For health-care professionals and aspirants, 2011 will be a building year. Health-care hiring may pick up a bit after slow growth in 2009 and 2010, but several factors will continue to constrain the creation of jobs and limit career mobility.
Still, health care continues to be the countercyclical career success story of the great recession. From the start of the downturn in December 2007 until September 2010, the health-care sector grew by 720,000 jobs while all other industries lost nearly 8.5 million jobs, according to an analysis of Bureau of Labor Statistics data by the Altarum Institute's Center for Studying Health Spending, a research and consulting organization.
And in the long term, health care is still expected to be a driver of broad economic expansion as well as a source for job growth. From 2008 to 2018, health-care and social-assistance employment will expand by nearly 4 million jobs, to 19.8 million, according to BLS projections.
The Economy Is Still a Drag on Health-Care Job Growth
Joblessness -- especially long-term unemployment -- is near its recent high, so consumers' lack of insurance and general belt-tightening are holding down health-care utilization.
"The economy is reducing the demand for nursing jobs," says Brenda Morris, senior director of baccalaureate programs at Arizona State University's College of Nursing and Health Innovation. "Patients are delaying elective procedures, and nurses are postponing retirement."
In a fiscal environment where many providers -- especially hospitals -- are in precarious condition, slack demand quickly trickles down to health-care employment. As the Altarum report notes, "The rate of growth in health-care employment fell considerably during the most recent recession, though it remained comfortably positive."
Hiring Picks Up -- Slightly
But there are signs that health-care hiring trends will improve in 2011 -- at least a bit. "We're seeing a very, very slight increase in openings in nursing and allied health," says Dennis Yee, a recruitment consultant at Children's Hospital Central California in Madera, California, and president of the National Association for Health Care Recruitment.
Entrants to health-care fields, even those that have suffered serious labor shortages for years, will likely continue to find their options limited. "It's taking our graduates longer to find a job," Morris says. "They're often not able to get their first or second choices, and it's very difficult to get a first job in specialties like pediatrics, perinatal or ICU." Many nursing graduates take a med/surg starter job by default, she says.
Still, 65% of new BSN grads had a job offer upon graduation in 2010; four to six months later, 89% had secured offers, according to a survey by the American Association of Colleges of Nursing.
"The educational requirements for some jobs have been raised," Yee says, with some physical therapy and rehabilitation jobs, for example, now requiring a doctorate. In nursing, "the advantage of a baccalaureate over an associate's degree in nursing has gotten greater," Morris says.
Despite Politics and Court Battles, Reform Likely Will Create Jobs
The 30 million Americans who are scheduled to gain insurance coverage under health-care reform will double their use of health care, which should drive hiring, says Charles Roehrig, director of the Altarum center.
But clouds of doubt continue to swirl around the Patient Protection and Affordable Care Act. "Hospitals don't know what's going to happen with health-care reform -- what will stick, what Congress will do," says Peter Ferguson, senior vice president of health and life sciences at Yoh, a Philadelphia-based recruitment and staffing firm. Ongoing legal challenges to health-care reform virtually guarantee the uncertainty will continue for years.
Yet "health-care executives are behaving as if they expect reform to happen," Roehrig says. Hospitals, for example, are beginning to buy up primary-care groups.
"Under health-care reform, there will be more opportunities for professionals who supply more physician services without increasing the number of physicians -- nurse practitioners, physician assistants and medical assistants," Roehrig says. However, state and federal budget deficits will constrain hiring somewhat for the foreseeable future, largely due to cuts in Medicare and Medicaid funding. "And with incentives to keep hospital costs down, the rate of growth in hospital employment is likely to stay low," he adds.
For his part, Yee says he's taking a more short-term view. "We're more focused on our immediate needs that we can [grasp], versus health-care reform over the next few years," he says.
Still, many health-care occupations are projected to expand mightily over the coming decade. Among the 30 jobs projected to grow the fastest from 2008 to 2018, seven are in health-care: RNs (582,000 more jobs); home-health aides (461,000); personal and home-care aides (376,000); nursing aides, orderlies and attendants (276,000); medical assistants (164,000); licensed practical nurses/licensed vocational nurses (156,000); and physicians and surgeons (144,000).
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