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Health Care Industry:

Information and healthcare facts.

• Health Care Careers

Significant Points:

• 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 the self-employed.
• 8 out of 20 occupations projected to grow the fastest are in health care.
• More new wage and salary jobs—about 19 percent, or 3.6 million—created between 2004 and 2014 will be in health care than in any other industry.
• Most workers have jobs that require less than 4 years of college education, but health diagnosing and treating practitioners are among the most educated workers.

Healthcare Establishment types:
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

Health services, total
Hospitals, public and private
Nursing and residential care facilities
Offices of physicians
Offices of dentists
Home healthcare services
Offices of other health practitioners
Outpatient care centers
Other ambulatory healthcare services
Medical and diagnostic laboratories

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 (chart 1). By contrast, 7 out of 10 hospital employees were in establishments with more than 1,000 workers (chart 2).

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.

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 olderthan 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.

Outlook:
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.

The health care industry consists of the following nine segments:

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.

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.

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.

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.

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.

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.

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.

Other ambulatory health care services. This relatively small industry segment includes ambulance and helicopter transport services, blood and organ banks, and other ambulatory healthcare services, such as pacemaker monitoring services and smoking cessation programs.

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 healthcare 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 healthcare 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 haelth 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.

More information:
American Medical Association/Health Professions Career and Education Directory, 515 N. State St., Chicago, IL 60610. Internet: http://www.ama-assn.org/go/alliedhealth

Association of American Medical Colleges, 2450 N Street NW., Washington, DC 20037.Internet: http://www.aamc.org/students

www.bls.gov/oco/cg/cgs035.htm

See:
• Dental Hygienists
• Medical Assistants

Guides:
• Guide to the Top Health Care Employers
• Career Guide to Biotech
• Career Guide to Pharmaceutical Sales & Marketing