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As the largest industry in 2002, healthcare provided 12.9 million jobs in the United States— 12.5 million jobs for wage and salary workers and about 382,000 jobs for the self-employed. Ten out of 20 occupations projected to grow the fastest are concentrated in health services. About 16 percent of all new wage and salary jobs created between 2002 and 2012 will be in health services— 3.5 million jobs, which is more than in any other industry. The majority of jobs require less than 4 years of college education, but health diagnosing and treating practitioners are among the most educated workers.
Health services 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 5 percent of employment. Other occupations in health services made up only 2 percent of the total.
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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. They may supervise other workers or conduct research, as well as provide services.
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.
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Service occupations attract many workers with little or no specialized education or training. Among 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 jobs in health services provide clinical services, but there also are many 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 services administration, some enter these jobs with a general business education.
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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 services industry. About 1 in 4 hospital workers is a registered nurse. Hospitals also employ many physicians and surgeons, therapists, and social workers. About 1 in 5 jobs is in a service occupation, such as nursing, psychiatric, and home health aide, or building cleaning worker. Hospitals also employ large numbers of office and administrative support workers.
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More than 3 out of 5 nursing and residential care facility jobs are in service occupations, primarily nursing, psychiatric, and home health aides. Professional and administrative support occupations are a much smaller percentage of employment than in other parts of the health services industry. Federal law requires nursing facilities to have licensed personnel on hand 24 hours a day and to maintain an appropriate level of care.
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Many of the jobs in offices of physicians are in professional and related occupations, primarily physicians and surgeons and registered nurses. A third of all jobs, however, are in office and administrative support occupations, such as receptionists and information clerks.
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More than half of all 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.
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Average earnings of nonsupervisory workers in most health services segments are slightly higher than the average for all private industry, with hospital workers earning considerably more than the average and those employed in nursing and residential care facilities and home healthcare services earning less. Average earnings often are higher in hospitals because the percentage of jobs requiring higher levels of education and training is greater than in other segments. Those segments of the industry with lower earnings employ large numbers of part-time service workers.
As in most industries, professionals and managers working in health services typically earn more than other workers in the industry. Earnings in individual health services occupations vary as widely as the duties, level of education and training, and amount of responsibility required by the occupation. Some establishments offer tuition reimbursement, paid training, child daycare services, and flexible work hours. Health services 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. Bonuses and profit-sharing payments also may add to earnings.
Earnings vary not only by type of establishment and occupation, but also by size; salaries thus tend to be higher in larger hospitals and group practices. Geographic location also can affect earnings.
Although unionization is more common in hospitals, the health services industry is not heavily unionized. In 2002, only 11 percent of workers in the industry were members of unions or covered by union contracts, compared with about 15 percent for all industries.
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As the largest industry in 2002, health services provided 12.9 million jobs—12.5 million jobs for wage and salary workers and about 382,000 jobs for the self-employed. Of the 12.5 million wage and salary jobs, more than 40 percent were in hospitals; another 22 percent were in either nursing or residential care facilities; and almost 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 workers were in offices of physicians, dentists, and other health practitioners—about 265,000 out of the 382,000 total self-employed.
Health services jobs are found throughout the country, but are concentrated in the largest States—in particular, California, New York, Florida, Texas, and Pennsylvania.
Workers in health services tend to be older than workers in other industries. They 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.
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Professional and related occupations, including physical therapists, occupational therapists, dispensing opticians, and chiropractors, accounted for about 2 in 5 jobs in this segment. Office and administrative support occupations also accounted for a significant portion of all jobs, about 34 percent.
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This segment of the health services industry employs a high percentage of professional and related workers, including counselors, social workers, and registered nurses.
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Because this industry segment includes ambulance services, it employs almost 2 out of every 5 emergency medical technicians and paramedics and a third of all ambulance drivers and attendants.
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Professional and related workers, primarily clinical laboratory and radiologic technologists and technicians, make up about 42 percent of all jobs in this industry segment. Service workers employed in this segment include medical assistants, medical equipment preparers, and medical transcriptionists.
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Average weekly hours of nonsupervisory workers in private health services varied among the different segments of the industry. Workers in home healthcare services averaged only 28.5 hours per week in 2002, while those in medical and diagnostic laboratories and other ambulatory healthcare services averaged 35.9 hours, compared with 33.9 hours for all private industry.
Many workers in the health services industry are on part-time schedules. Part-time workers made up about 16 percent of the workforce as a whole in 2002, but accounted for almost 38 percent of workers in offices of dentists and more than 21 percent of those in offices of physicians. Students, parents with young children, dual jobholders, and older workers make up much of the part-time workforce.
Many health services establishments operate around the clock and need staff at all hours. Shift work is common in some occupations, such as registered nurses. Numerous health services workers hold more than one job.
In 2002, the incidence of occupational injury and illness in hospitals was 7.4 cases per 100 full-time workers, compared with an average of 5.3 for private industry overall. Nursing care facilities and hospitals had much higher rates of 12.6 and 9.7 cases, respectively. Health services 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.
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1. Bureau of Labor Statistics, U.S. Department of Labor, Career Guide to Industries, 2004-05 Edition, Health Services, on the Internet at http://www.bls.gov/oco/cg/cgs035.htm (visited November 26, 2004).
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