During good economic times and bad, one truth endures in the job market: Healthcare workers are always in demand. Everyone occasionally gets sick, babies don’t stop being born, new health research is a constant, and our population is aging. We will always need doctors, nurses, and their support staffs to keep us in good shape. The healthcare industry was a shining light of employment during the recent recession – and the good news is that light is getting brighter.
The news is good, but not perfect: Experts predict that reform, changes in reimbursement methods, government cuts, and hospital debt will shake up the healthcare world. Even now, some hospitals are making tough choices and cutting costs. But that said, some fields – such as primary care and nursing – face significant staffing shortages.
To adapt to the changes, healthcare workers are becoming more accessible. They are working with patients in not only professional offices, professional clinics, and hospitals, but also schools, retail clinics, workplaces, and private homes. And care is increasingly focusing on prevention and wellness.
In addition, experts predict an increase in the use of mid-level providers such as nurse practitioners and physician assistants. That increase is likely, according to the Association of American Medical Colleges, because there could be a shortage of 92,000 doctors by 2020. The gap could be even bigger if the United States Congress funds more doctors for Department of Veterans Affairs (VA) hospitals.
But of all statistics pertaining to healthcare, transitioning and veteran job seekers should be most aware of one number: 4 million. That is the increase – per year! – in expected hospital visits between now and 2020. That will be a tremendous driver of demand.
Experts project rapid employment growth in occupations concentrated outside the inpatient hospital sector – for example, pharmacy technicians and personal and home care aides. Demand for dental care will rise due to 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.
The median age of registered nurses is increasing, and not enough younger workers are replacing them in many areas. As a result, employers in some parts of the country are reporting difficulties in attracting and retaining nurses.
Healthcare workers at all levels of education and training will continue to be in demand. In many cases, it may be easier for job seekers with health-specific training to obtain jobs and advance in their careers. Specialized clinical training is a requirement for many jobs in healthcare, and is an asset even for many administrative jobs that do not specifically require it.
The Bureau of Labor Statistics (BLS), a part of the Department of Labor, analyzes future demand for different types of goods and services, and then projects the employment necessary to produce and perform them. The BLS projects a 10.8 percent growth in employment between 2012 and 2022, and says that most of the growth will occur in service-providing industries. See www.bls.gov/emp/ep_table_102.htm. (The BLS updates these statistics every two years; the most recent update was in 2014 and includes projections for the years 2012-2022.)
The BLS expects four “major groups” of occupations to grow more than 20 percent – nearly double the overall growth – from 2012 to 2022. Leading the pack at 28.1 percent will be Healthcare Support Occupations, which has a Standard Occupational Code (SOC) of 31-0000; see “Your Guide to Industrial and Occupational Employment Statistics” on page 36 of this magazine.
The others will be Healthcare Practitioners and Technical Occupations (SOC 29-0000) at 21.5 percent, Construction and Extraction Occupations (SOC 47-0000) at 21.4 percent, and Personal Care and Service Occupations (SOC 39-0000) at 20.9 percent.
Of the 30 “detailed occupations” projected to have the largest percentage increase between 2012 and 2022, 14 are related to healthcare. Within the Personal Care and Service Occupations major group (SOC 39-0000), Personal Care Aides (SOC 39-9021) are expected to grow the most percentage-wise. They are predicted to increase by 48.8 percent by 2022. Personal Care Aides had a median annual wage of $19,910 in 2012.
Home Health Aides (SOC 31-1011) are next, growing by 48.5 percent. They had a $20,820 median annual wage in 2012.
Diagnostic Medical Sonographers (SOC 29-2032) are expected to grow by 46 percent, Physical Therapy Assistants (SOC 31-2021) by 41 percent, Physical Therapy Aides (SOC 31-2022) by 40.1 percent, Physician Assistants (SOC 29-1071) by 38.4 percent, and Physical Therapists (SOC 29-1123) by 36.0 percent.
Within the Office and Administrative Support Occupations major group (SOC 43-0000), Medical Secretaries (SOC 43-6013) are expected to grow by 36.0 percent.
Because percentages can be misleading, below is a list of detailed occupations in terms of predicted increases in individual jobs from 2012 to 2022.
* Personal Care Aides (SOC 39-9021) 580,800
* Registered Nurses (SOC 29-1141) 526,800
* Home Health Aides (SOC 31-1011) 424,200
* Nursing Assistants (SOC 31-1014) 312,2000
* Medical Secretaries (SOC 43-6013) 189,200
* Licensed Practical and Licensed Vocational Nurses (SOC 29-2061) 182,900
The BLS expects the service-providing sectors of the economy to account for more than 90 percent of the jobs that will be added between 2012 and 2022; see www.bls.gov/emp/ep_table_207.htm. The Health Care and Social Assistance sector, which was largely unaffected by the most recent recession, will experience the largest and fastest employment gains among all sectors. That sector has a North American Industry Classification System (NAICS) code of 62; see “Your Guide to Industrial and Occupational Employment Statistics” on page 36 of this magazine. The BLS projects that NAICS 62 will add almost 5 million jobs, a 2.6-percent-per-year increase, between 2012 and 2022.
Changing demographics will drive much of this growth, because older people require more healthcare services. The BLS expects the number of people 65 years old and older to increase from 41.9 million (13.3 percent of the total population) in 2012 to 58.6 million (17.3 percent) in 2022.
