Monday, April 9, 2012

Employment Projections for Health Science, 2010-2020

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Heath Science will be the fastest growing career cluster over the next decade, according to projections by the Bureau of Labor Statistics (BLS).  By 2020, employment in Health Science occupations is projected to grow from 12 million to over 15 million, with 3.5 million new jobs added.  Overall employment is expected to increase by 29 percent, much faster than other clusters and than the national growth rate of 14%.

Cluster Overview: Expectations for Change, 2010-2020
America's population is growing and is growing older, which will result in an increased demand for health services. Registered Nurses, the largest health occupation by far with an estimated  2.7 million workers, is expected to grow by over 25 percent to 3.45 million by 2020 and to offer about 1.2 million job openings. The second and third largest occupations, Home Health Aides and Nursing Aides, employ over a million workers each, and are expected to grow at a fast pace and to offer over an additional 1.2 million job openings through 2020.

These are not the only fast growing Health Science occupations. In fact, the BLS projects that all but six of the 62 health science occupations that they track will grow at or above the projected national growth rate of 14 percent for all occupations. The fastest growing occupations are primarily concerned with care and treatment of conditions related to aging. Jobs for Home Health Aides are expected to grow by 70 percent. Jobs for Physical and Occupational Therapists and Assistants are expected to grow by 40 percent or more. But opportunities are projected to grow rapidly in almost every area of health care.

A Note of Caution
Despite these extremely promising projections, I want to raise a few notes of caution. Employment in health occupations has been growing at a faster than average pace for decades, but this is a trend that cannot continue indefinitely. According to BLS estimates, about 8 percent of 2010 occupational employment is in the Health Science cluster. This is projected to rise to about 9 percent by 2020. I expect that it cannot rise much further and be economically sustainable. When an industry becomes economically unsustainable, it is ripe for the introduction of dramatic cost-saving innovations in technology and processes. This kind of transformation swept through agriculture in the first half of the 20th century and manufacturing in the second half. At some point, a similar wave of innovation will reach health care, radically raising productivity and cutting employment. Whether this transformation will come in this decade, or the next one, or the next, cannot be accurately projected. But it is surely coming, and many people writing on the issue say that it has already begun.

It is impossible, at this point, to predict exactly what the impact of such a transformation might be, and which specific occupations will be most affected. A few speculations are possible, however. Basic, hands-on health care is likely to be affected least. Nursing Aides and Registered Nurses will probably always be needed in large numbers. But demand for expensive diagnostic technicians might slow if we devise more accurate ways to determine exactly who needs particular types of tests. Demand for Medical Laboratory Technicians might slow as technology continues to revolutionize the laboratory process. And surely the next few decades will see steady growth in demand for medical researchers, engineers, and data analysts who create the technology and the processes that will shape the health care system of the future.

