CHAPTER 1
HEALTH CARE
Even in the worst economic climate, there are certain constants you can counton. Among them is the fact that people will still get sick, people will stillget hurt, and people will still grow old. Certainly no one is going to stopaging or catching colds just because the Dow dropped another 600 points. As longas people continue to have health needs, they are going to require an industryto take care of them.
As health care continues to evolve with technological advances and clinicaldevelopments, Americans are generally living longer than ever before. In theUnited States alone, 13,000 individuals are expected to turn 60 each day overthe next 20 years. With our aging population requiring more and more healthcare, advances in medical technology that have improved the survival rates oftrauma victims and the severely ill, and retiring baby boomers projected toleave thousands of vacancies in the field over the next 10 years, opportunitiesin the health-care industry aren't drying up anytime soon. In fact, in February2009, while the recession was cutting away another 650,000 jobs, employment inhealth care actually grew by 30,000 jobs. According to the Department ofLabor, some 413,000 jobs were added to the field over the 12-month periodbetween May 2008 and April 2009, and there are no signs of this growth stopping.
Because of our nation's increasing needs, health care has become the singlelargest industry in the United States. With the consideration of theprofessional workforce and the ancillary jobs within the industry, it'sestimated that 1 in every 11 U.S. residents works in the health-care business.Furthermore, the need for more workers is increasing so drastically that healthcare is expected to generate 3,000,000 new jobs by 2016, more than any otherindustry.
The face of the health-care industry is one everybody knows well: doctors,nurses, ambulance drivers, hospital staff, and so on. Yet within the industry,there are actually hundreds of different roles that need to be filled in orderto keep up with the growing demand for health care, roles that can be foundwithin the approximately 580,000 establishments across the country that composethe health-care industry.
The best known and most visible health-care establishment is, of course, thehospital. Every year, hospitals provide vital health-care services for anestimated 700 million people, services that include everything from emergencycare to surgery to delivering babies. As a result, hospital care makes up thelargest component of the health-care sector. With the industry in totalrepresenting about 16 percent of the gross domestic product (GDP)—ameasure of economic output—or approximately $2.1 trillion, hospitals aloneaccount for $648 billion of that total. With numbers like these, it's easy tosee why the health-care industry is an economic mainstay, providing stabilityand growth even during times of recession.
A report by the American Hospital Association in 2006 concluded that hospitalsare among the largest employers in many communities, employing more than 5million people and spending about $286 billion on goods and services in additionto employee wages. Taken on a national scale, this means each hospital jobactually supports almost two additional jobs, and every dollar spent by ahospital supports more than $2 of additional business activity. Counting theseripple-effect benefits to the community, hospitals support nearly $1.9 trillionof economic activity across the United States. This makes hospitals not only alarge, established source of employment providing jobs for a wide range of skilllevels, but it also makes hospitals a stable source of employment growth despiteeconomic turmoil. Hospitals employ workers with all levels of education andtraining, from highly skilled physicians, surgeons, nurses, therapists, andsocial workers to lower-skilled workers in a variety of support positions.Roughly 3 out of every 10 hospital employees are registered nurses, while about1 out of 5 employees are in a service occupation, such as nurses' assistants,psychiatric care staff, and home health aides. Earnings of hospital workers, onaverage, tend to be higher than those of workers in most other sectors of theservice industry. Additionally, hospitals also furnish benefits like healthinsurance that are often lacking in other jobs available to lower-skilledworkers, such as retail or other service jobs.
Facing a shortage of skilled workers, hospitals are currently investing inworkforce development and retention activities. Some hospitals offer tuitionreimbursement programs, partner with local colleges to provide training programsfor employees to update or develop their skills, or implement mentoring programsfor less experienced staff.
It might surprise you to learn that although hospitals employ 34.8 percent ofall health-care workers, they only constitute about 1 percent of all health-careestablishments. An amazing 87.1 percent of health-care establishments areactually the smaller, more widely distributed establishments that when takentogether are known as ambulatory health-care services. These establishmentscollectively employ 42.2 percent of workers in the industry, even more thanhospitals. They include the following:
• Physicians' offices, which employ 17.1 percent of workers in the industry.Many of the jobs in these offices are in professional and related occupations,primarily physicians, surgeons, and registered nurses. However, about two out ofevery five jobs in physicians' offices are in administrative supportoccupations, such as receptionists and information clerks.
• Home health-care services employ 6.9 percent, primarily registered nurses,physical therapists, home health aides, and personal and home-care aides toprovide skilled nursing and medical care in the home for the elderly and infirm.
• Dentists' offices employ 6.3 percent, primarily dental hygienists and dentalassistants. With demand for dental care on the rise due to population growth anda greater retention of natural teeth by the middle-aged and elderly, largerpractices are more likely to employ office managers and administrative supportworkers as well as to help meet their increased workloads.
