
Healthcare
Related
Profiles of
Professionals
Industry
Overview
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 580,000 establishments make up the health care industry; they vary
greatly in terms of size, staffing patterns, and organizational
structures. Nearly 77 percent of health care establishments are offices
of physicians, dentists, or other health practitioners. Although
hospitals constitute only 1 percent of all health care establishments,
they employ 35 percent of all workers .
Percent distribution of
employment and establishments in health services by detailed
industry sector, 2006
|
Industry segment |
Employment |
Establishments |
|
|
|
|
|
Total |
100.0 |
100.0 |
|
|
|
|
|
Ambulatory health care services |
42.2 |
87.1 |
|
Offices of physicians |
17.1 |
36.7 |
|
Home health care services |
6.9 |
3.3 |
|
Offices of dentists |
6.3 |
20.7 |
|
Offices of other health practitioners |
4.6 |
19.3 |
|
Outpatient care centers |
3.9 |
3.4 |
|
Other ambulatory health care services |
1.7 |
1.4 |
|
Medical and diagnostic laboratories |
1.6 |
2.3 |
|
|
|
|
|
Hospitals |
34.8 |
1.3 |
|
General medical and surgical hospitals |
32.8 |
1.0 |
|
Other hospitals |
1.3 |
0.2 |
|
Psychiatric/substance abuse hospitals |
0.8 |
0.1 |
|
|
|
|
|
Nursing and residential care facilities |
23.0 |
11.5 |
|
Nursing care facilities |
12.6 |
2.8 |
|
Community care facilities for the elderly |
5.0 |
3.4 |
|
Residential mental health facilities |
4.0 |
4.1 |
|
Other residential care facilities |
1.3 |
1.1 |
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 2006,
almost half of non-hospital health care establishments employed fewer
than five workers (chart 1). By contrast, 7 out of 10 hospital employees
were in establishments with more than 1,000 workers.
The health care
industry consists of the following nine segments:
1.
Hospitals
Hospitals provide
complete medical care, ranging from diagnostic services, to surgery, to
continuous nursing care. Some hospitals specialize in 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.
2. Nursing and Residential Care
Facilities
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.
3. Offices of Physicians
About 37 percent of all health care establishments fall into this
industry segment. 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.
4.
Offices of Dentists
About 1 out of every 5 health care establishments is a dentist's office.
Most employ only a few workers, who provide general or specialized
dental care, including dental surgery.
5. 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.
6. Offices of Other Health
Practitioners
This segment of the industry includes the offices of chiropractors,
optometrists, podiatrists, occupational and physical therapists,
psychologists, audiologists, speech-language pathologists, dietitians,
and other health practitioners. Demand for the services of this segment
is related to the ability of patients to pay, either directly or through
health insurance. Hospitals and nursing facilities may contract out for
these services. This segment also includes the offices of practitioners
of alternative medicine, such as acupuncturists, homeopaths,
hypnotherapists, and naturopaths.
7. 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.
8.
Other Ambulatory Health Care Services
This relatively small industry segment includes ambulance and helicopter
transport services, blood and organ banks, and other ambulatory health
care services, such as pacemaker monitoring services and smoking
cessation programs.
9. 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. 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
Environment
Average weekly hours of nonsupervisory workers in private health care
varied among the different segments of the industry. Workers in offices
of dentists averaged only 27.1 hours per week in 2006, while those in
psychiatric and substance abuse hospitals averaged 35.7 hours, compared
with 33.9 hours for all private industry.
Many workers in the health care industry are on part-time schedules.
Part-time workers made up about 19 percent of the health care workforce
as a whole in 2006, but accounted for 38 percent of workers in offices
of dentists and 31 percent of those in offices of other health
practitioners. 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.
In 2006, the incidence of occupational injury and illness in hospitals
was 8.1 cases per 100 full-time workers, compared with an average of 4.4
for private industry overall. Nursing care facilities had a higher rate
of 9.8. Health care workers involved in direct patient care must take
precautions to prevent back strain from lifting patients and equipment;
to minimize exposure to radiation and caustic chemicals; and to guard
against infectious diseases, such as AIDS, tuberculosis, and hepatitis.
Home care personnel who make house calls are exposed to the possibility
of being injured in highway accidents, all types of overexertion when
assisting patients, and falls inside and outside homes.
