The extensive health care industry is represented by numerous health careers. Many different roles are involved in caring for people's health, from the receptionist who greets a patient, to the nurse who takes a patient's history and vital signs, and the physician who diagnoses and treats any problems a patient is experiencing. Even in private practice, it doesn't stop there. There's still the medical assistant who helps with the lab work or schedules diagnostic testing and the medical transcriptionist who types the records.
In a hospital setting, patients may be examined by a physician assistant working in an emergency room while a medical technologist in the laboratory evaluates a patient's blood sample. In the background, a health information technologist ensures that a patient's digital records are accurately and safely maintained. An aide may help a patient to a room, while another patient consults with a patient advocate to help arrange both treatment and payment by an insurance company. Each position forms a vital piece of the collective effort to provide health care.
Workers with different levels of education and experience fill this variety of roles. Highly trained physicians, physician assistants, and advanced practice nurses possess extensive responsibilities and a strong income commensurate with their education and duties. Trained technical staff supports the technical functions of a hospital including information technology, clinical laboratory procedures, and radiologic technology. Support staff keeps everything running smoothly. Medical receptionists, nursing assistants and aides, medical assistants, and medical transcriptionists ensure that all tasks are completed in a professional and timely manner.
Private Practice Physician or Nurse. A private practice physician may be a general practitioner or a specialist who works from his own office rather than at a hospital or corporation. Private practice physicians include pediatricians, obstetricians-gynecologists, cardiologists, and other specialists, or primary care doctors working solo or in a group practice. These individuals take direct responsibility for their patients and work to develop long-term relationships with them. A private practice physician builds his practice on referrals, word of mouth, community contacts, and advertising. Typically, patients are seen at scheduled appointments during a defined workday. Private practices maintain an established, consistent staff that includes one or more medical receptionists and nurses and may also include a practice manager, physician assistant, medical assistant, laboratory technologist, and medical transcriptionist.
Sometimes, a physician will also manage the practice, but the physician's primary job is to evaluate and examine patients, pursue diagnostic testing, diagnose patients, and treat patients. Generally, a private practice physician will also be responsible for training staff and establishing practice protocol. A private practice physician's income will vary based on location, hours worked, and specialty. According to the U.S. Bureau of Labor Statistics, family and general practitioners earn a median annual salary of $173,860. Pediatricians earn slightly less with a median salary of $165,720 per year, while obstetricians and gynecologists tend to earn more with a median annual salary of $210,340. Illustrative of regional differences, physicians in Florida earn an average of about $23,000 less per year than physicians in Texas.
Eight percent of nurses work in private practice in a physician's office. In this setting, a nurse handles a subset of patient appointments including routine vaccinations or injections, blood pressure checks, and patient counseling or education. Private practice nurses also participate in the physician's appointments by taking patient histories, recording vital signs, and conducting or arranging diagnostic tests. Nursing income depends on education, experience, location, and hours worked. The median annual salary of a registered nurse equals $67,720 with a licensed practical nurse earning about $41,360 each year.
Health careers as private practice physicians and nurses are rewarding and lucrative. A substantial need exists for more physicians, and many medical schools are increasing the number of physicians they graduate to help meet this need. Job opportunities for nurses are excellent and expected to grow at a rate far faster than average. The U.S. Bureau of Labor Statistic expects a 22% increase in available nursing positions between 2008 and 2018.
Physician or Nurse in a Hospital Setting. Health careers as hospital-based physicians and nurses offer a good fit for individuals who prefer shift work, research, and a large, collegial environment. Working in a hospital setting provides a very different feel than working in private practice.
Physicians working in a hospital setting may be generalists or internal medicine specialists who work as hospitalists who care for hospitalized patients not directly supervised by specialists. Hospitalists coordinate a patient's care and communicate with family and outside doctors.
Other hospital-based physicians include specialists who provide care not easily available in private practice. Hospital physician specialties include radiology, surgery, and emergency medicine. Some physicians, such as radiologists, may work a fairly typical day shift with some night, weekend, or on-call hours for emergency review of radiographs, MRIs, and the like. Other positions, such as emergency medicine physicians, may work long shifts and irregular hours treating patients on a 'walk-in' basis. Almost half of all physicians and surgeons work 50 or more hours per week.
An advantage to hospital-based practice is the ability to consult with other specialists and develop relationships with a large and diverse group of colleagues. Many hospitals, particularly those associated with medical schools, focus on teaching and research. In this capacity, physicians often fill the role of teacher. They teach their patients about tests, disorders, and how to manage their disease, while also teaching their staff about practice policy and protocol. It is a natural corollary, then, that physicians also instruct up-and-coming physicians so they can pass on their wealth of knowledge and experience. Although focusing on research isn't for every physician, it opens new worlds when physicians use what they see in practice to establish science for future improvements. Working in a research or teaching hospital provides opportunities for cutting-edge practice and notable excellence.
Physician specialties more commonly found in hospital settings include hospitalists, emergency medicine physicians, anesthesiologists, and surgeons. Surgical specialists earn toward the high end of the physician pay scale with a mean annual salary of $225,390. Anesthesiologists earn only a little less with a mean annual salary of $220,100.
60% of registered nurses have hospital-based jobs with consistent primary nursing duties. Nurses in a hospital setting teach patients and their families to manage illness and injury, to use equipment, take medications, and to eat a proper diet. They also establish patient care plans, administer medications, manage intravenous lines, administer treatments, observe patients, and maintain patient and hospital records. These tasks can look very different, however, based on the hospital department in which a nurse works. A surgical or perioperative nurse helps a surgeon prepare for surgery, keeps surgical records, and manages surgical supplies. A cardiovascular nurse develops special knowledge in the field of cardiology to properly monitor and treat cardiac patients and run cardiovascular tests. An emergency room nurse's duties vary greatly depending on the patients that come in on any given shift. Duties range from inducing emesis to medicating to monitoring an electrocardiogram.
Hospital schedules can offer both an advantage and a disadvantage. Hospitals require round-the-clock patient care. Nurses who have many demands on their time may prefer the ability to work nights and weekends. For others, this atypical schedule would be problematic. In a hospital setting, particularly in a teaching or research hospital, nurses have the opportunity to participate in complex and unusual cases and participate in research studies. A disadvantage of working in a hospital setting is that nurses have limited, short-term relationships with their patients. An obstetrics nurse, for example, trades the joy of a child's birth for the joy of a private practice pediatric nurse who watches a child grow from year-to-year. Job opportunities for hospital-based nurses are expected to grow. Salaries for hospital-based nurses run similar to those in private practice with a mean annual wage of $68,610.
Physician or Nurse with a Concentration in Various Specialties. Health careers in specialized fields often bridge private practice and hospital-based work. While some specialists work solely in a hospital setting, many emergency room physicians, nurses, and anesthesiologists, for example, many have a separate primary office. Neurologists, orthopedists, obstetricians, allergists, and internal medicine specialists are all likely to have a primary office with their own staff to which patients are referred by primary care doctors or from emergency rooms. A specialist's patients may visit for only one limited episode, such as a patient with a broken arm seeing an orthopedist, for example, or become lifelong patients, like a patient with heart disease at a cardiologist. In their private practices, specialists confer with clients regarding their medical histories and their physical exams. Diagnostic testing and procedures are often performed in the office, though more complex procedures are often handled at a hospital.
Consequently, specialist physicians have relationships with one or more hospitals and hospital privileges so that they may see patients at the hospital and utilize hospital equipment and staff. An obstetrician might see a pregnant woman in her office regularly throughout the patient's pregnancy, and at the time of birth, the obstetrician will meet the soon-to-be parents at the hospital for the delivery. An orthopedist will treat patients with sprains and minor fractures at his or her office, but will take a patient with a complex fracture or one needing surgery to a hospital.