• Other health practitioners' offices—such as chiropractors, optometrists,podiatrists, occupational and physical therapists, psychologists, audiologists,speech-language pathologists, dietitians, acupuncturists, homeopaths, andhypnotherapists—employ 4.6 percent. While two in five jobs here areprofessional and related occupations, office managers and technical andadministrative support positions make up the rest.
• Outpatient care centers, which include diverse establishments like kidneydialysis centers, outpatient mental health and substance abuse centers, HMO(health maintenance organization) medical centers, clinics, and freestandingambulatory surgical and emergency centers, employ 3.9 percent, mostlycounselors, social workers, and registered nurses.
• Other ambulatory health-care services, composed of everything from ambulanceand helicopter transport services, to blood and organ banks, to pacemakermonitoring services and smoking cessation programs, employ 1.7 percent of theindustry, approximately half of which are emergency medical technicians (EMTs),paramedics, and ambulance drivers and attendants.
• Medical and diagnostic laboratories, which provide supplemental services likeanalyzing blood or taking X rays, employ 1.6 percent of the industry.Professional and related workers, primarily clinical laboratory and radiologictechnologists and technicians, are joined here by services workers such asmedical assistants, medical equipment preparers, and medical transcriptionists.
After hospitals and ambulatory health-care services, the remaining 23 percent ofemployment in the health-care industry comes from nursing and residential carefacilities. About two out of three jobs in these facilities are in serviceoccupations, primarily nursing, psychiatric counseling, and home healthaides—a much higher ratio of service workers to professionals than existsin other health-care establishments. Because federal law requires all nursingfacilities to have licensed personnel on hand 24 hours a day in order tomaintain an appropriate level of care, these establishments tend to employ largegroups of workers. These establishments include the following:
• Nursing care facilities, which provide inpatient nursing, rehabilitation, andhealth-related personal care to those who need continuous nursing care but donot require hospital services, employ 12.6 percent of health-care workers.
• Community care facilities for the elderly, which employ 5 percent.
• Residential mental health facilities, which employ 4 percent.
• Other residential care facilities, such as alcohol and drug rehabilitationcenters, group homes, and halfway houses, which employ 1.3 percent.
Employment in the health-care industry will continue to boom for severalreasons. The number of people in older age groups, with much greater thanaverage health-care needs, is projected to grow faster than the total populationby 2016, and as a result, the demand for health care will only increase.Employment in home health care, nursing, and residential care will also increaserapidly as life expectancies rise, and as aging children are less able to carefor their parents and rely more on long-term care facilities. Advances inmedical technology will continue to improve the survival rate of severely illand injured patients, who will then need extensive physical therapy and recoverycare. New technologies are also making it possible to identify and treatconditions that were previously untreatable. Medical group practices andintegrated health systems are poised to become larger and more complex,increasing the need for office and administrative support workers. Industrygrowth will also occur as a result of the shift from inpatient to less expensiveoutpatient and home health care, thanks to improvements in diagnostic testingand surgical procedures, as well as an increasing number of patients who wish tobe treated at home.
Not that this means you have to rush off to medical school for four years topursue an expensive M.D. degree. There are plenty of opportunities availablethat you can take advantage of a lot faster and without having to make anenormous monetary investment. Your existing skills could translate quite easilyto a job in the health-care industry, as the field has a constant need forprofessionals with diverse backgrounds, including accounting, management,finance, communications, law, science, administrative services, and informationtechnology, particularly now with President Obama's push to get health-carerecords digitized, which could create as many as 50,000 new tech jobs.Opportunities also exist for workers in custodial, non-emergency patienttransport, and food services roles, especially in hospitals and largerhealthcare establishments.
If you are looking to learn new skills and become a licensed health-careprofessional, there's good news on two fronts. First, grants totaling nearly $50million are being funded across the nation to help workers prepare for careersin the health-care industry. Second, many of the occupations projected to growthe fastest in the economy are concentrated in the health-care industry. Forexample, total employment of home health aides—including the self-employed—isprojected to increase by 49 percent in the next six years.Medical assistants are projected to grow by 35 percent, physical therapyassistants by 32 percent, and physicians' assistants by 27 percent.
According to the Council on Physician and Nurse Supply, an independentconsortium of health-care leaders based out of the University of Pennsylvania,the demand for registered nurses (RNs) is the fastest growing in the industry.An estimated 30,000 RNs are needed to enter the workforce each year to meet thenation's growing health-care needs. However, as the median age of registerednurses increases, not enough younger workers are replacing them, and as aresult, employers in some parts of the country are reporting difficulties inattracting and retaining nurses. The imbalance between the supply and demand forqualified workers should spur efforts to attract and retain qualified registerednurses, including higher pay and subsidized training.
