QCT Windows 2016 Migration OOQ Feature Article

| August 2020

Health care: Millions of jobs now and in the future

Elka Torpey

Elka Torpey is an economist in the Office of Occupational Statistics and Employment Projections, BLS. She can be reached at torpey.elka@bls.gov.

Squib: Doctor, nurse, aide—there are lots of career options in health care. Learn more about this fast-growing industry.

In career news, healthcare is everywhere. That’s because the health care industry is projected to add more jobs—over 4 million—than any other industry between 2012 and 2022, according to the U.S. Bureau of Labor Statistics (BLS). And it is projected to be among the fastest-growing industries in the economy.

“Without a doubt, there’s a lot of opportunity in healthcare,” says Stephanie Drake, executive director of the American Society for Healthcare Human Resources Administration in Chicago, Illinois.

But which areas of work are expected to have the best outlook? What are the occupations, and what do they pay? And how do you prepare for them?

This article answers those questions. The first section describes the industry and how it’s growing. The second section discusses the occupations in health care. And the third section explains how to get started in these occupations. Sources for more information are at the end.

A growing industry

Businesses are grouped into industry sectors based on the goods they produce or the services they provide. Health care, part of the health care and social assistance sector, provides services related to treating illness, maintaining wellness, and managing disease.

For workers in health care, helping people is the core of their jobs. “When you work in health care, you serve the public every day,” says pharmacist Jennifer Adams, a senior director at the American Association of Colleges of Pharmacy in Alexandria, Virginia.

Where the jobs are

In this article, health care jobs are in five detailed industries: hospitals, offices of health practitioners, nursing and residential care facilities, home health care services, and outpatient, laboratory, and other ambulatory care services.

In 2013, there were more than 15.8 million jobs in health care, according to BLS. Table 1 shows where these jobs were, by detailed industry.

            The data in this section are from the BLS Current Employment Statistics survey, which cover wage and salary workers only and do not include self-employed and unpaid family workers.

            Hospitals accounted for the largest number of jobs in health care, about 39 percent of total employment in 2013. Employers include general medical and surgical hospitals, psychiatric and substance abuse hospitals, and specialty hospitals. Most jobs are in private hospitals, but some jobs are in hospitals funded by federal, state, or local governments.

Offices of health practitioners made up about 26 percent of health care employment in 2013. Employers include offices of physicians, dentists, and other health practitioners, such as chiropractors and physical therapists.

            Nursing and residential care facilities accounted for about 20 percent of health care jobs in 2013. Skilled nursing facilities, assisted living facilities for the elderly, and continuing care retirement communities are included in this detailed industry. Other facilities offer housing and care for people who need help related to mental health, substance abuse, or intellectual or developmental disability.

Home health care services had about 8 percent of health care jobs in 2013. Employers include businesses that provide a variety of services in peoples’ homes, such as skilled nursing care, personal care, and physical therapy.

Outpatient, laboratory, and other ambulatory care services also had about 8 percent of health care jobs in 2013. Employers include ambulance services, medical and diagnostic laboratories, family planning centers, and outpatient mental health and substance abuse centers.

Past and future growth

Employment in the health care industry has been growing steadily for years, BLS data show. (See chart 1.) This growth is due, in part, to people depending on health services no matter what the economic climate.

Even when total U.S. employment fell during the 2007–09 recession, for example, health care employment continued to rise. “Healthcare is recession-proof,” says Kimberley Brummett, who worked in a home health agency for 17 years and is now a senior director at the American Association for Homecare in Washington, D.C. “There is always a need.”

In addition, because healthcare-related jobs often require personal interaction, they are difficult to outsource or replace with automation as happens in some other industries. “Job stability is one of the best parts about any healthcare career,” says Adams. “We’re always going to need healthcare providers, no matter what area of health care you choose for a career.”

            The 2012­–22 projections data are from the BLS Employment Projections program and cover wage and salary, self-employed, and unpaid family workers.

