Job Opportunities

Key Jobs

Physician
Doctors have long been at the peak of the health care pyramid. Although most medical students today will tell you that the industry has changed for the worse and that they'll be lucky to be able to pay back their school loans, physicians still get the most pay and respect in health care. But they also study the hardest; in most cases, a doctor must complete seven years of graduate school and residency before being certified to practice medicine and often more if he or she wishes to specialize.

There are currently more than half a million physicians in the U.S., of which about one-third are primary-care physicians. Most of the rest have some sort of specialty: surgery, neurology, anesthesiology, radiology, and so on. The demands of the work, the pay, and the lifestyle vary considerably from one specialty to another. Salary range: as low as $32,000 for residents to $180,000 and up for many practicing physicians.

Registered Nurse (RN)
The U.S. is facing a fairly severe nursing shortage brought on in part by lower nursing school enrollment and an aging workforce. On the one hand, it’s a good thing—lots of jobs, more leverage, and signing bonuses. On the other hand, it’s bad—diminished quality of care for patients and a heavier workload for those in the profession.

But, finally, nurses have proof to back up their argument that staff cuts and replacement of RNs with medical assistants and licensed practical nurses equals harm to patients, usually dismissed by managers and executives as “anecdotal” or as just complaints. The Journal of the American Medical Association documents the link between the increased risk to patients with decreases in nurse staffing as well as nurse burnout and job dissatisfaction. Investigators found that, when nurse caseloads exceeded four patients, the risk of patient death increased by 7 percent per extra patient, meaning if eight patients are under the care of one nurse, those patients are 31 percent more likely to die. This harsh reality will hopefully force the health care system to improve working conditions for nurses. Salary range: $40,000 to $65,000.

Licensed Practical Nurse (LPN)
LPNs make up the second-largest health occupation and is projected to be the fourth fastest-growing employment category of positions that require post-secondary or associate degrees. As with RNs, there is a shortage of LPNs, and employers report it’s taking more time to recruit and hire for this position, meaning more leverage and choice for the job seeker. In addition to jobs in hospitals, good job prospects exist in nursing homes, home health care services, medical centers, and ambulatory surgi-centers. Physicians' offices are also popular, particularly as more and more become outpatient clinics for orthopedics and other specialties. Salary range: $33,400 to $38,000.

Nurse Practitioner (NP)
This is a good career choice for those of you who have a master's degree and training in pediatrics or family health, but can't afford or don't want to go to medical school. In many states, NPs can prescribe medicine and are increasingly allowed primary-care status for basic health problems. Oxford Health and Columbia-Presbyterian Hospital pioneered these new responsibilities for NPs in the New York area, and HMOs elsewhere are following suit. Salary range: physician's rates for primary care; $60,000 to $70,000.

Medical Technician
A good career choice, particularly for those with IT and other computer skills. There's brisk demand everywhere in the country, particularly on the West Coast and in the Rockies, and in every type of facility—hospitals, medical labs, and anywhere else special tests such as electroencephalographs, MRIs, and CAT scans are administered. Budget cuts may come and go, but as is the case with so many other aspects of modern life, technical expertise commands its own price. Moreover, this is knowledge based on experience, not academic credentials; many technicians have only high school or college degrees, plus several years of specialized training. Salary range: $35,000 and up, with the best pay in nuclear medicine technology.

Physical Therapist
As the general population ages and athletes—weekend warriors or otherwise—continue to get injured, physical therapy becomes ever more popular. One unexpected drawback is that PT master's programs are in such demand that, according to one insider, "those interested in PT should start early, because it may take a few attempts to be accepted into a program—and you need to have a master's to get a job." For communities where managed care predominates, home care and nursing homes are better long-term bets; their focus is on the benefit, not the cost, of physical therapy for their patients. Salary range: $50,000 to $70,000 or more for those in private practice. PT assistants can expect to make between $26,000 and $40,000.

Health Care Managers
These are the jobs where an MBA comes in handy and a background in cost cutting, marketing, and information management will give you an edge over the competition. Lots of people want these jobs, and though industry observers predict that the number of managerial slots in hospitals and HMOs will shrink to perhaps half the current number, the need for qualified executive staff in home health care, nursing homes, and clinics is expected to more than make up the difference. Salary range: $55,000 on up. Experienced managers with an impressive track record in meeting and maintaining strict budgets can earn well over six figures.

Home Health Care Aides
This encompasses a wide spectrum from the high school student with minimal training who shops, cleans, and cooks part-time for an elderly or infirm patient to a full-time nurse who can perform many of the procedures available in a hospital and be on call 24 hours a day. Many states now require brief training and some form of certification for all such workers, but these regulations are difficult to enforce. This is where the jobs will be as the population ages and hospital facilities become less available, especially for long-term care. But bathing, dressing, feeding, and administering to the disabled and the very ill translates into difficult work. And not surprisingly, the biggest growth is at the bottom end of the pay scale. Salary range: $8 to $12 per hour—lowest for those without formal training or state certification—up to $25 to $50 per hour for aides with a BS in nursing.

Medical Secretaries
Mergers, budget cuts, financial and insurance misdeeds: None of these nor any of the other more permanent changes in the health care industry seem to have much affect on the patient souls who answer the phones, juggle all the canceled and emergency appointments, and comfort the tearful and frightened. Computer networking and sophisticated record-keeping skills are necessary these days, but these workers are an essential part of every doctor's office, clinic, outpatient center, and hospital. As with secretarial positions in other industries, training is usually done on the job, though classes in computers and administrative tasks will give you a leg up on the competition. Salary range: $25,000 to $40,000.

Getting Hired

Much depends on what aspect of this diverse and changing industry you choose to pursue. For anything involving a high level of medical or technical skill, you're going to need a lot of training and equal amounts of personal dedication. For the growing home care sector, training is less important than stamina, patience, and an empathy for the sick and elderly. Here are some things to consider before starting your job search: