An aging population, technological advances and cost-containment efforts will all have a significant effect on the healthcare industry over the next decade. What does this mean for people seeking positions in this sector? The Bureau of Labor Statistics (BLS) projects that 3.1 million new jobs will be created by 2006 in this sector. Although the demand is high for professionals in a variety of healthcare occupations, the industry is facing a labor shortage.

"Many people are asking, 'With our baby boom generation getting older, what will happen with healthcare?'," states Bill Styring, an economist with Indianapolis-based Hudson Institute. Styring predicts there will be a tremendous rise in the area of geriatrics as well as home healthcare services. According to the Administration on Aging, Styring's forecast is accurate. It reports that the number of people age 65 and over will reach 34.7 million by next year and as much as 53.2 million by 2020. Styring, who is also the author of Health Care 2020: The Coming Collapse of Employer Provided Health Care, says that the employment demand will be in many different areas such as physical therapy, occupational therapy, speech pathology and nutrition.

Employment opportunities for physical therapists, occupational therapists and speech pathologists can be found not only in hospitals but in outpatient rehabilitation centers, nursing homes, home health agencies and schools. Many are also attracted to working in private practice or with consulting groups.

The aging population will create the need for more professionals in nursing homecare and home healthcare. Traditionally women have taken care of their parents; however, with so many in the work force now that isn't always possible. As a result of this and the drain on Medicaid funds by nursing homes, more families are turning to home healthcare. Unfortunately, there aren't nearly enough people to fill all of the vacant positions in the home healthcare arena. In an effort to alleviate the shortage, the U.S. House of Representatives recently passed the H-1C bill authorizing temporary work visas for as many as 500 licensed, foreign nurses. The bill restricts the nurses to working in understaffed hospitals, mainly in inner city and rural areas, for up to five years.

Hospitals continue to be the largest employers of Registered Nurses (RNs), but employment growth is expected to slow due to the stabilization of inpatients. However, with demand coming in other areas outside of the hospital setting, by next year it is expected that more than 300,000 nurses will be needed nationwide. "We will see a shortage of critical-care nurses," says Jeff Cutruzzula, senior vice president of the Healthcare Division with The Armstrong Group, in Pittsburgh. This shortage will drive starting salaries up for nurses. Currently, RNs with five years of experience earn anywhere from $22 an hour to $30 an hour, he says.

Although RNs make up the largest group of healthcare professionals, there is a definite lack of new blood entering this profession. According to Bethesda, Md.-based Health Trends Inc.'s 1999 Industry Outlook, in 1996 (the latest data available) the average age reached 44.3 years and women continue to dominate the profession.

The need for physicians is also on the rise and their salaries are going up due to the shortage. In a 1997 study conducted by Health Trends Inc., the median net earnings for all physicians were $160,450, with a range from $86,640 for general practitioners to $288,830 for neurosurgeons. Among physicians in partnerships and groups, net earnings were highest for physicians in a group of five to nine physicians, at $217,040.

Physicians shouldn't only look for positions in urban areas. There is a large need in rural America. Tennessee-based LifePoint Hospitals Inc. owns and manages 23 hospitals in nine states, including Alabama, Florida, Georgia, Kansas, Kentucky, Louisiana, Tennessee, Utah and Wyoming, primarily in rural markets where the LifePoint system is the only hospital in the community. One of the organization's key focuses is physician recruitment. LifePoint reports that 103 physicians were successfully recruited at the end of its second quarter.

According to John Von Arb, director of compensation and benefits at LifePoint, the organization is attempting to reduce out-migration in these hospitals by instilling a community trust that residents don't have to travel to large cities to get the care they need. He adds that the aging boomers will most definitely impact the rural healthcare market.

Huge costs due to inpatient care have brought about a trend toward outpatient and other nontraditional providers. Today, because many procedures are done on an outpatient basis, there are hospital outpatient facilities designed for same-day surgery, rehabilitation and chemotherapy. Due to this, employment opportunities in different outpatient services have skyrocketed.

Health technology is growing by leaps and bounds. Some of the areas health technology is focusing on include mapping the human genome, gene therapy and conflicts between new assisted-reproduction techniques and bioethics. According to Tampa, Fla.-based Romac International Inc., increased use of innovative medical technology for "intensive diagnosis and treatment will create more opportunities within the outpatient settings, such as ambulatory surgery, physician offices and rehabilitation centers." Some of the areas that will thrive from technological advancement include radiology's MRI (magnetic resonance imaging), laser surgery, ultrasound and diagnostic testing.

Other areas in this sector that will experience overwhelming growth include administrative positions and clinical case managers. Support-service managers, operations managers and professionals in practice management are being highly pursued. Because disease management is a booming area of practice, clinical case managers will also be needed, says Ted Schwab, president and partner with Los Angeles-based Sokolov, Schwab and Bennett, a healthcare-management and consulting firm. Schwab explains that instead of an older patient going from specialist to specialist for his or her diagnosis and treatment, the case manager will guide the individual through the healthcare system to make the process easier.

As for the future of the industry, Peter Alonso, Romac Healthcare president with Tampa-based Romac International Inc., predicts this sector will run more like a business. "It will grow at an astronomical rate," he says. "It will become more efficient and sophisticated." One thing is certain. With the growing population and never-ending need for healthcare services, this sector gets a clean bill of health. - SHERRI PFEIL, Staff Writer

Fast-growing occupations in healthcare