As our nation's populace continues to age, the need for physical therapists,especially in the home-care field, is also booming. Employment for physicaltherapists is expected to grow an astonishing 27 percent in the next six years.In addition to the aging population, this growth is also spurred by theimpending retirement and age-related health issues of the baby boomergeneration, increasing numbers of children who will need physical therapy astechnological advances save the lives of a larger proportion of newborns withsevere birth defects, a higher percentage than ever before of trauma victimsurvival, and advances in medical technology that will permit the treatment ofan increasing number of disabling conditions that were untreatable in the past.Assisting in the rapid growth of this occupation is that fact that in order tokeep expenses low, some hospitals and doctors are referring their patients tooutside physical therapy centers instead of performing the therapy in-house, aswell as the fact that insurance companies are now required by law not to limitthe coverage for physical therapy claims.
Opportunities for physical therapists exist both in and out of the hospitalsetting, extending to clinics, rehabilitation centers, nursing homes, sportsmedicine facilities, adult daycare facilities, outpatient care centers, wellnesscenters, doctors' offices, schools, research centers, privately owned physicaltherapy businesses, and self-employment.
Related Growth Industries
A variety of supplemental occupations and industries are also riding the health-care boom to increased growth, serving the needs of health-care workers andpatients alike.
Pharmacists
Chief among the related growth occupations are pharmacists. One side effect ofthe general populace living longer is an increasing number of middle-aged andelderly people who rely on prescription drugs. As the use of prescription drugsincreases, the demand for pharmacists is growing in a variety of practicesettings, such as community pharmacies, hospital pharmacies, and mail-orderpharmacies. As the population continues to age, assisted living facilities andhome-care organizations are also seeing particularly rapid growth in the needfor pharmacists. According to the Bureau of Labor Statistics, this increaseddemand will drive employment of pharmacists to grow by an estimated 22 percentover the next six years.
Not all pharmacists stand behind a counter and hand out pills. Some cost-consciousinsurers, in an attempt to improve preventative care, are making useof pharmacists in areas such as patient education and vaccinationadministration. Similarly, managed-care organizations are hiring pharmacists toanalyze trends in medication use and to study the cost and benefit analysis ofdifferent drug therapies. New pharmacist jobs are also being created all thetime in disease management—the development of new methods for curing andcontrolling diseases—and in pharmacy informatics, which is the applicationof computers to the storage, retrieval, and analysis of drug and prescriptioninformation in order to ensure pharmacists make the best possible decisionsabout drug therapies.
Medical Equipment and Supplies
Another industry being lifted along with health care, especially as newtechnologies and treatments are developed, is the medical equipment and suppliesfield. Roughly 15,000 companies across the nation currently employ some 423,000workers to design, manufacture, sell, and distribute medical instruments, labapparatus, dialysis equipment, prosthetic appliances, machinery—even low-techsupplies like syringes, catheters, and bandages. Home delivery of medicalsupplies is on the rise as well. No matter the state of the economy, people willalways need their diabetic testing supplies, ostomy supplies, and painmanagement products delivered to them.
This $100-plus billion industry also happens to be one of the country's largestexport industries, with an additional estimated $14 billion in internationalsales. This too will only increase as the world's population continues to livelonger and have more health-care needs.
As the inherent demand for health care continues to grow, so will the demand forthe tools and technologies through which health care is administered. As themedical equipment field expands, it is poised to increase job opportunities foreveryone from office professionals, engineers, mechanics, and manufacturers tosales reps, customer service professionals, and delivery and installationpersonnel.
Taken as a whole, the health-care industry offers a stable and lucrative sourceof employment with a consistently growing need for new, qualified personnel.Furthermore, as our nation's health needs increase and evolve, health care willremain a thriving career opportunity well into the future. In the appendix,you'll find a comprehensive list of health-care career resources, includingcertification courses, industry news, and job sites, and information on how toapply for related grants, scholarships, and loans.
CHAPTER 2
BIOTECHNOLOGY
Biotechnology, or biotech for short, may sound like something out of sciencefiction, but it has actually been around for millennia, ever since the earliestcivilizations crossbred their domestic animals and genetically engineered theircrops. Biotech refers to any technology that uses biological systems, organisms,and their derivatives to make or modify products, and the modern biotech fieldhas applications in everything from food science to genetic research. However,today's biotech industry is primarily concerned with the manufacturing ofmedicine and pharmaceutical drugs.
In the previous chapter on health care, we discussed our aging population'sescalating health needs driving that sector of industry into unprecedentedgrowth. As those needs continue to grow, the creation of new drugs is one of thefactors driving the health-care boom, and the result is that the biotechindustry has seen the largest number of new venture-capital investments inrecent years. As a necessary and cutting-edge development field, biotech is alsoone of the industries that has the been specifically targeted for the Obamaadministration's Recovery Act stimulus funding on both the state and federallevel, including tax credits, grants, and loan programs that will ensure theindustry's vitality and create thousands of new jobs. Increased growth is alsoexpected with the Obama administration lifting the restrictions on embryonicstem cell research, as well as the U.S. Food and Drug Administration's (FDA's)approval of clinical trials for drugs based on stem cell research.
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