According to the Bureau of Labor Statistics, more than 11.3 million Americans are employed in some aspect of health care, and approximately 14 percent of all wage and salary jobs created in the last decade are in health services. Following is a list of the industry’s major employers:
Medical centers and community hospitals
These large organizations, owned by private investors, educational institutions, churches, or communities, are composed of departments that handle different medical specialties. Institutions such as Massachusetts General Hospital and Johns Hopkins Medical Center provide extended-stay care, specialty surgical procedures, and treatment for extremely rare diseases. Some hospitals are expanding into home health care services.
Hospitals and medical centers provide a broad range of health care services, and they employ many entry-level workers as support staff. Administrative assistant, clinical lab assistant, volunteer services coordinator, medical assistant, nurse’s aide, and physical therapist aide are some of the positions available to recent grads.
“Everything is moving to outpatient home health care. People don’t stay in hospitals anymore because the push is to get people out quickly and send home care to them. Today, hospitals and insurance companies want only the sickest of patients in hospitals for a limited number of days.” – Volunteer Services Coordinator, Community Hospital
Managed care organizations
A managed care organization provides an agreed-upon set of services, both for health maintenance (staying well) and for treatment. The services available through an HMO (health maintenance organization) or PPO (preferred provider organization) are no different than those available from a hospital or medical center, however, the payment for those services is what makes an HMO or PPO different.
In order to reduce the overall cost of health care, managed care plans “contract” with value providers who agree to offer care for a fixed price, using practices like diagnostic related groups and rebundling. Companies like Aetna-U.S. Healthcare and Kaiser-Permanente lead the managed care field. Half of all practicing physicians contract with at least one managed care program.
For physicians, salaried jobs in managed care organizations offer regular hours and the opportunity to consult with peers. Salaried positions are also attractive to young doctors who can’t afford the high cost of medical malpractice insurance or the start-up costs of founding a private practice while paying off med school loans.
Managed care companies vary in size and in the number and type of entry-level opportunities they offer. Similar to hospitals and medical centers, managed care companies need support staff in many of their departments. New grads can also easily get involved in the business side of health care at a managed care company by working in the financial, customer service, marketing, or communications departments.
“Most health care specialists are affiliated with HMOs because HMOs take care of overhead expenses and provide their staff with a steady income and regular hours. An HMO is a very open environment. Direct, honest communication is valued rather than just doing what someone tells you to do. Unlike more traditional settings, you depend less on established practice and more on innovation. You will work very hard. You will look for ways to service a growing number of people better and faster than your competitors. The environment is changing. No one knows what the industry will look like in five years.” – Marketing Manager, Harvard Pilgrim Healthcare
Extended care facilities
Also known as nursing homes, extended care facilities serve as an alternative to long-term hospitalization for patients who can no longer care for themselves. Patients in extended care facilities are often older, or they may have a condition that prevents them from living an independent life. Entry-level positions include administrative assistant, nurse’s aide, physical therapist aide, social worker, mental health counselor, fitness instructor, and health educator.
The large majority of patients in extended care facilities are older, and with the aging of the U.S. population, that probably won’t change. The number of those aged 85 and older will nearly triple between now and 2030- from 3 million to more than 8 million. To provide for the growing geriatric patient base, extended care facilities are adding services such as adult day care, home care, and rehabilitation. One offshoot of this is the trend toward assisted living facilities which offer home-like, independent settings for elderly residents.
“Working in a nursing home is not for everyone. You greet the same patients, hear their stories…it’s not like a hospital where people are in transition. You deal with depressed patients and anger. I like it because I can build relationships with these people. They have been caring for younger people all their life, and here we can ‘do’ for them.”-Nursing Home Volunteer
Home health care services
Home health care services are mainly designed for the elderly. Skilled nurses and other care providers- under a physician’s supervision-visit patients’ homes to provide services. This trend is one of the fastest growing in the U.S. economy, according to the Bureau of Labor Statistics.
Clinics and community health centers
Although community health centers and clinics perform hospital procedures, they focus on community education, disease prevention, and outpatient care. Some clinics are privately-owned, for-profit centers, such as the Mayo Clinic in Minnesota, which specializes in cancer treatment. Government-owned health centers serve people who cannot otherwise afford medical care. Because they have relatively small staffing needs and tight budgets, these facilities fill fewer entry-level positions than hospitals do, and rely heavily on volunteers. Entry-level employees at clinics must handle a broad range of responsibilities and are expected to learn a lot while on the job. Community health centers offer resourceful grads the opportunity to gain experience quickly and to have a positive impact on a community. One advantage to a position with a clinic or health center is the regular daily schedule; although employees often take turns being “on-call” for emergencies during their off-duty hours.
“In primary care, you have a defined patient population; these are your patients, you take care of them, and they see specialists from time to time. To me it’s much more rewarding to confront a clinical problem: this is what I need to treat, I do it right now, do it well, dictate my report, and that’s it-I move onto something else.” -Radiologic Technologist, community clinic
Independent testing or research labs
In the past, health care providers often had testing labs in their offices, which has become an increasingly expensive way to operate. To control those costs, hospitals and medical centers “outsource” their lab work, sending patient samples to independent labs for testing. Few independent commercial labs hire college grads without specialized training for direct test work, but entry-level positions in data entry and administration provide exposure to the lab environment. University, government, and industry-related research labs hire recent grads as lab assistants, research assistants, and clinical data managers, especially if the applicants have had previous lab experience in college science courses.
“I think a common misconception is that scientists rush around in white coats discovering exciting things all the time. Only occasionally do we do those exciting experiments and only even more occasionally do we get interesting results! Just like the corporate world, science rewards accomplishments. If you discover a novel mechanism by serendipity, that’s just as good as slaving for years.” – Independent Lab Researcher
Physicians who set up private practices must combine health care with business management. They rent or own office space, hire administrative and medical support staff, and purchase diagnostic equipment, such as x-ray machines. The advantages of private practice are that providers determine their own pricing for services and make their own hours, unlike salaried doctors in HMOs. Positions for recent college grads in private offices are generally limited to reception or volunteer work. Working in a small office, even in a limited capacity, exposes you to both the clinical and the managerial aspects of care.
“I certainly like the freedom that comes with managing my own time, but it can be a double-edged sword. With increased staff comes a lot of management requirements: training new staff, responding to emergencies, evaluating new products. It’s difficult to be three places at once.” – Dentist, private practice
Public health agencies
The National Institutes of Health, the Centers for Disease Control, the Food and Drug Administration, and the federal or state departments of public health study the causes and effects of large disease outbreaks, environmental problems, and other health hazards. Straddling the health care and government fields, these organizations need people with varied backgrounds. Federal or state department of public health employees see the process of policy-making from up close, which can be a useful experience for later positions inside or outside of the health care industry. As certain diseases spread and pose a threat to the health and safety of large numbers of people, the demand is growing for specialists in environmental science and epidemiology. Of the thousands employed in public health, many begin in health education, health policy research, social services, environmental inspection, and administration.
“Given my interest in the structure of the system, I chose health policy. This involves clinical decision making instead of treating patients. For example, instead of performing Pap smears, evaluating the adequacy of them: How many women are having Pap smears, and why? What do the results mean?” – Health Policy Analyst, Yale School of Public Health
As you can see, there are many opportunities for educated candidates to enter the healthcare industry. It’s not just an industry for premed majors. Opportunities abound for college grads who are willing to contribute their creativity and ambition.