About the Healthcare Industry

• Nature of the Industry
• Working Conditions
• Employment
• Occupations In The Industry

Significant Points

• 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 the self-employed.
• 7 of the 20 fastest growing occupations are health care related.
• Health care will generate 3 million new wage and salary jobs between 2006 and 2016, more than 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.

Nature of the Industry		Back to Top

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.

Industry organization. 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

 

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 preventative, cosmetic, or emergency care. Some offices specialize in a single field of dentistry such as orthodontics or periodontics.

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 health care 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 health care industry.

Recent developments. 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 infection control, less invasive surgical techniques, advances in reproductive technology, 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. 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 health 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.

Working Conditions		Back to Top

Hours. 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.

Work environment. 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		Back to Top

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.

Occupations in the Industry		Back to Top

Health care firms employ large numbers of workers in professional and service occupations. Together, these two occupational groups account for 3 out of 4 jobs in the industry. The next largest share of jobs, 18 percent, is in office and administrative support. Management, business, and financial operations occupations account for only 4 percent of employment. Other occupations in health care made up only 2 percent of the total.

Professional occupations, such as physicians and surgeons, dentists, registered nurses, social workers, and physical therapists, usually require at least a bachelor’s degree in a specialized field or higher education in a specific health field, although registered nurses also enter 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- 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.

Most workers in health care jobs provide clinical services, but many also are employed in occupations with other functions. Numerous workers in management and administrative support jobs keep 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.

Each segment of the health care industry provides a different mix of wage and salary health-related jobs.

Hospitals. Hospitals employ workers with all levels of education and training, thereby providing a wider variety of services than is offered by other segments of the health care industry. About 3 in 10 hospital workers is a registered nurse. Hospitals also employ many physicians and surgeons, therapists, and social workers. About 1 in 5 hospital jobs are in a service occupation, such as nursing, psychiatric, and home health aides, or building cleaning workers. Hospitals also employ large numbers of office and administrative support workers.

Nursing and residential care facilities. About 2 out of 3 nursing and residential care facility jobs are in service occupations, primarily nursing, psychiatric, and home health aides. Professional and administrative support occupations make up a much smaller percentage of employment in this segment, compared to other parts of the health care industry. Federal law requires nursing facilities to have licensed personnel on hand 24 hours a day and to maintain an appropriate level of care.

Offices of physicians. Many of the jobs in offices of physicians are in professional and related occupations, primarily physicians, surgeons, and registered nurses. About two-fifths of all jobs, however, are in office and administrative support occupations, such as receptionists and information clerks.

Offices of dentists. Roughly one-third of all jobs in this segment are in service occupations, mostly dental assistants. The typical staffing pattern in dentists’ offices consists of one dentist with a support staff of dental hygienists and dental assistants. Larger practices are more likely to employ office managers and administrative support workers.

Home health care services. About 3 in 5 jobs in this segment are in service occupations, mostly home health aides and personal and home care aides. Nursing and therapist jobs also account for substantial shares of employment in this segment.

Offices of other health practitioners. About 2 in 5 jobs in this industry segment are professional and related occupations, including physical therapists, occupational therapists, dispensing opticians, and chiropractors. Healthcare practitioners and technical occupations and office and administrative support occupations also accounted for a significant portion of all jobs—34 percent and 32 percent, respectively.

Outpatient care centers. This segment of the health care industry employs a high percentage of professional and related workers, including counselors, social workers, and registered nurses.

Other ambulatory health care services. Because this industry segment includes ambulance services, it employs about 2 out of every 5 emergency medical technicians and paramedics and ambulance drivers and attendants.

Medical and diagnostic laboratories. Professional and related workers, primarily clinical laboratory and radiologic technologists and technicians, make up 44 percent of all jobs in this industry segment. Service workers employed in this segment include medical assistants, medical equipment preparers, and medical transcriptionists.