Home health aides, medical assistants and other workers with less than a four-year college degree account for nearly half of the health care workforce in Florida and across the country, a new Brookings Institute analysis reports.
Between 2009 and 2011, a total of 3.8 million people in 10 different “pre-baccalaureate” fields worked in the nation’s 100 largest metropolitan areas, including eight regions in Florida, said Martha Ross, a Brookings fellow and author of the reportreleased today.
In Florida, the 280,000 workers identified in those fields accounted for more than half of the health care workforce, providing medical treatment in hospitals, doctors’ offices, other medical facilities and homes. The Lakeland and Winter Haven region had the fourth highest percentage of those workers in the country, at 59 percent.
“There are a lot of important and necessary things that happen in a doctor’s office that do not have to be done by the doctor,” Ross said. “If there is a patient who has a chronic case of diabetes and they are stable, the medical assistant can be a primary point of contact with them. You don’t have to be an MD to go over a blood glucose reading or to talk about nutrition and exercise.”
Nursing, psychiatric and home health aides are the largest group of workers in the report, at 1.2 million nationally, and numbering 92,554 in Florida. And demand for workers in this field has grown 37 percent in the past decade.
“We have a growing population and we have an aging population. And we have a fairly large number of people who have chronic diseases or disabilities,” Ross said. “And these are people who use the services of the nursing aides and the home health aides.”
However, it’s also a field that gets at the report’s main concern, about income. Between 2009 and 2011, nursing, psychiatric and home health aides earned on average just $25,000 a year.
“If we want to upskill these jobs to help provide higher quality care, we have to compensate them accordingly or we’re not going to hold on to people,” she said.
It’s easy to see how education influences what people make. Registered nurses who can be licensed after earning a two-year Associate’s Degree, on average, were paid $60,000 a year. Personal care workers often get a high school diploma or less and post average annual earnings of $21,000, the report found.
The Brookings analysis looked at 10 health professions where workers may not need a bachelor’s degree in order to practice: personal care aides; nursing, psychiatric, and home health aides; health practitioner support technologists and technicians; medical assistants; registered nurses; licensed practical nurses (also known as vocational nurses); dental assistants; diagnostic related technologists and technicians; emergency medical technicians and paramedics; and clinical laboratory technologists and technicians.
It found that in four fields (health aides, medical assistant, dental assistant, and licensed practical or vocational nurses), 90 percent or more of the workers did not have a four-year degree. Only two fields had fewer than half of workers earning lesser degrees: registered nurses, (39 percent), and clinical lab technicians and technologists (45 percent).
Geography also plays a part in both the education level of workers and the size of their paychecks, Ross said. Salaries in the Tampa Bay area were between $2,000 and $6,000 more a year, in some occupations, compared to Lakeland, the report shows.
Ross said the University of South Florida College of Medicine and teaching hospitals such as Moffitt Cancer Center and Tampa General Hospital influence the education levels of their health care workers.
“The presence of the teaching hospital and medical school are important because they point to a different makeup of the local health care market. So that’s where research is happening and advanced medical treatment that relies on highly educated people and specialists,” she said.
Demand for these kinds of workers will continue to grow, especially as the health care system continues to push for more treatment outside of hospitals and other facilities. In order to succeed, she said, it will require everyone working in health care to look at redefining who does what, and the level of training needed. Ross said physicians are a key to that equation.
“Where I see opportunities for change is that many doctors, those who are at the top of the food chain, are miserable with the status quo,” Ross said.
“They don’t want to be stuck in a system where they see too many patients in time slots that are too short, and where they feel like they always have to be entering data into charts or filling out forms for insurance.”
--Health News Florida is part of WUSF Public Media. Contact Reporter Mary Shedden at (813) 974-8636, on Twitter @MaryShedden, or email at shedden@wusf.org. For more health news, visit HealthNewsFlorida.org.
