4 million.

Thirty-seven percent (three of eight) of all health care establishments, employing 17 percent of all workers in the health care field, are physicians’ offices. Physicians and surgeons practice privately or in groups of practitioners, with offices typically employing less than 20 employees.

In fact, half of all nonhospital health care establishments employ from one to four workers, and another 38 percent employ five to 19. Although many of the jobs in physicians’ offices are in professional and related occupations (physicians, surgeons and registered nurses), about 40 percent are in office and administrative support occupations, such as receptionists and information clerks.

One in five health care establishments is a dentist’s office, with the office consisting of one dentist and a support staff of dental hygienists and dental assistants. In smaller dental practices, one-third of all workers provide care in support of the dentist, although larger practices are more likely to employ office managers and administrative support workers.

The segment of the industry referred to as “other practitioners” includes the offices of chiropractors, optometrists, podiatrists, occupational and physical therapists, psychologists, audiologists, speech-language pathologists, dietitians and other health practitioners of complementary and alternative modalities such as acupuncture, massage, aromatherapy, homeopathic or naturopathic medicine, traditional Chinese medicine or Ayurveda (including yoga).

Combined, offices of physicians, dentists and other health practitioners will add 1.4 million jobs (3.2 percent annual growth) and grow to 5.2 million by 2020.

According to the National Institutes of Health, 1998 was the first year that Americans made more visits to practitioners of complementary and alternative medicine than they did to mainstream doctors, and more than 75 percent of Americans have used at least one of these modalities, yet we spend less than 4 percent of our health care dollars in the offices of these “other practitioners.”

The home health care services segment is one of the most rapidly growing areas of the entire U.S. workplace, employing one of every 14 health care workers. Provided mainly to the elderly, skilled nursing or medical care in the home has been driven by patients’ preference for treatment at home as well as a demand for substantial cost savings, and has been facilitated by in-home medical technologies.

Increasing cost pressures are expected to shift demand from higher cost hospitals and long-term care services to lower cost health practitioners, home health care services and clinical services. As a result, there is a projected growth of almost 6.1 percent in the number of home health aides in this decade, adding 871,000 jobs and reaching 2 million by 2020.

Outpatient care centers make up a diverse group of establishments from dialysis centers to mental health and substance abuse centers to health maintenance organization medical centers to freestanding ambulatory surgical and emergency centers. Because of the recognized ability of these facilities to do highly specialized work, this segment of the industry employs a high percentage of professional and related workers such as counselors, social workers and registered nurses. This area is projected to grow in numbers of establishments, numbers of jobs and revenue.

The relatively small industry segment referred to as “other ambulatory health care services” includes ambulance and helicopter transport services, blood and organ banks, and other services like pacemaker monitoring services and smoking cessation programs. Because this industry segment includes ambulance services, it employs about 40 percent of all paid emergency medical technicians, paramedics, ambulance drivers and attendants.

Finally, in the medical and diagnostic laboratories segment, where medical and diagnostic laboratories provide analytic or diagnostic services to the medical profession or directly to patients following a physician’s prescription, professional and related workers like clinical laboratory technicians make up 44 percent of the jobs. Service workers employed in this segment include medical assistants, medical equipment preparers and medical transcriptionists.

Other than this breakdown of employment segments of the health care field, here are other important things to know.

The health care industry provides many job opportunities for people without specialized training beyond high school. In fact, more than half of workers in nursing and residential care facilities and a fifth of hospital workers have a high school diploma or less.

At the same time, almost 20 percent of all health care workers work part time, allowing for great flexibility in issues like work-life balance and attending school. These two conditions, along with a growing workplace demand for rising educational requirements, are producing an environment conducive to educational advancement in the field.

As a result, an increasing amount of health care establishments provide on-the-job or classroom training, continuing education, and even tuition assistance or reimbursement. Larger establishments generally have greater resources to offer a broader range of opportunities.

Health care will generate more new wage and salary jobs by 2020 than any other industry, and many of the fastest growing occupations are in this field. Projected rates of employment growth range from 13 percent in hospitals (the largest and slowest growing industry segment) to 55 percent in the much smaller home health care services.

Wages and salaries are projected to increase 22 percent during this period, compared with 11 percent for all industries. Overall, earnings in health care are 4 percent higher than in the rest of the workforce, and although the unemployment rate nationally is 7.6 percent, it is only 4.9 percent in the health care sector. (This measurement varies by study; some place is even lower.)

For people with a desire to help others, with a concern for the welfare of others and of the public in general, with the ability to deal with potentially stressful situations and with people of diverse backgrounds and needs, the health care field beckons.

With consistent growth, projected to continue indefinitely, health care offers much in the way of opportunity.

And it also offers much in the way of rewards — in many ways.

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