Projections Data: What the BLS tells us about employment
Every two years the BLS releases new national employment projections for over 700 different occupations. The projections include five important pieces of information discussed in this post.
Estimated 2010 employment: The estimated number of jobs or positions in each occupation. (This is a count of positions, not workers; many people have two jobs).
Projected 2020 employment: The estimated number of jobs or positions in each occupation. (A count of positions, not workers; many people have two jobs).
Numeric Change 2010-2020 or "New Jobs:" Most occupations are expected grow by 2020 as employers  create new positions or "new jobs."
Percent Change 2010-2020: The percent increase or decrease in employment over the decade. This information helps us compare the rate of change across jobs of different sizes.
Job Openings 2010-2020: Job opportunities arise in two ways: when employers create new jobs and when workers retire or leave an occupation and need to be replaced by new hires. The BLS projects how many people will be retiring from each occupation over the decade and combines this with the number of new jobs to predict how many "job openings" will become available. Even shrinking occupations have job openings because employers  need to replace some of the people who retire with new workers.
Pathways Overview
The Health Science cluster is divided into five pathways. Therapeutic Services and Diagnostics Services include the main medical occupations with which we are all familiar.  The other pathways, Biotechnology Research and Development, Health Informatics, and Support Services include occupations that support and sustain health care service providers. There are a number of problems with the occupations matched to these pathways in the original cluster crosswalk. For this discussion, I have used my own crosswalk.  The original crosswalk and mine are both presented at the end of this post so that they can be compared.
  • Therapeutic Services was the largest pathway in 2010. It includes 47 occupations involved with patient treatment, from physicians to dental and ophthalmic laboratory technicians. With a projected growth rate of 30 percent, this will remain the largest pathway in 2020. Within this pathway, Registered Nurses are expected to add the most new jobs by far. Employment for RNs is projected to grow by over 700,000 by 2020.
  • Diagnostic Services is comprised of six occupations, including Clinical Laboratory Technicians and Nuclear Medicine Technicians. It is projected to grow from about 675,000 workers in 2010 to about 820,000 in 2020.
  • The Support Services Pathway includes health related counselors, educators, and social workers.  Each of these occupations is projected to grow by more than 20 percent through 2020. Taken together they are expected to provide over 325,000 job openings, including almost 200,000 new jobs.  
  • Health Informatics is a new discipline at the intersection of information science, computer science, and health care. It deals with the acquisition, storage, and use of information in health care. Unfortunately the occupation system used by the BLS does not give us good information about the jobs and the number of people working in this field. At the moment, the only relevant occupation on which we have data is Medical Records and Health Information Technicians. Nonetheless it is clear that there is enormous potential for future growth for computer science and data management occupations in the Health Science cluster.
  • The Biotechnology Research and Development pathway includes occupations involved in medical research. The only occupations that can be clearly crosswalked to this cluster are Medical Scientists, Medical Equipment Preparers, Epidemiologists, and Biomedical Engineers, but many people in STEM occupations like Biochemists, Biophysicists, and Microbiologists also do medical research. With the exception of Medical Equipment Preparers, occupations in this cluster are expected to grow rapidly, providing over 55,000 new jobs through 2020.
  • In addition to direct medical occupations that are part of this cluster, there are many administrative occupations related to health care that may appeal to students who are interested in health care but don't want to work hands on with patients. Medical Secretaries is a large occupation that is expected to grow by over 40 percent by 2020. Positions for Medical and Health Services Managers are also projected to increase significantly.
Pathways Employment Overview (in 1000s)

Pathways and Occupations IncludedEmployment 2010Employment 2020New JobsPercent ChangeJob Openings
Biotechnology Research and Development
Diagnostics Services
Health Informatics
Support Services
Therapeutic Services
Related Business, Management, and Administration Occupations
Related Human Services Occupations
Related STEM Occupations

Job Openings and New Jobs
The BLS projects the number of new jobs that will be created in each occupation as it grows. They also they project the number of "job openings" for each occupation that will result from the combination of newly created positions and the need to replace workers who retire.

Over 3.5 million new jobs are expected in Health Sciences over the next  decade. The number of job openings is expected to be much larger than this. Almost 6 million openings are expected through 2020. The occupations expected to produce the most job openings are:
  • Registered Nurses (1,207,400);
  • Home Health Aides (837,500);
  • Nursing Aids, Orderlies, and Attendants (496,100);
  • Licensed Practical Nurses (369,200); and
  • Physicians and Surgeons (305,100)

Health Science Occupations of Particular Interest to CTE

Career and Technical Education programs prepare students for direct entry into a number of Health Science occupations as well as for postsecondary programs. It may be of interest to see the projections for these potential direct entry jobs.

Home Health Aides, Licensed Practical Nurses, and Nursing Aides are the largest of these occupations with more projected job openings than all of the others together. Physical and Occupational Therapy are smaller fields, but they are expected to be particularly fast growing. All of these occupations are promising, and graduates from any of CTE Health Science program should be able to find steady work if schools maintain close ties with employer partners.

Occupations of Particular Interest to CTE (in 1000s)
Home Health Aides1,017.71,723.9706.370%837.5
Licensed Practical and Licensed Vocational Nurses752.3920.8168.522%369.2
Medical and Clinical Laboratory Technicians161.2184.923.815%55.1
Medical Assistants527.6690.4162.931%243.8
Nursing Aides, Orderlies, and Attendants1,505.31,807.2302.020%496.1
Occupational Therapy Aides7.59.92.533%3.6
Occupational Therapy Assistants28.540.812.343%16.8
Pharmacy Aides50.865.314.529%22.3
Pharmacy Technicians334.4442.6108.332%166.3
Physical Therapist Aides47.067.320.343%27.6
Physical Therapist Assistants67.498.230.846%41.2
Respiratory Therapists112.7143.931.228%52.7
Surgical Technologists93.6111.317.719%33.9

Complete Listing
The following table gives a complete picture of how the Health Science cluster is expected to change between 2010 and 2020.