Employment
As
the largest industry in 2006, health care provided 14 million jobs—13.6
million jobs for wage and salary workers and about 438,000 jobs for
self-employed and unpaid family workers. Of the 13.6 million wage and
salary jobs, 40 percent were in hospitals; another 21 percent were in
nursing and residential care facilities; and 16 percent were in offices
of physicians. 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 295,000 out of the 438,000 total
self-employed.
Health care jobs are found throughout the country, but they are
concentrated in the largest 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, in part because of the high level of education
and training required for many health occupations.
Industry
Forecast
Health
care will generate 3 million new wage and salary jobs between 2006 and
2016, more than any other industry. Seven of the twenty fastest growing
occupations are health care related. Job opportunities should be good in
all employment settings.
Wage and salary employment in the health care industry is projected to
increase 22 percent through 2016, compared with 11 percent for all
industries combined (table 3). Employment growth is expected to account
for about 3 million new wage and salary jobs—20 percent of all wage and
salary jobs added to the economy over the 2006-16 period. Projected
rates of employment growth for the various segments of the industry
range from 13 percent in hospitals, the largest and slowest growing
industry segment, to 55 percent in the much smaller home health care
services.
Employment in health care by industry segment, 2006 and
projected change, 2006-16
(Employment in thousands)
|
Industry
segment |
2006
Employment |
2006-16
Percent change |
|
|
|
|
|
Health services,
total |
13,621 |
21.7 |
|
|
|
|
|
Hospitals,
public and private |
5,438 |
13.0 |
|
Nursing and
residential care facilities |
2,901 |
23.7 |
|
Offices of
physicians |
2,154 |
24.8 |
|
Home health care
services |
867 |
55.4 |
|
Offices of
dentists |
784 |
22.4 |
|
Offices of other
health practitioners |
571 |
28.3 |
|
Outpatient care
centers |
489 |
24.3 |
|
Other ambulatory
health care services |
216 |
32.3 |
|
Medical and
diagnostic laboratories |
202 |
16.8 |
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 2006 and 2016; 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.
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 of the occupations projected to grow the fastest in the economy are
concentrated in the health care industry. For example, over the 2006-16
period, total employment of home health aides—including the
self-employed—is projected to increase by 49 percent, medical assistants
by 35 percent, physical therapist assistants by 32 percent, and
physician assistants by 27 percent.
Rapid growth is expected for workers in occupations concentrated outside
the inpatient hospital sector, such as pharmacy technicians and personal
and home care aides. 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. Hospitals will be the slowest growing segment within the
health care industry because of efforts to control hospital costs and
the increasing use of outpatient clinics and other alternative care
sites.
Demand for dental care will rise due to population growth, greater
retention of natural teeth by middle-aged and older persons, greater
awareness of the importance of dental care, and an increased ability to
pay for services. Dentists will use support personnel such as dental
hygienists and assistants to help meet their increased workloads.
In some management, business, and financial operations occupations,
rapid growth will be tempered by restructuring to reduce administrative
costs and streamline operations. Office automation and other
technological changes will slow employment growth in office and
administrative support occupations; but because the employment base is
large, replacement needs will continue to create substantial numbers of
job openings. Slower growing service occupations also will provide job
openings due to replacement needs.
Job opportunities should be good 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 United
States.
Occupations with the most replacement openings are usually large, with
high turnover stemming from low pay and status, poor benefits, low
training requirements, and a high proportion of young and part-time
workers. Nursing aides, orderlies and attendants, and home health aides
are among the occupations adding the most new jobs between 2006 and
2016, about 647,000 combined. By contrast, occupations with relatively
few replacement openings—such as physicians and surgeons—are
characterized by high pay and status, lengthy training requirements, and
a high proportion of full-time workers.
Another
occupation that is expected to have many openings is registered nurses.
The median age of registered nurses is increasing, and not enough
younger workers are replacing them. As a result, employers in some parts
of the country are reporting difficulties in attracting and retaining
nurses. Imbalances between the supply of and the demand for qualified
workers should spur efforts to attract and retain qualified registered
nurses. For example, employers may restructure workloads and job
responsibilities, improve compensation and working conditions, and
subsidize training or continuing education.
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 administrative jobs that do
not specifically require it.
Office
automation and other technological changes will slow employment growth
in office and administrative support occupations; but because the
employment base is large, replacement needs will continue to create
substantial numbers of job openings. Slower growing service occupations
also will provide job openings due to replacement needs.
Related
Degree Fields
Professional
Associations
Note: Some resources in this section are provided by the US Department
of Labor, Bureau of Labor Statistics.
|
|