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Health Occupations

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 3 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-year 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.

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.

Working Conditions

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 26.9 hours per week in 2004, while those in psychiatric and substance abuse hospitals averaged 36.4 hours, compared with 33.7 hours for all private industry.

Many workers in the health care industry are on part-time schedules. Part-time workers made up about 20 percent of the workforce as a whole in 2004, but accounted for 39 percent of workers in offices of dentists and 33 percent of those in offices of other health practitioners. Students, parents with young children, dual jobholders, and older workers make up much of the part-time workforce.

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.

In 2004, the incidence of occupational injury and illness in hospitals was 8.7 cases per 100 full-time workers, compared with an average of 5.0 for private industry overall. Nursing care facilities had a much higher rate of 10.1. 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.