Projections. BLS projects health care employment to grow by 26 percent between 2012 and 2022, an increase of about 4.1 million jobs. Several factors are expected to lead to this growth, including the following:

·       A growing population. Over the decade, the U.S. population is projected to increase by about 8 percent. A larger population requires more healthcare services, leading to projected job growth in the industry.

·       More people who are older. The number of people ages 65 and older is projected to grow by about 38 percent between 2012 and 2022—the fastest of any age group. Compared with younger people, older people typically have greater healthcare needs. As a result, the health care industry is expected to add jobs.

·       Medical advances. Improvements in medicine and technology are also expected to increase demand for healthcare services, creating more jobs for the workers who provide these services.

·       Health insurance reform. As more people get health insurance coverage, the number of people seeking routine medical care is expected to grow. In turn, more jobs are projected to be added to treat these people.

Growth by detailed industry. Table 2 shows the number of new jobs projected by detailed health care industry between 2012 and 2022.

Offices of health practitioners are projected to add more jobs—1.2 million—than any other type of health care employer. Some of this increase reflects expected cost-cutting efforts to shift demand for health services away from hospitals, which are relatively expensive.

Because hospitals make up a big portion of all health care employment, however, the number of new jobs in hospitals is still expected to be large over the decade.  

Home health care services is expected to grow faster than any other type of health care employer. In fact, it is projected to be the fastest growing detailed industry in the economy, with employment projected to increase by almost 60 percent between 2012 and 2022. As greater numbers of older people seek care that allows them to stay in their homes and maintain their independence, the need for workers in home health care services is expected to expand.

Occupations in health care

In addition to offering many opportunities, the health care industry offers plenty of career options. Healthcare workers perform tasks such as scheduling patient appointments, drawing blood for laboratory work, cleaning facilities, preparing food, diagnostic testing, and filling prescriptions.

The accompanying charts highlight occupations that BLS projects will add the most jobs in each of the detailed health care industries between 2012 and 2022. Additional job openings should arise because of the need to replace workers who retire or otherwise leave these occupations.

Employment and median annual wages shown in the charts are from the BLS Occupational Employment Statistics survey and are for wage and salary workers only. (The median is the point at which half of all wage and salary workers in the occupation made more than that amount, and half earned less.)

In each of the sections, the highest and lowest wages are for occupations with 1,000 jobs or more in the detailed industry in May 2012. For comparison purposes, the median annual wage for wage and salary workers across all industries in May 2012 was $34,750.

Understanding the charts

The BLS data in these charts show:

·       May 2012 employment in the detailed industry

·       May 2012 median annual wages in the detailed industry

·       2012–22 projected number of new jobs in the detailed industry.

This information is shown in a bubble chart. The larger the bubble, the more jobs there were in the occupation. The higher a bubble is on the chart, the greater the occupation’s wage. The farther to the right the bubble is, the more new jobs are projected for the occupation.

Hospitals                                   

Occupations in hospitals are diverse. The work is often shift-based, with weekend and holiday work sometimes required, because hospitals provide care 24 hours a day, 365 days a year.

            For example, registered nurse Heather Hahn works a 12-hour shift 3 days a week, mostly 7 a.m. to 7 p.m. Every 4 weeks she works nights for a week.

Employment. Some of the largest occupations—those that had at least 50,000 jobs in hospitals in May 2012—are in the following occupational groups.

Health technologists and technicians:


·       Licensed practical and licensed vocational nurses

·       Radiologic technologists

·       Medical and clinical laboratory technologists

·       Medical records and health information technicians

·       Medical and clinical laboratory technicians

·       Surgical technologists

·       Pharmacy technicians


Health diagnosing and treating practitioners:

  • Registered nurses

  • Respiratory therapists

  • Pharmacists

  • Physical therapists

Office and administrative support

  • Medical secretaries

  • General office clerks

  • Interviewers

  • Secretaries and administrative assistants, except legal, medical, and executive

  • Billing and posting clerks

Healthcare support:

  • Nursing assistants

  • Medical assistants

Building cleaning:

  • Maids and housekeeping cleaners

  • Janitors and cleaners, except maids and housekeeping cleaners

Management:

  • Medical and health services managers

Occupational wages. According to BLS, May 2012 median annual wages in hospitals ranged from $20,360 for dishwashers to more than $187,200 for surgeons, chief executives, anesthesiologists, and obstetricians and gynecologists.