Employment Projections (in 1000s)

Pathways and Occupations Included
Employment 2010Employment 2020New JobsPercent ChangeJob Openings
Biotechnology Research and Development Pathway169.9 225.8 55.9 73%33%
Medical Scientists, Except Epidemiologists100.0136.536.436%42.6
Medical Equipment Preparers49.257.88.618%16.2
Biomedical Engineers15.725.49.761%13.1
Diagnostics Services Pathway675.5 821.6 146.0 22%263.6
Medical and Clinical Laboratory Technologists169.4188.619.211%52.1
Medical and Clinical Laboratory Technicians161.2184.923.815%55.1
Cardiovascular Technologists and Technicians49.463.914.529%22.1
Diagnostic Medical Sonographers53.777.123.444%31.7
Nuclear Medicine Technologists21.926.14.119%7.5
Radiologic Technologists and Technicians219.9281.061.028%95.1
Health Informatics Pathway179.5 217.3 37.7 21%73.7
Medical Records and Health Information Technicians179.5217.337.721%73.7
Support Services Pathway592.3 786.4 194.1 33%327.5
Health Educators63.486.623.237%36.9
Healthcare Social Workers152.7203.951.234%87.4
Mental Health Counselors120.3163.943.636%69.4
Rehabilitation Counselors129.8166.436.628%64.4
Mental Health and Substance Abuse Social Workers126.1165.639.531%69.4
Therapeutic Services Pathway10,396.8 13,478.9 3,082.9 30%4,966.5
Dentists, General130.7158.327.621%66.4
Oral and Maxillofacial Surgeons8.09.71.721%4.1
Dentists, All Other Specialists7.88.70.912%3.2
Dietitians and Nutritionists64.477.112.720%35.4
Physicians and Surgeons691.0859.3168.324%305.1
Physician Assistants83.6108.324.730%40.6
Registered Nurses2,737.43,449.3711.926%1,207.4
Occupational Therapists108.8145.236.434%57.1
Physical Therapists198.6276.077.439%100.6
Radiation Therapists16.920.33.420%6.7
Recreational Therapists22.426.33.817%11.9
Respiratory Therapists112.7143.931.228%52.7
Speech-Language Pathologists123.2152.028.823%52.3
Therapists, All Other33.142.39.228%16.3
Health Diagnosing and Treating Practitioners, All Other55.666.210.619%21.2
Dental Hygienists181.8250.368.538%104.9
Dietetic Technicians24.228.13.916%8.1
Pharmacy Technicians334.4442.6108.332%166.3
Psychiatric Technicians74.986.411.615%24.6
Respiratory Therapy Technicians13.814.30.64%3.0
Surgical Technologists93.6111.317.719%33.9
Licensed Practical and Licensed Vocational Nurses752.3920.8168.522%369.2
Opticians, Dispensing62.680.718.129%30.6
Orthotists and Prosthetists6.37.00.812%2.0
Health Technologists and Technicians, All Other93.5115.221.723%40.4
Athletic Trainers18.223.75.530%11.9
Healthcare Practitioners and Technical Workers, All Other60.471.911.519%32.8
Home Health Aides1,017.71,723.9706.369%837.5
Nursing Aides, Orderlies, and Attendants1,505.31,807.2302.020%496.1
Psychiatric Aides67.777.910.215%19.0
Occupational Therapy Assistants28.540.812.343%16.8
Occupational Therapy Aides7.59.92.533%3.6
Physical Therapist Assistants67.498.230.846%41.2
Physical Therapist Aides47.067.320.343%27.6
Dental Assistants297.2388.991.631%154.0
Medical Assistants527.6690.4162.931%243.8
Pharmacy Aides50.865.314.529%22.3
Healthcare Support Workers, All Other202.3237.034.817%65.8
Dental Laboratory Technicians40.941.20.31%13.2
Ophthalmic Laboratory Technicians29.833.63.813%13.2
Health-Related Administrative Occupations906.8 1,190.6 283.8 31%440.5
Medical Transcriptionists95.1100.75.66%20.2
Medical Secretaries508.7718.9210.241%278.4
Medical and Health Services Managers303.0371.068.022%141.9

Occupations Matched to Pathways According to Original Crosswalk (in 1000s)

