Personal Finance
Working Your Degree
November 24, 2000: 10:53 a.m. ET

Health majors have to choose between the administrative and clinical
by Staff Writer Shelly K. Schwartz
graphic graphic
NEW YORK (CNNfn) - The health care industry today is best described as a work in progress. Economic, political and social forces are reshaping the field of medicine and more specifically, the way health care is delivered.

Cost concerns, for example, have ushered in the new era of managed care. And technological advancements are giving doctors the tools they need to move patients out of the hospital and into outpatient care settings. Needless to say, it's all created a good deal of uncertainty over the future of health care in this country.

Luckily for college students, though, it's also opened the doors to a whole new world of professional possibilities.

"Medicine and health care are becoming increasingly complex," said David Gans, survey operations director for Medical Group Management Association, the trade group representing administrators of medical practices.

"Just look at the reimbursement system," he said. "It's extraordinarily complex and contractual in nature. There's a very good opportunity for those with a business or health services background to move into administration jobs and have extremely successful careers."

On the job

Those who major in health typically sequence in either health services management, which trains students to handle the business and administrative end of the industry, or they focus on health care clinician programs, where they learn to work with patients directly. They work for the same employers health maintenance organizations, physician's clinics and hospitals but have very different responsibilities.

"In some ways the undergraduate degree students get today in health isn't what it was when I got mine," said Brett Wright, chair of the health, fitness and recreation department at George Mason University in Northern Virginia. "We try to approach health in a broad and proactive way. Some of our students go graphicinto more traditional health careers, working for hospitals or in health promotion jobs, working in fitness clubs and physicians offices and doing health assessments and basic screenings. But most these days end up in the non-clinical, administrative side."

Your first step as an undergraduate student will be to determine on which side of the fence you fall, clinical or administrative.

"It takes some good thought and work by the student and their parents to really figure out what you want to do," said William Walence, chair of the health systems administration department at Rochester Institute of Technology. "One of the things about health care is that you have to like working with people, both being with them and servicing them."

He suggests, however, that students keep an open mind when starting their college careers. Many students, Wallace said, who pursued a biology degree or nursing degree at the outset end up switching into health services management or administration mid-way through their college career, and vice versa.

Visit CNNfn's Career page regularly to read "Working your Degree," a new column that highlights job opportunities for a different college major each week. Click here for previous profiles on professions including: philosophy, political science, engineering, economics, computer science, physical therapy, history and teaching professions.

What's out there?

Some of the most common job opportunities for those who major in clinical health include becoming a registered nurse, home health aide, physicians assistant, occupational therapists or some other specialist. Another option is to become a licensed practical nurse, or LPN, who cares for the sick and injured under the supervision of doctors and registered nurses.

"We are on the edge of a nursing shortage, because we can't replace the early Baby Boomers who are retiring," Walence said. "Occupational and physical therapists are very popular now, too, as is the physician's assistant degree because you have a lot of the same rights and privileges as a doctor, including good pay, with fewer responsibilities."

Walence adds that many hospitals and health care clinics in rural parts of the country seek out physicians assistants because they can't attract enough doctors.

Non-clinical jobs among health industry specialists, however, are growing the fastest.

Many who major in health services management or health administration end up as underwriters at health insurance companies, directors of voluntary health agencies and professional health associations, public health directors and social welfare administrators.

graphicNon-profit groups, such as the American Health Association, hospitals and physicians offices are in constant need of trained professionals who have the necessary training to run their business.

"Years ago we always took our best clinicians out of the lab and put them into administrative positions, which removed all the good ones from the clinics," Walence said. "They weren't really trained to handle personnel and finance issues though."

Today, those front-office functions, including billing, HMO contract management and accounting, are handled by administrators with a health services management or business degree.

Looking ahead

According to the Bureau of Labor Statistics, health services managers essentially just run the business of health care. They plan, direct, coordinate, and supervise the delivery of care.

More specifically, the agency writes in its latest Occupational Outlook report, health services managers are broken down into two distinct categories: generalists and specialists. Generalists manage or help to manage an entire facility or system, while specialists are in charge of specific clinical departments or services.

The report reveals that the market for health services managers, for example, is expected to grow between 21 percent and 35 percent through 2008, faster than the national average, with employment growing the fastest at home health agencies, residential care facilities and practitioners' offices.

The same growth rate is projected for physical therapists, occupational therapists and registered nurses. Jobs for home health care nurses will grow an eye-popping 36 percent or more through 2008.

Keep in mind, too, that education in the field of health care regardless of your specialty is key to climbing the corporate ladder. The BLS notes a master's degree in health services administration, long-term care administration, health sciences, public health, public administration, or business administration is the standard credential for most generalist positions in this field.

A bachelor's degree, however, is "adequate for some entry-level positions in smaller facilities and for some entry-level positions at the departmental level within health care organizations," it notes, adding those with only a bachelor's degrees usually start out as administrative assistants or assistant department heads in larger hospitals, or as department heads or assistant administrators in small hospitals or nursing homes.

Some colleges and universities allow students in their health administration programs to specialize in one type of facility -- hospitals; nursing homes; mental health facilities; HMOs; or medical groups. Other programs encourage a generalist approach to education.

Paycheck check-up

Earnings in the field are relatively high, according to Department of Labor data, but long work hours are common.

The median annual earnings of medical and health service managers, for example, were $48,870 in 1998, the most recent year for which data are available. The lowest 10 percent earned less than $28,600 and the highest 10 percent earned more than $88,730 a year.

Hospitals paid the most, at nearly $53,000, followed by home health services agencies, which paid roughly $46,000.

But the Medical Group Management Association reports higher salaries still. Its data reveal the median salary in 1998 for administrators in small group practices of fewer than 7 physicians was closer to $60,000. Those who worked in offices with 7 to 25 physicians earned roughly $77,000 and administrators in large offices of more than 26 physicians brought home $124,500.

Nursing is a high paying field, as well. The median average salary for a Registered Nurse in 1998 was close to $41,000, with the lowest 10 percent earning $29,000 and the highest 10 percent earning $69,000.

Occupational therapists earned slightly more that year at $48,230 and physical therapists earned about $57,000.

Walence said if you're considering a health degree keep in mind which areas of specialty are growing the fastest, including occupational therapy and home health care services. You should also think long and hard about whether you're willing to continue your education for a higher degree and higher pay.

It may be that another degree, particularly when it comes to administrative jobs, would serve you just as well.

"There are a few ways to get into health administration," Walence suggests. "One is to graduate with a bachelor's degree in health. The other is to get a business degree in accounting or finance, and just happen to land a job in health care."

Either way should have plenty of options. graphic


Medical Group Management Association

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