
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 545,000
establishments make up the health care industry; they 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.
|
Percent
distribution of wage and salary employment and
establishments in health services, 2004 |
|
Establishment
type |
Establishments |
Employment |
|
Health services,
total |
100.0 |
100.0 |
|
Hospitals, public
and private |
1.9 |
41.3 |
|
Nursing and
residential care facilities |
11.6 |
21.3 |
|
Offices of
physicians |
37.0 |
15.5 |
|
Offices of
dentists |
21.0 |
5.7 |
|
Home healthcare
services |
3.0 |
5.8 |
|
Offices of other
health practitioners |
18.7 |
4.0 |
|
Outpatient care
centers |
3.2 |
3.4 |
|
Other ambulatory
healthcare services |
1.5 |
1.5 |
|
Medical and
diagnostic laboratories |
2.1 |
1.4 |
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 nonhospital 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 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 26.9 hours per week in 2004, while those in
psychiatric and substance abuse hospitals averaged 36.4 hours, compared
with 33.7 hours for all private industry.
Many workers in the
health care industry are on part-time schedules. Part-time workers made
up about 20 percent of the workforce as a whole in 2004, but accounted
for 39 percent of workers in offices of dentists and 33 percent of those
in offices of other health practitioners. Students, parents with young
children, dual jobholders, and older workers make up much of the
part-time workforce.
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 2004, the incidence
of occupational injury and illness in hospitals was 8.7 cases per 100
full-time workers, compared with an average of 5.0 for private industry
overall. Nursing care facilities had a much higher rate of 10.1. 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 2004, health care 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.
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.
Industry
Forecast
Job
opportunities 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
percent through 2014, compared with 14 percent for all industries
combined. Employment growth is expected to account for about 3.6 million
new wage and salary jobs -- 19 percent of all wage and salary jobs added
to the economy over the 2004–14 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 69
percent in the much smaller home health care services.
|
Employment in
health care by industry segment, 2004 and projected change,
2004-14 (Employment in thousands) |
|
Industry
segment |
2004
Employment |
2004-14
Percent change |
|
All industries |
145,612 |
14.0 |
|
Health Services |
13,062 |
27.3 |
|
Hospitals, public
and private |
5,301 |
13.1 |
|
Nursing and
residential care facilities |
2,815 |
27.8 |
|
Offices of
physicians |
2,054 |
37.0 |
|
Home health care
services |
773 |
69.5 |
|
Offices of
dentists |
760 |
31.7 |
|
Offices of other
health practitioners |
524 |
42.7 |
|
Outpatient care
centers |
446 |
44.2 |
|
Other ambulatory
health care services |
201 |
37.7 |
|
Medical and
diagnostic laboratories |
189 |
27.1 |
Many of the
occupations projected to grow the fastest in the economy are
concentrated in the health care industry. For example, over the 2004–14
period, total employment of home health aides -- including the
self-employed -- is projected to increase by 56 percent, medical
assistants by 52 percent, physician assistants by 50 percent, and
physical therapist assistants by 44 percent.
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.
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. Nursing aides, orderlies and attendants, and home health
aides are among the occupations adding the most new jobs between 2004
and 2014, about 675,000 combined.
Another
occupation that will add many new jobs 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.
Fast growth is
expected for workers in occupations concentrated outside the inpatient
hospital sector, such as medical assistants and home health 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. 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.
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.
Related
Degree Fields
Professional
Associations
Note: Some resources in this section are provided by the US Department
of Labor, Bureau of Labor Statistics.
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