Jobs and Job Growth

What Kind of Jobs Exist?

About 3 out of 4 healthcare jobs are in professional and service occupations, according to the Occupational Outlook Handbook by the U.S. Department of Labor’s Bureau for Labor Statistics (BLS).

Professional occupations include physicians and surgeons, dentists, registered nurses, social workers, and physical therapists, and usually require at least a bachelor’s degree in a specialized field or higher education in a specific health field.  Registered nurses also enter the field through associate degree or diploma programs. Professional workers often have high levels of responsibility and complex duties. In addition to providing services, these workers may supervise other workers or conduct research.

Other health professionals and technicians work in many fast growing occupations, such as medical records and health information technicians and dental hygienists. These workers may operate technical equipment and assist health diagnosing and treating practitioners. Graduates of 1-year or 2-year training programs often fill such positions; the jobs usually require specific formal training beyond high school, but less than 4 years of college.

Service occupations attract many workers with little or no specialized education or training. For instance, some of these workers are nursing aides, home health aides, building cleaning workers, dental assistants, medical assistants, and personal and home care aides. Nursing or home health aides provide health-related services for ill, injured, disabled, elderly, or infirm individuals either in institutions or in their homes. By providing routine personal care services, personal and home care aides help elderly, disabled, and ill persons live in their own homes instead of in an institution. Although some of these workers are employed by public or private agencies, many are self-employed. With experience and, in some cases, further education and training, service workers may advance to higher level positions or transfer to new occupations.

In addition to those jobs directly related to clinical care, numerous management and administrative support jobs keep healthcare organizations running smoothly. Although many medical and health services managers have a background in a clinical specialty or training in health care administration, some enter these jobs with a general business education.

Which Jobs Represent the Fastest Growing Sector?

Healthcare is among the fastest-growing industries in the U.S. economy.  According to BLS projections, 8 of the top 20 fastest-growing occupations are in healthcare, and the industry is also expected to lead in new wage and salary job creation — generating some 3.6 million between 2004 and 2014.

Several factors are spurring this rapid growth. 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. 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 2004 and 2014, about 675,000 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.

As the median age of registered nurses increases, too few 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.

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.

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.

Earnings

As in most industries, professionals and managers working in health care typically earn more than other workers in the industry. However, earnings in individual health care occupations vary as widely as the duties, level of education and training, and amount of responsibility required by the occupation.

Average earnings of non-supervisory workers in most health care segments are higher than the average for all private industry, with hospital workers earning considerably more than the average and those employed in nursing and residential care facilities and home health care services earning less. Average earnings often are higher in hospitals because the percentage of jobs requiring higher levels of education and training is greater than in other segments. Those segments of the industry with lower earnings employ large numbers of part-time service workers.

Although some hospitals have unions, the health care industry is not heavily unionized. In 2004, only 11 percent of workers in the industry were members of unions or covered by union contracts, compared with about 14 percent for all industries.

The BLS publishes an analysis of differences in earnings for different occupations depending on their employment in a hospital, nursing/residential care, or ambulatory healthcare service setting.