In addition, increasing cost pressures will shift demand from higher-cost hospitals and inpatient physician services to lower-cost home healthcare services, outpatient physician services, and clinical services. A part of the NAICS 62 sector and the Ambulatory Health Care Services “subsector” (NAICS 621), the Home Health Care Services “industry group” (NAICS 6216), will add 715,700 jobs, at an annual growth rate of 4.8 percent, reaching a level of more than 1.9 million jobs by 2022. This industry provides in-home care such as nursing and physical therapy,
The BLS expects the industry groups called Offices of Health Practitioners (NAICS 6211, 6212, 6213) – including offices of physicians, dentists, and other health practitioners such as chiropractors and optometrists – to add the largest number of jobs among the service-providing industry groups. The number of jobs in Offices of Health Practitioners will increase from almost 4 million in 2012 to 5.2 million in 2022, a gain of more than 1.2 million jobs, at an annual growth rate of 2.7 percent.
A part of the Social Assistance subsector (NAICS 624), the Individual and Family Services industry group (NAICS 6241) will register the second-fastest growth in employment. The group will add 711,500 jobs, at an annual rate of 4.4 percent, to reach a level of just over 2.0 million jobs in 2022. Individual and Family Services organizations provide a variety of social services to children, elderly people, people with disabilities, and others.
The Hospitals subsector (NAICS 622) will add 814,800 jobs between 2012 and 2022, according to the BLS, reaching more than 5.6 million. But because hospitals already employ a great number of people, the annual rate of growth will be just 1.6 percent.
Due to cost-reduction measures, the Outpatient, Laboratory, and Other Ambulatory Care industry groups (NAICS 6214, 6215, 6219) will be among the largest and fastest growing. Employment will to grow from just under 1.2 million in 2012 to just under 1.7 million in 2022, an annual growth rate of 3.8 percent.
The Nursing and Residential Care Facilities subsector (NAICS 623) provides assisted-living services, including nursing, rehabilitation, and other related personal care, to those who need continuous care but do not require hospital services. The BLS expects this industry to become one of the largest and fastest growing due to the shift to more outpatient services, the increasing population of elderly people seeking to maintain some level of independence, and improvements in technology allowing younger patients shorter rehabilitation stays. According to the BLS, the number of jobs in nursing and residential care facilities will grow by 760,700, from almost 3.2 million in 2012 to almost 4 million in 2022, an annual rate of increase of 2.2 percent.
Most of the expected influx of healthcare jobs will require post-secondary education and/or training. Even nursing candidates, who in years past could begin their careers with just associate’s degrees, should consider advanced degrees. Now more than 55 percent of all nurses have a four-year degree or better. That number used to hover around 20 percent. The nursing industry is pushing hard to get the number of nurses with four-year degrees or better to 80 percent.
The Institute of Medicine (IOM) is calling for that number as well as doubling the number of nurses with doctorates. The IOM says those goals are necessary because patient needs have become more complicated, and that nurses must be better educated to ensure high-quality care. The industry’s research shows that lower mortality rates, fewer medication errors, and more overall positive outcomes are all linked to nurses with baccalaureate and graduate degrees. Furthermore, data from the American Association of Colleges of Nursing’s (AACN) indicate that 79 percent of employers now require – or express a strong preference for – nurses with at least a four-year degree.
Health technologists and technicians work in many fast-growing occupations, such as medical records and health information technicians, diagnostic medical sonographers, radiologic technologists and technicians, and dental hygienists. These workers may operate medical equipment and assist health-diagnosing and treating practitioners. The workers are typically graduates of one-year or two-year postsecondary training programs.
Service occupations attract many workers with little or no specialized education or training. They include nursing aides, home health aides, building cleaning workers, dental assistants, medical assistants, and personal and home care aides. Nursing and home health aides provide health-related services for ill, injured, disabled, elderly, or infirm individuals either in institutions or in their homes.
Most healthcare workers have jobs that require less than four years of college education. However, education does lead to higher salaries. Registered nurses have an annual average salary greater than $67,000. But personal care aides and home health aides have average annual salaries closer to $20,000.
Anyone considering a career in health care should have a strong desire to help others, genuine concern for the welfare of patients and clients, and an ability to deal with people of diverse backgrounds in stressful situations. Many of the healthcare jobs that are regulated by state licensure require healthcare professionals to complete continuing education at regular intervals to maintain valid licensure.
Average earnings of nonsupervisory healthcare workers are higher than the average for all private industry. Hospital workers earn considerably more than the average. Workers in nursing and residential care facilities earn less, as do people who provide home care.
Average earnings often are higher in hospitals because the percentage of jobs requiring higher levels of education and training is greater. Those segments of the industry with lower earnings employ large numbers of part-time service workers.
As in most other industries, professionals and managers working in healthcare typically earn more than other workers in the industry. Wages in individual healthcare occupations vary as widely as the duties, level of education and training, and amount of responsibility required by the occupations.
Some establishments offer tuition reimbursement, paid training, child day-care services, and flexible work hours. Healthcare establishments that must be staffed around the clock to care for patients and handle emergencies often pay premiums for overtime and weekend work, holidays, late shifts, and time spent on call.