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By Monica E. Oss

Recruiting is usually on the list of strategic issues for managers of health care provider organizations. And for good reason. Between 2000 and 2016, while overall private sector employment grew by 9.8%, health care employment grew by 42.0%. This caused health care services’ share of total private sector employment to rise from 9.8 percent in 2000 to 12.6% in 2016 as reported in a report by Deloitte, Driving Healthy Employment Growth: A Look at Occupations in Health Care. In raw numbers, U.S. health care employment rose by 4.6 million jobs.

So where was the growth in health care employment? The Deloitte analysis looked at five sub-sectors: outpatient care centers, hospitals, home health agencies, physician offices, and skilled nursing facilities. The highest growth as a percentage was in home health care services, a 115.1% increase. But the highest growth in numbers was in hospital employment, from 4,000,000 to 5,000,000 employees. Hidden in the Deloitte analysis are some interesting changes in health care employment over this time period:

  1. Different sectors of the health care field have different employment demands, and not surprisingly. Outpatient care centers and hospitals had the highest proportion of highly-skilled clinical professionals (65% and 68%, respectively) which Deloitte defined as physicians, registered nurses, physicians, and therapists. Home health care services and nursing care facilities had a lower proportion of the highly-skilled professionals, but a higher proportion of lower-skilled aide occupations.
  2. Physicians’ offices have a high proportion of highly-skilled clinical professionals (50%) and a large segment of office workers (32%). Physicians accounted for 17.8% of those working in a physician’s office setting (marking a decrease from 19.9% in 2000). Other reported decreases? Secretaries and administrative assistants and office supervisors; while medical assistants, billing and posting clerks, and medical and health services managers saw increases.
  3. In hospital settings, the proportion of physicians and nurses increased, while the proportions of health aides, secretaries, and administrative assistants decreased.
  4. The nursing facility segment had growth rates below the national average but saw an increase in the proportion of nurses. The proportion of health aides and medical aides declined.
  5. Home health care employment doubled between 2000 and 2015 – and the proportion of personal care aides more than doubled (10.4% to 25.4%).

These changes in employment patterns are reflective of the changes in the health care delivery system. High-cost care settings – hospitals and nursing homes – saw an increase in the proportion of highly-skilled clinical staff, reflecting the increasing acuity of consumers in those facilities. The growth of employment in the home health care system – doubling in size in 15 years – is a byproduct of the move to support consumers in the community and in their homes. In physician offices, like elsewhere in health care, the proportion of general administrative staff shrank (secretaries, administrative assistants, and office supervisors), while the numbers of specialized administrative staff increased – medical assistants, billing and posting clerks, and medical and health services managers.

For specialist organizations serving complex consumers, there are some clear takeaways. There is growing competition for the highly-skilled clinical staff (physicians, nurses, therapists) coming from hospital systems while the competition for aides and attendants is coming from the home care segment of the field. The health care employment growth – coupled with an aging workforce and an aging population with more chronic conditions – is going to challenge the talent management strategies of executive teams. Developing agile workforce strategies (see Does An ‘Agile’ Workforce Want Your Jobs? and The Gig Economy – Welcome To The World Of Microentrepreneurs) and increasing productivity with technology (see In All That Tech Spending, Don’t Forget The ROI and “Growing” The Tech-Savvy Staff You Need) will likely be factors in successful talent management in the years ahead.

Want to learn more on “growing” the staff you need, check out the session, “How To Retain & Grow Employees: Turning The Millennial Generation Into The Leaders Of Tomorrow” at The 2017 OPEN MINDS Executive Leadership Retreat on September 28 in Gettysburg, Pennsylvania.


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