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The Gap Between Skilled Healthcare Workers and Support Jobs

 |  By John Commins  
   July 02, 2012

A stubborn line of demarcation exists between the haves and have-nots in the U.S. healthcare workforce. For skilled technicians and healthcare practitioners, there are more than two job openings for every qualified candidate. The Conference Board Help Wanted OnLine data series for June reports 615,800 online job ads seeking skilled healthcare workers, led primarily by the demand for registered nurses and physical therapists. The number of online job ads for this skill set grew by more than 28,000 in June, and the average hourly wage for those jobs was $34.97.

That factoid is turned on its head when examining the demand for healthcare support jobs such as nurses' aides, technology and clerical support staff, and phlebotomists. According to the Conference Board, there are two candidates for every healthcare support job, which paid an average hourly wage of $13.16.

"The pathways are pretty good on the professional and technical side. In theory you can go from a high school diploma to a nursing certificate to an LPN to a BA or a BSN to a master's degree," says Anthony P. Carnevale, director of the Georgetown University Center on Education and the Workforce.

But when it comes to career advancement opportunities for healthcare support staff, "There are almost none that we can find that get you from the support side to the professional and technical sides," Carnevale says. "There is the big valley there. It looks like the bridge between support and professional/technical is just not built."

 

"Support staff move into these jobs with minimal training and actually the amount of training is declining. More and more people in support have no certificate and no formal preparation," he says. "Where there is formal preparation it is minimal. We don't see movement out. There is a void and the difference between the two groups is very striking."

Yet even with their relatively low wages, healthcare support staff tend to be very loyal. "They show up for work and they stay. You would think these would be transitional jobs but they aren't," Carnevale says. "In low-wage labor markets there is lots of churn. That doesn't happen in healthcare. They stay on the job for a long time. There is a commitment, and we believe the commitment comes from the fact that, relatively speaking, this is a better job than the one they'd get if they left."

Carnevale says that test scores show that many healthcare support staff come from the bottom half of their high school classes. "But relative to other people in the bottom half of the high school class the healthcare support workers have more job security and they earn two to three grand more a year than the people who tested like them. From their point of view, this is as good a deal as they are going to get," he says. "But it is not a good deal. … These jobs tends to make people better off but they don't make them well off, that is clear."

The big hurdle for support staff remains the level of education. "When we look at the test scores typical of a healthcare support worker and the test scores of a professional and technical worker, there are about three to four school years of difference," Carnevale says. "The ability to move someone from support to professional technical is going to take a lot of doing."

Still, Carnevale says, the Georgetown center has examined years of national educational longitudinal surveys and estimates that about 20% of the healthcare support staff have the test scores that would suggest they are "highly trainable."

For any healthcare provider attempting to tap into its support staff for advanced training, Carnevale says the first step is to determine who has the basic skills. "Any community college has lots of tests you can give people to see if they are training-ready," he says. "All of the placement exams in community colleges and colleges do that pretty efficiently. You could find these people. You could tell them ‘If you want to join this program at entry level, you have to take the placement test.'"

Carnevale believes that hospitals and other healthcare providers should be promoting from within to fill vacant skilled positions. Rather than scouring the Internet to fill skilled healthcare job vacancies, he says healthcare providers could redirect some resources to identify and advance the best and brightest among the support workforce who are already on payroll.

"Obviously this is a missed opportunity," he says. "There are a fair number of people in support functions who, when we look at their test scores, look perfectly capable of training up. We know that is not going on in the aggregate. It may be going on here and there in little programs. I am struck that it is not more widespread because it seems so obvious that somebody would do this."

 

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John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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