Specialists who bridge private practice and hospital-based practice have the best of both worlds. They have control over their own office to establish a style of medicine, practice culture, and management practices, yet still enjoy professional interaction in a hospital setting, as well as access to costly equipment. Sometimes, though, it can be a challenge to manage two workplaces and adjust to their different demands. Specialists are often in the undesirable position of needing to be in two places at once. The obstetrician, for example, may have appointments scheduled at her own practice, but be tied up with a delivery at the hospital.
Specialists can expect a substantial income and stable job prospects. Different specialties offer varying rates of pay with anesthesiologists and surgeons at the high end of the scale. Obstetricians and gynecologists earn a mean annual salary of $210,340; pediatricians, $180,870; and internists, $189,480.
Nurses in specialty practice tend to work in either private practice or in a hospital, but do not usually move back and forth as specialist physicians do. A nurse in a specialty practice can focus all her training and continuing education on a single field, allowing in-depth study of the topic. Specializing allows a nurse to focus on an area of particular interest to her. Registered nurses who provide direct patient care and consultation in a specialty are known as clinical nurse specialists.
Critical care nurses work in critical or intensive care units treating serious illnesses when a sudden debilitating event occurs, conducting initial assessments, and providing nursing care. Infusion nurses have a highly specialized job, usually in a hospital, handling intravenous injections of blood, blood products, and fluids. Cardiac nurses, on the other hand, may work in private practice as much as in a hospital. Cardiac care nurses may take a patient's initial history, take vital signs, and conduct introductory testing such as an electrocardiogram. Addiction nurses care for patients suffering with drug and alcohol addictions.
Job prospects are quite promising for nurses. In some areas, employers have trouble staffing all needed nursing positions. Specialty registered nurses earn a mean annual wage of $73,280, but the full range of annual salaries falls from about $43,410 to more than $93,240.
Physician Assistant. Physician assistants work in private practice alongside physicians and under their supervision. Because a physician is ultimately responsible for a physician assistant's work, physician assistants are given more independent responsibility with exhibited expertise when caring for patients. Physician assistants have important health careers as members of the health care team. Extensive training for this position includes completion of a master's degree program with internships followed by national licensure. Physician assistant training involves substantial science coursework and medical coursework akin to that studied by physicians.
Physician assistants (PAs) work under the supervision of physicians to examine, diagnose, and treat patients. For example, a PA meets a patient to discuss the patient's history, concerns, and symptoms. The physician assistant then examines the patient and conducts or orders any necessary diagnostic testing. Reviewing the results of the diagnostic testing, the PA would also make a diagnosis and initiate treatment for the patient. Physician assistants work both in private practice and hospital settings. They are also in high demand in rural settings and institutional facilities.
Physician assistants may work as general practitioners or work solely in one department or specialty, such as pediatrics or internal medicine. A physician assistant who chooses to specialize in a field, such as emergency medicine or surgery, may continue his education in a specialized post-graduate program with additional practical experience.
In private practice or in an institutional setting, physician assistants may work an established 40-hour work week. Hospital-based PAs, however, may be required to work irregular shifts including nights and weekend.
Although they have many responsibilities in common with physicians, physician assistants possess less education and earn a lower salary with a median annual salary of $87,140. The job market for physician assistants should remain strong. The U.S. Bureau of Labor Statistics anticipates that employment of physician assistants will grow 39 percent from 2008 to 2018, a rate that far exceeds other occupations.
Medical Technologist. Health careers encompass a broad variety of positions including non-physician technical jobs. A medical technologist, also referred to as a clinical laboratory technologist or scientist, performs most of the laboratory tests related to detection of disease. Health careers in medical technology begin with a bachelor's degree in medical technology or the life sciences. Medical or clinical laboratory technicians generally handle less complex tasks and may have an associate's degree or certificate. Certification is available through several professional organizations including the American Medical Technologists and National Credentialing Agency for Laboratory Personnel. Medical technologists usually work in hospital settings performing a variety of laboratory functions. They examine and analyze cells, blood, and other bodily fluids. These tests include everything from blood typing to bacterial cultures to plasma levels of liver enzymes.
