Emurse

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 (table 3). 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.

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 patient's 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.

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. 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.