Food preparation and serving occupations, such as cafeteria, food concession, and coffee shop counter attendants ($22,890), had some of the lowest wages in hospitals in May 2012. But hospitals also have many high-paying occupations. All of the occupations in the health diagnosing and treating practitioners group, for example—including nurse anesthetists ($161,920)—had median annual wages in hospitals that were higher than the median annual wage for all occupations.

Projected new jobs. BLS projects hospitals to add about 826,000 jobs between 2012 and 2022. Nearly one-third—about 262,000 jobs—are expected to be for registered nurses.

In addition to the occupations in chart 2, others that are projected to add many jobs in hospitals between 2012 and 2022 include radiologic technologists, maids and housekeeping cleaners, pharmacists, respiratory therapists, and medical and clinical laboratory technicians.

Offices of health practitioners

Workers in offices of health practitioners usually work a standard 9-to-5, Monday-through-Friday schedule. Some offices, however, are also open on weekends or in the evenings to accommodate patient schedules. And workers may be on call at other times to respond to emergencies.

Employment. Some of the largest occupations (those that had more than 50,000 jobs in offices of health practitioners in May 2012) are grouped as follows.

Office and administrative support:

  • Receptionists and information clerks

  • Medical secretaries

  • General office clerks

  • Billing and posting clerks

  • First line supervisors of office and administrative support workers

  • Secretaries and administrative assistants, except legal, medical, and executive

Health diagnosing and treating practitioners:

  • General dentists

  • Physical therapists

  • Family and general practitioners

  • Nurse practitioners

  • Physician assistants

Healthcare support:

Health technologists and technicians:

Occupational wages. BLS data show that May 2012 median annual wages in offices of health practitioners ranged from $20,240 for personal care aides to more than $187,200 for surgeons, general internists, anesthesiologists, obstetricians and gynecologists, orthodontists, and oral and maxillofacial surgeons.

Office and administrative support occupations, such as general office clerks ($27,130), accounted for many jobs and had relatively low wages in this detailed industry in May 2012. Health diagnosing and treating practitioners, including general dentists ($147,600), also had many jobs, but these occupations had some of the highest median annual wages of any occupations.

Projected new jobs. Between 2012 and 2022, BLS projects offices of health practitioners to add about 1.2 million jobs. Medical secretaries is projected to add the most jobs in this detailed industry: 123,800 jobs over the decade.

In addition to the occupations shown in chart 3, registered nurses, physical therapists, billing and posting clerks, and first line supervisors of office and administrative support workers also are projected to add many jobs in this detailed industry.

Nursing and residential care facilities

Like hospitals, nursing and residential care facilities provide care around the clock, so shift work is common. And schedules can include holidays and weekends. 

Employment. Some of the largest occupations (those with more than 50,000 jobs in nursing and residential care facilities in May 2012) are in the following occupational groups.

Healthcare support:

  • Nursing assistants

  • Home health aides

Food preparation and serving:

  • Nonrestaurant food servers

  • Institution and cafeteria cooks

Personal care and service:

  • Personal care aides

  • Recreation workers

Health diagnosing and treating practitioners:

  • Registered nurses

Health technologists and technicians:

  • Licensed practical and licensed vocational nurses

Building cleaning:

  • Maids and housekeeping cleaners

Community and social service:

  • Social and human service assistants

Occupational wages. May 2012 median annual wages in nursing and residential care facilities ranged from $18,560 for dining room and cafeteria attendants and bartender helpers to more than $118,380 for chief executives, BLS data show.

Many of the occupations in nursing and residential care facilities, including maids and housekeeping cleaners ($19,910), had wages that were lower than the median for all occupations in May 2012. Among the higher paying occupations are health diagnosing and treating practitioners, such as physical therapists ($85,950).