Much of today's clinical laboratory is automated with sophisticated equipment, but technologists must be experienced at working with a microscope and doing many tests by hand in the event that results need to be verified or equipment is unavailable. Medical technologists must be meticulous about technique and procedures, as well as the maintenance of equipment. Aside from setting up and running tests, technologists will evaluate results, ensure their accuracy, and develop or modify laboratory procedures to maximize accuracy and efficiency.
Exact duties vary among laboratories. Some technologists have management responsibility for running the laboratory and supervising clinical laboratory technicians. Technologists in large laboratories may specialize in certain tests, while those in a smaller laboratory may perform a breadth of tests. Blood bank or immunohematology technologists collect blood, type blood, separate blood into its components, and prepare blood and blood components for transfusion. Cytotechnologists specialize in preparing slides of cells and microscopically examining cells for abnormalities. Technologists in a research laboratory may perform highly specialized duties, running only one or a few laboratory tests repeatedly.
Medical technologists primarily work in a comfortable, well-lit environment, but they must take precautions against infectious and hazardous specimens and chemicals. Although more technologists are needed during a standard day shift, many laboratories operate 24 hours a day and will need technologists to work night, weekend, and holiday hours. Job prospects for medical technologists are excellent both in a hospital setting and in other laboratories. Employment is expected to increase 14% between 2008 and 2018. The median annual wage for medical technologists is $53,500, with individuals working in hospitals earning more than technicians at colleges or in physicians' offices. A health career in medical technology offers the opportunity for ongoing learning as new methods and machines are developed.
Medical Assistant. Health careers as medical assistants are available without a college degree. The need for medical assistants is growing fast and creating outstanding job prospects.
Medical assistants work primarily in physicians' offices performing administrative and clinical tasks. While the precise duties vary based on the size, specialty, and organization of the practice, medical assistants handle administrative tasks including completing insurance forms, updating and filing patient records, and arranging for additional services. On the clinical side, state law and each physician's preference limit a medical assistant's duties. Tasks include taking patient histories, recording vital signs, assisting physicians during examinations, and educating patients. Medical assistants may administer medications, perform basic laboratory tests, and change wound dressings.
Medical assistants in private practice often work a stable schedule and a 40-hour work week. Their work reflects upon the practice and physicians. Consequently, medical assistants are expected to act cordially, capably, and professionally at all times. Medical assistants should be well-spoken, detail-oriented, intelligent, and focused.
While no standard educational requirement exists for medical assistants, most have a high school diploma. Some are trained on the job, and some participate in medical assisting programs at vocational schools and community colleges. Medical assistant training programs consist of anatomy, physiology, medical terminology, and laboratory techniques. Individuals also learn to administer medication and first aid, as well as office skills. The American Association of Medical Assistants awards certification credentials to medical assistants.
Wages for medical assistants vary considerably based on skills, experience, and location. Overall, the median annual wage of a medical assistant is $28,300. However, the top paid 10% earned more than $39,570, while the lowest paid earned less than $20,600. Hospital positions pay an average of $1,000 a year more than private practice positions. The number of available positions is expected to increase 34% between 2008 and 2018.
Patient Advocate. Patient advocate is a relatively new position in the world of health careers. Part counselor, part information specialist, and part concierge, patient advocates may be privately employed by individual patients or employed by hospitals and insurance companies.
A patient advocate who works directly for a patient supports that patient and advocates for that patient's needs. Advocates will sign a legal contract for services including arbitration, mediation, and negotiation to settle issues. Advocates commonly handle issues such as access to care, medical debt, and job retention. Some large employers now contract with advocacy companies to provide patient advocacy services for their employees.