Occupations and PathwaysEmployment 2010Employment 2020New JobsPercent ChangeJob Openings
Biotechnology Research and Development Pathway149.2 194.3 45.0 30%58.8
Medical Scientists, Except Epidemiologists100.0 136.5 36.4 36%42.6
Medical Equipment Preparers49.2 57.8 8.6 18%16.2
Diagnostics Services Pathway675.5 821.6 146.0 22%263.6
Medical and Clinical Laboratory Technologists169.4 188.6 19.2 11%52.1
Medical and Clinical Laboratory Technicians161.2 184.9 23.8 15%55.1
Cardiovascular Technologists and Technicians49.4 63.9 14.5 30%22.1
Diagnostic Medical Sonographers53.7 77.1 23.4 44%31.7
Nuclear Medicine Technologists21.9 26.1 4.1 29%7.5
Radiologic Technologists and Technicians219.9 281.0 61.0 28%95.1
Health Informatics Pathway343.0 410.7 67.7 20%132.3
Epidemiologists5.0 6.1 1.2 34%1.5
Health Educators63.4 86.6 23.2 37%36.9
Medical Records and Health Information Technicians179.5 217.3 37.7 21%73.7
Medical Transcriptionists95.1 100.7 5.6 6%20.2
Support Services Pathway126.1 165.6 39.5 31%69.4
Mental Health and Substance Abuse Social Workers126.1 165.6 39.5 31%69.4
Therapeutic Services Pathway10,396.8 13,478.9 3,082.9 30%4,966.5
Chiropractors52.6 67.4 14.9 28%25.3
Dentists, General130.7 158.3 27.6 21%66.4
Oral and Maxillofacial Surgeons8.0 9.7 1.7 21%4.1
Orthodontists8.3 10.1 1.8 21%4.2
Prosthodontists1.0 1.2 0.2 21%0.5
Dentists, All Other Specialists7.8 8.7 0.9 12%3.2
Dietitians and Nutritionists64.4 77.1 12.7 20%35.4
Optometrists34.2 45.5 11.3 31%23.4
Pharmacists274.9 344.6 69.7 25%139.6
Physicians and Surgeons691.0 859.3 168.3 24%305.1
Physician Assistants83.6 108.3 24.7 29%40.6
Podiatrists12.9 15.5 2.6 20%5.1
Registered Nurses2,737.4 3,449.3 711.9 26%1,207.4
Occupational Therapists108.8 145.2 36.4 34%57.1
Physical Therapists198.6 276.0 77.4 39%100.6
Radiation Therapists16.9 20.3 3.4 20%6.7
Recreational Therapists22.4 26.3 3.8 17%11.9
Respiratory Therapists112.7 143.9 31.2 27%52.7
Speech-Language Pathologists123.2 152.0 28.8 23%52.3
Therapists, All Other33.1 42.3 9.2 28%16.3
Audiologists13.0 17.8 4.8 36%5.6
Health Diagnosing and Treating Practitioners, All Other55.6 66.2 10.6 19%21.2
Dental Hygienists181.8 250.3 68.5 38%104.9
Dietetic Technicians24.2 28.1 3.9 16%8.1
Pharmacy Technicians334.4 442.6 108.3 32%166.3
Psychiatric Technicians74.9 86.4 11.6 16%24.6
Respiratory Therapy Technicians13.8 14.3 0.6 4%3.0
Surgical Technologists93.6 111.3 17.7 19%33.9
Licensed Practical and Licensed Vocational Nurses752.3 920.8 168.5 22%369.2
Opticians, Dispensing62.6 80.7 18.1 29%30.6
Orthotists and Prosthetists6.3 7.0 0.8 12%2.0
Health Technologists and Technicians, All Other93.5 115.2 21.7 23%40.4
Athletic Trainers18.2 23.7 5.5 30%11.9
Healthcare Practitioners and Technical Workers, All Other60.4 71.9 11.5 19%32.8
Home Health Aides1,017.7 1,723.9 706.3 69%837.5
Nursing Aides, Orderlies, and Attendants1,505.3 1,807.2 302.0 20%496.1
Psychiatric Aides67.7 77.9 10.2 15%19.0
Occupational Therapy Assistants28.5 40.8 12.3 43%16.8
Occupational Therapy Aides7.5 9.9 2.5 33%3.6
Physical Therapist Assistants67.4 98.2 30.8 46%41.2
Physical Therapist Aides47.0 67.3 20.3 43%27.6
Dental Assistants297.2 388.9 91.6 31%154.0
Medical Assistants527.6 690.4 162.9 31%243.8
Pharmacy Aides50.8 65.3 14.5 29%22.3
Healthcare Support Workers, All Other202.3 237.0 34.8 17%65.8
Dental Laboratory Technicians40.9 41.2 0.3 1%13.2
Ophthalmic Laboratory Technicians29.8 33.6 3.8 13%13.2