Projected new jobs. BLS projects about 760,700 new jobs to be created in nursing and residential care facilities over the 2012­–22 decade. Nursing assistants is projected to add the most jobs of any occupation in this detailed industry: 142,700 jobs over the decade.

In addition to the occupations in chart 4, other occupations projected to add many jobs in this detailed industry include nonrestaurant food servers, maids and housekeeping cleaners, institution and cafeteria cooks, social and human service assistants, and recreation workers.

Home health care services

Because home health care services involves visits to people's residences, many workers prefer these jobs to those with other types of health care employers. “When you work in home care, you spend time with patients in a more natural setting,” says Brummett. “And you tend to have more control over your schedule.”

Employment. In May 2012, five occupations accounted for nearly 80 percent of all jobs in home health care services. These occupations were the only ones with more than 50,000 jobs each in home health care services in May 2012, and they are grouped as follows.

Healthcare support:

  • Home health aides

  • Nursing assistants

Health technologists and technicians:

  • Licensed practical and licensed vocational nurses

Health diagnosing and treating practitioners:

  • Registered nurses

Personal care and service:

  • Personal care aides

Occupational wages. May 2012 median annual wages in home health care services ranged from $18,520 for personal care aides to $133,000 for chief executives, BLS data show.

Some of the largest occupations in home health care services—such as personal care aides ($18,520)—pay relatively low wages. Higher paying occupations, such as pharmacists ($110,730), accounted for fewer jobs.

Projected new jobs. Home health care services is projected to add about 715,700 jobs between 2012 and 2022, according to BLS. Home health aides is projected to add the most jobs—about 214,300—in home health care services over the decade.  

Other occupations projected to add many jobs in this detailed industry, in addition to those in chart 5, are general office clerks, medical and health services managers, physical therapists, healthcare social workers, and occupational therapists.

Outpatient, laboratory, and other ambulatory care services

Schedules and working conditions for occupations in this detailed industry vary. Jobs in outpatient care centers and medical and diagnostic laboratories, for example, often involve standard work hours in routine settings. In contrast, jobs in ambulance services can have unpredictable work hours and settings, because emergencies can happen anytime and nearly anywhere.

Employment. In May 2012, two occupations had more than 50,000 jobs each in outpatient, laboratory, and other ambulatory care services. By occupational group, they are:

Health technologists and technicians:

Health diagnosing and treating practitioners:

Occupational wages. According to BLS, May 2012 median annual wages in outpatient, laboratory, and other ambulatory care services ranged from $21,270 for personal care aides to more than $187,200 for psychiatrists, surgeons, and obstetricians and gynecologists.

Wages for health technologists and technicians—the occupational group with the most jobs in outpatient, laboratory, and other ambulatory care services—varied considerably. Psychiatric technicians ($23,610), for example, had relatively low median annual wages in this detailed industry in May 2012. But nuclear medicine technologists ($69,070) had median annual wages that were higher than the median for all occupations. 

Projected new jobs. BLS projects outpatient, laboratory, and other ambulatory care services to add about 522,300 jobs between 2012 and 2022. Registered nurses are projected to add the most jobs, about 59,800, in this detailed industry over the decade.

Although not shown in chart 6, medical secretaries, medical and health services managers, medical and clinical laboratory technologists, and substance abuse and behavioral disorder counselors are also projected to add many jobs in this detailed industry.  

Getting started in health care

There are lots of ways to start a healthcare career. Specific skills, education and training, and other preparation—such as licenses, certification, or registration—are often required.

Skills

Good people skills are essential, because healthcare workers spend a lot of time interacting with patients and colleagues. Workers also need patience and emotional stability. “You really have to care about people,” says Brummett. “It’s that compassion, that empathy, that makes people good at their jobs.”

It’s also important to be a team player, as healthcare workers collaborate when delivering care. Being able to communicate with people of diverse backgrounds is also key.