A hospital-based patient advocate acts as the point person for patient complaints or concerns. The advocate reports, investigates, and monitors complaints as well as takes steps to resolve issues. This is a customer service or public relations position that can have a direct impact on patient care. The advocate improves care to individual patients experiencing an issue. The advocate also creates a database of concerns or issues that hospital administrators evaluate to adjust hospital policies and procedures as necessary.
Patient advocates working in the insurance industry act as liaisons between customers, physicians, and the insurance company. They handle communication between all parties and manage the payment process. In this environment, patient advocates need to possess knowledge of insurance systems, coding, and knowledge of the claims and reimbursement processes.
Due to the varied responsibilities of a patient advocate, individuals in this position come from a range of backgrounds. Often, patient advocates have a bachelor's degree in behavioral sciences, nursing, health information technology, or healthcare administration. Patient advocates are expected to have outstanding customer service skills, professionalism to deal with physicians and administrators, excellent analytical skills, and well-developed conflict resolution skills. Advocates must be familiar with medical information systems, insurance systems and procedures, computer skills, and medical terminology. They also must be able to advocate for a patient's needs while maintaining positive relationships with colleagues.
A student considering a career in patient advocacy should consider for whom and in what capacity they would like to work. An in-house patient advocate at a hospital or nursing home typically comes from a nursing or social work background. A patient advocate in an advocacy company may first work in nursing or insurance benefits administration. Patient advocacy may be a good choice for nurses, benefits experts, or information specialists looking for a change of pace. The average salary for a patient advocate is about $44,000.
Medical Receptionist. Some health careers are open to workers without higher education, but with marketable skills and a desire to work in the field of health care. Medical receptionist positions are available to candidates with a high school education. Receptionists handle a number of tasks, the most important being patient communication. A medical receptionist becomes the first representative of a practice when she answers the phone to schedule an appointment and answer questions, then as the first face of the practice when a patient arrives. Consequently, professionalism, strong interpersonal skills, and a kind but efficient manner all form necessary qualities for a medical receptionist.
Medical receptionists are also tasked with clerical and organizational skills. The receptionist handles mail, updates medical records, takes and manages health insurance information, and assists with maintaining a smooth workflow. For these tasks, a medical receptionist must be detail-oriented, efficient, able to track workflow and information, and comfortable with computer systems and office equipment. Receptionists are responsible for the doctor's schedule, the appointment schedule, and, often, basic bookkeeping or word-processing tasks. A medical receptionist must be able to maintain the confidentiality of all patients. Receptionists must also learn medical terminology and common medical procedures to work with patients and staff in a meaningful, knowledgeable way.
Receptionists often work in a comfortable environment with a standard 40-hour work week. Part-time positions are sometimes available. This work will appeal to employees who wish to use their substantial office skills in a dynamic medical office. Employees must be able to confidently and calmly respond to patients' questions, handle multiple urgent tasks, and manage a schedule to accommodate urgent medical needs. Medical receptionists must be able to learn new technology, from phone systems to computer systems, as they are integrated into the workplace.
While most medical receptionist positions occur in private practices, hospitals and clinics also hire receptionists. In these environments, receptionists may be asked to work in different departments or perform shift work.
The median hourly wage for a medical receptionist is $12.20 an hour. The best paid receptionists, those in the top 10% of the field, earn $17.07 or more per hour. Job opportunities for receptionists are stable and expected to increase. The Bureau of Labor Statistics projects that employment for receptionists will grow 15% from 2008 to 2018. The opportunity for advancement is moderate. Successful medical receptionists may be offered on the job training to move into another role, such as medical assistant or benefits manager. Highly skilled receptionists may also be offered supervisory positions.
Health Information Technicians. Health careers managing information include the positions of medical records technician and health information technicians. Health information technology (IT) allows health care providers to optimize patient care through the secure use of health information. Health IT includes the use of electronic health records to eliminate problems with handwriting interpretation and the need to find a single physical record. Electronic health records allow easy access to a legible and complete record, improving efficiency and patient safety. System-wide health IT minimizes paperwork and allows efficient information sharing and information tracking.
