Health Kick

By Jyoti Thottam

Let the software makers and factories creep cautiously out of this recession. Texas Health Resources is barreling full speed into a boom. Demand for health care is expected to be so strong that over the next 10 years, this group of 13 hospitals dotting the cities and suburbs of north Texas will hire 2,000 people as part of a $1.5 billion expansion.

It's great news for the local economy--not to mention the construction companies building the new patient wings and the medical-equipment providers filling them. But Mark Morales, the company's vice president for planning and placement, has a nagging worry. He needs people--half of them nurses--to staff all those new floors, and he isn't sure where he is going to find them.

There has been no recession at all in health care, thanks to an aging U.S. population and the growth of new and better treatments. While fast-food and customer service may churn out a greater total volume of new jobs, those in health care are almost as plentiful and offer better pay, prospects and benefits, plus the stability of a nearly recession-proof industry. Job growth is expected to be twice that of other industries over the next several years. But hospital executives and health-care experts say too many of those jobs will go unfilled. "We need to provide professionals to meet that demand," Morales says. "There have got to be different ways to produce them."

In an economy that has lost 2.7 million jobs over the past two years, you might expect that at least a few out-of-work machinists or switchboard operators would migrate into health care. To some extent, they have. There's some anecdotal evidence of career switchers, particularly from high-tech fields. The poor economy has also pulled some nurses out of retirement or into extra shifts to support their families. But this worker shortage will require much more than that, because it's doubtful that the American education system in its current state can deliver the needed quantity of next-generation health-care professionals. While only 5% of hospitals report shortages of doctors, the numbers are significantly higher in other health professions.

The quick fixes for many hospitals are perks and bonuses. Registered nurses and radiology technologists (the people who operate X-ray, C.T. and MRI scanning machines) are the most in demand, along with respiratory therapists, pharmacists and clinical-lab technicians. With average vacancy rates for those professions approaching 15%, hospitals in some cities offer signing bonuses of $5,000 to $7,000. But cash alone does little more than spark a bidding war. "You end up poaching from the facility five miles down the road," says Ceela McElveny, spokeswoman for the American Society of Radiologic Technologists.

The deeper problem isn't lack of interest--it's lack of instructors. Public-awareness campaigns have built the message that health care is a rewarding and stable, if demanding, career. Nursing schools are filled to capacity. Last year they turned away more than 5,000 qualified applicants simply for lack of faculty--a significant loss to the pool of 70,000 nursing graduates each year. Pasco-Hernando Community College in New Port Richey, Fla., for example, has no openings in its registered-nursing program until 2005.

"You can't expand these programs if you don't have the trained educators," says Stephen Collier, director of the Health Professions Education and Workforce Development program at the University of Alabama at Birmingham. Nursing schools and, increasingly, training programs for other health professions complain that they cannot hire enough instructors to add new students. (Licensing requirements mandate low student-to-teacher ratios.) Salaries for educators are well below those for clinical practice, and budget cuts at state colleges and universities have prevented them from offering more. "If we don't have educators, we won't have the nurses," says Amanda Engler, spokeswoman for the Texas Hospital Association.

Not everyone who wants to take advantage of the health-care boom needs medical training. For potential job switchers there is some good news: demand in hospitals for nontechnical positions like billing and information technology will be strong over the next few years, with vacancy rates from 5% to 10%. And laid-off middle managers could transfer their experience to health care; hospitals will need 123,000 more managers by 2010, a 32% increase in their ranks from 2001. Many entry-level jobs in health care also provide on-the-job training.

Until the faculty shortage eases, hospitals are finding creative ways to fill the gaps in nurses and technicians. JPS Health Network in Fort Worth, Texas, helped three local schools add 60 spots to their nursing programs by lending its own nurses, on hospital pay, as instructors. Pasco Hernando Community College found that local hospitals were so desperate for nurses that they were willing not only to lend clinical instructors but also to pay tuition and expenses for students who would make a two-year commitment to work as nurses when they graduate.

A long-term solution, hospitals say, will require more funding for health-care education. Schools and professional groups are lobbying against provisions in the Bush Administration's proposed budget that would cut federal funding for nursing education and eliminate it for other health professions. "There is a crisis brewing," Collier says. "With no funding, it will only get worse." --With reporting by Barbara Burgower Hordern/Houston

With reporting by Barbara Burgower Hordern/Houston