Education and training

Building the foundation for a healthcare career often starts long before you prepare for a specific occupation. As early as high school, you should study algebra, biology, chemistry, and related subjects. “Taking math and science classes is important to just about any health profession,” says Adams.

            In addition, many healthcare occupations require education beyond high school. The paths people take to enter an occupation, however, can vary. For example, radiologic technologists typically complete a 2-year associate’s degree program in radiologic technology, but some people complete a 1 to 2 year certificate program or a 4-year bachelor’s degree program.

There are lots of education programs out there for healthcare careers. Make sure a school’s credentials are up to date and that their program has a good reputation before you sign up. “Do your research,” says Hahn. “You don’t want to pay more than you should for a degree you need, only to find out that no hospital will sponsor you for a residency.”  

Some healthcare occupations require on-the-job training—such as a residency, employer-sponsored training program, or informal training combined with experience on-the-job—in addition to education. Other occupations require work experience in a related occupation.

BLS helps to clarify occupational requirements by assigning the typical level of education or training workers need to enter an occupation and attain competency.

Less than high school. Healthcare occupations that require less than a high school diploma often involve basic tasks, such as cleaning rooms, dressing and bathing patients, and preparing or serving food. All of the occupations listed here typically require short-term on-the-job training of 1 month or less.

  • Home health aides

  • Institution and cafeteria cooks

  • Janitors and cleaners, except maids and housekeeping cleaners

  • Maids and housekeeping cleaners

  • Nonfarm animal caretakers

  • Nonrestaurant food servers

  • Personal care aides

High school diploma or equivalent. With a high school diploma or the equivalent, your employment options are concentrated in office and administrative support.

Most of the occupations below require short-term on-the-job training, but there are a few exceptions. Medical secretaries, team assemblers, and pharmacy technicians typically need moderate-term on-the-job training (1 to 12 months), and first line supervisors of office and administrative support workers typically need fewer than 5 years of work experience in a related occupation.

  • Billing and posting clerks

  • First line supervisors of office and administrative support workers

  • General office clerks

  • Interviewers, except eligibility and loan

  • Locker room, coatroom, and dressing room attendants

  • Medical secretaries

  • Pharmacy technicians

  • Psychiatric aides

  • Receptionists and information clerks

  • Secretaries and administrative assistants, except legal, medical, and executive

  • Social and human service assistants

  • Team assemblers

Associate’s degree. Health technologists and technicians are among the occupations you can prepare for with an associate’s degree. Associate’s degree programs usually require at least 2 years of academic study beyond high school.

  • Dental hygienists

  • Medical and clinical laboratory technicians

  • Radiologic technologists

  • Registered nurses

  • Respiratory therapists

Postsecondary non-degree award. Some health technologists and technicians require a postsecondary non-degree award, such as a certificate. These programs may last from a few weeks to 2 years.

  • Dental assistants

  • Emergency medical technicians and paramedics

  • Licensed practical and licensed vocational nurses

  • Medical assistants

  • Medical records and health information technicians

  • Nursing assistants

  • Surgical technologists

Bachelor’s degree. You may qualify for several types of occupations in the health care industry with a bachelor’s degree, including those in management. To become a chief executive, you also typically need 5 years or more of work experience in a related occupation.

  • Chief executives

  • Medical and clinical laboratory technologists

  • Medical and health services managers

  • Recreation workers

Master's degree. Many health diagnosing and treating practitioners require education beyond a bachelor’s degree, such as a master’s degree (1 or 2 years of additional study).

  • Nurse anesthetists

  • Nurse practitioners

  • Occupational therapists

  • Physician assistants

Professional degree. Professional degrees include the M.D. for physicians and surgeons, Pharm.D. for pharmacists, D.D.S. for dentists, and DPT for physical therapists. Completing a professional degree program usually takes 3 or 4 years of study after earning a bachelor's degree.

Many of these occupations also require a residency—on-the-job training that is often required for state licensure or certification. Residency programs typically last from between 1 to 2 years for dental specialties and pharmacists to between 3 to 8 years for physicians and surgeons.