Health information technician offers one of the few health careers without direct, hands-on patient care. Medical records and health information technicians assemble complete patient information to create a record or lengthen an existing record. They organize and manage health data, as well as improve systems to maximize the quality and security of that data. Technicians communicate with physicians, nurses, and administrators to gather needed information. Technicians may be generalists or specialists. A specialist might become a medical coder who codifies patients' medical information for reimbursement or a cancer registrar who maintains a cancer patient database.
This position requires specific technical skills that are generally gained in an associate degree program at community colleges. Health information technicians study life sciences, medical terminology, health data requirements and standards, data analysis, coding systems, reimbursement methods, database security, and database management. Job candidates increase their likelihood of hire and increase their salary by becoming a Registered Health Information Technicians (RHIT). Separate certification programs exist for a registered Health Information Administrator (RHIA), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Certified Health Data Analyst (CHDA), and Certified in Healthcare Privacy and Security (CHPS). In order to become certified, health information technicians must complete an accredited health information program and pass its certifying exam. Certification provides employers with a standard, a guarantee of knowledge and ability.
Health information technicians looking to advance their career prospects should pursue a bachelor's degree or master's degree and advanced specialty certification. Technicians may specialize or become information managers. About 40% of medical records and health information technicians work in hospitals. Others work in private practice, government agencies, and at other healthcare providers. The median annual wage for a health information technician is $30,610, though wages for an experienced technician can exceed $50,000. Individuals working for the federal government tend to earn more than those working in hospitals. On average, technicians working in private practices earn the least. The outlook for future employment is strong since this is a growing field.
Medical Transcriptionist. Medical transcriptionist is one of the few health careers that requires no direct patient contact. A medical transcriptionist listens to recordings, primarily dictated by physicians, and transcribes them into medical reports. A transcriptionist may also transcribe letters, such as referral letters, and administrative documents. Transcribed medical reports contain all substantial aspects of patient records including history and physical examination reports, surgery reports, consultation reports, reports on the results of diagnostic testing, and autopsy reports. After being transcribed, the documents return to the physician or medical office for review, correction, and signature, where they become part of patients' permanent files. Transcriptionists who work in physicians' offices may perform additional office duties.
With today's technology, dictation can be transferred instantly over the Internet to a personal computer or personal data assistant. Speech recognition technology can be used to create a draft of the text that the transcriptionist edits and formats.
Training to become a medical transcriptionist requires completing a one-to-two year certificate or associate's degree program at a vocational school, community college, or distance-learning program. Students complete coursework in computer equipment, word processing, medical terminology, anatomy, physiology, and pharmacology. Transcriptionists must learn the standards of medical record keeping, as well as the legal and ethical requirements of maintaining records and confidentiality.
To assure potential employers of their competence, medical transcriptionists may become certified. Recent graduates of medical transcription programs are eligible to sit for the AHDI Level-1 registered medical transcription exam and become Registered Medical Transcriptionists (RMT). Experienced transcriptionists may sit for the certification exam to earn the designation of Certified Medical Transcriptionist (CMT). Transcriptionists must update their skills through continuing education and take a final exam to maintain their certification.
Effective medical transcriptionists possess good English language skills, substantial knowledge of medical terminology, good listening skills, swift and accurate typing skills, and proficiency with computers and word-processing software. This career is ideal for individuals wishing to work from home on their own schedule, as many transcriptionists do so.
Typically, medical transcriptionists work a standard 40-hour week, though the self-employed may work irregular hours, particularly to manage other demands on their schedule. The median hourly wage for a medical transcriptionist is $15.41. Transcriptionists working in laboratories tend to earn more than individuals physician offices. Pay may be based on lines transcribed rather than hours worked. Job opportunities for this health career are good, though prospects are no better than for other jobs in the U.S. market.
Last Updated: 05/21/2014