  • Anesthesiologists

  • Family and general practitioners

  • General dentists

  • General internists

  • General pediatricians

  • Obstetricians and gynecologists

  • Oral and maxillofacial surgeons

  • Orthodontists

  • Pharmacists

  • Physical therapists

  • Psychiatrists

  • Surgeons

Other preparation

Workers in some healthcare occupations need a state-issued license, certification, or registration. Other ways to get ready for a healthcare career include gaining firsthand experience and learning more about careers.

Licenses, certifications, and registrations. To work in some healthcare occupations—especially those that treat or care for patients—workers need a license, certification, or registration. Requirements may differ by state. For example, physicians and surgeons must be licensed in all states. But nursing assistants have varying requirements. In some states, they must be on a state registry; in others, they must become certified nursing assistants.

Earning a license, certification, or registration often involves completing an approved education or training program and passing a competency exam. Sometimes, workers must also pass a background check, and people with a criminal history might not be eligible to work in certain occupations.

             Career exploration. As with most industries, getting practical experience in health care is usually helpful for deciding on—or against—a career. “It’s not like what you see on TV,” says Hahn. “Some people get into it and discover it’s not for them.”

Volunteering, part-time jobs, and internships are great ways to get a feel for what health care work is really like—and to gain knowledge and start making contacts. “Ask family members or guidance counselors if they know of anyone who works in health care,” says Drake. “Start to network, and ask workers for informational interviews to find out about entry-level positions.”

The more you know about the occupations in health care, the easier it will be to identify those that best fit your interests and skills.  “Learn about what each of the health professions does,” says Adams. “A lot of times we have our own perceptions about what people do, which may not be accurate.”

Deciding on a healthcare occupation to pursue could be the starting point to a rewarding career. “Knowing that every day you’ve made someone’s life better," says Adams, "there’s a huge value to that.”

           

Sources for more information

Learn more about the occupations in this article, and hundreds of others, in the Occupational Outlook Handbook. You'll find the OOH online at www.bls.gov/ooh. Public libraries also have resources on careers, including those in health care.

For more about the BLS 2012–­22 employment projections, see the winter 2013-14 issue of the Quarterly, online at www.bls.gov/ooq/2013/winter/home.htm. Other Quarterly articles on related topics include the following:

  • "STEM 101: Intro to the future," spring 2014, www.bls.gov/ooq/2014/spring/art01.pdf

  • "Certificates: A fast track to careers," winter 2012, www.bls.gov/ooq/2012/winter/art01.pdf

  • "Medical physicists and health physicists: Radiation occupations," summer 2011, www.bls.gov/ooq/2011/summer/art02.pdf.

  • "Nursing jobs in nursing homes," spring 2011, www.bls.gov/ooq/2011/spring/art03.pdf

  • "Employment and wages in selected healthcare practitioner and technical occupations and healthcare support occupations, May 2008," (chart) spring 2010, www.bls.gov/ooq/2010/spring/oochart.pdf

The Virtual Career Network, a website sponsored by the U.S. Department of Labor and the American Association of Community Colleges, also helps you to research healthcare careers, get qualified, find job openings, and more. Visit www.vcn.org.

ExploreHealthCareers.org also has resources to guide you when considering a healthcare career. This site is a collaboration involving, the Federation of Associations of Schools of the Health Professions, the National Association of Advisors for the Health Professions, and the National Association of Medicine Minority Educators. Visit explorehealthcareers.org.  

Sidebar, near beginning of article:

Why does this article use both "health care" and "healthcare"? The North American Industry Classification System defines health care industries. The Standard Occupational Classification system defines healthcare occupations. Therefore, in this article and in other BLS discussions of industries and occupations, "health care" refers to industry classifications and "healthcare" to occupations and services.

Suggested citation:

Carol Dodson, "QCT Windows 2016 Migration OOQ Feature Article," Career Outlook, U.S. Bureau of Labor Statistics, August 2020.

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