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In the Unemployment Office, the Promise of Health Care Jobs

March 8, 2012

It’s 9:30 in the morning and Peter Andrews, a labor services representative in the New York State Department of Labor is facing a packed room. There are more than 60 of us seated at long tables and along the wall of a conference room where extra chairs have been brought in from another part of the building. At least two-thirds of us are middle-aged or beyond. Despite the size of the crowd, there is no talking—rather, an air of despondency suffuses the room.

I’m here, along with everyone else, because I am officially unemployed and in order to keep collecting our weekly checks we are required to attend this “workshop” on improving our job search skills. As Peter notes, none of us really want to be here.

But Peter is really trying; at the tender age of 26, he’s dressed in a dark grey and white pin-striped suit, a black dress shirt and a silver tie and he’s eager, helpful, working the crowd. He gives a shout-out to some people he notes that have been here before; “If you send me a list of jobs you’ve applied for every six weeks you won’t have to keep coming to these sessions anymore,” he tells them. “It’s simple, just write down a list of like 15 places and email it to me and I’ll take care of it for you.” I’m mentally calculating the number of “places” I’ve applied for a job and it’s nowhere near 15—there just aren’t that many full-time job opportunities for someone whose last job was working on health policy at a “progressive think-tank.” To most people, I don’t really “do” anything.

But Peter has lots of ideas; he rattles through a list of workshops the Labor Department offers in resume writing, interviewing techniques, help for “The Mature Worker,” and “Introduction to Social Media.” There are special programs for ex-offenders and immigrants looking for jobs; referrals to charities that offer free business clothing for women (although Peter recommends we avoid the center in Brooklyn because there are reports of bed bugs there) and—this seems to perk up the crowd just a tad—we are told that unemployed New Yorkers can take civil service exams for government jobs free of charge. There are funding opportunities for job training and free use of resource room computers and printers; just be sure to get here early—the line to get into the room is down the block by 11 AM.

OK. Now it’s on to getting us really fired up about the job search. Peter begins the part of his talk that focuses on where we should be looking for employment. In a word, it’s in healthcare or health care (depending on which style guide you follow). He tells us about the brave new world of Health IT where jobs pay $100,000 or more and the industry is flush with “$20 billion in stimulus funding from the government.” The biggest mistake we can make, he tells us, is undergoing training to work in medical coding and billing. Of 300 applications he approved two years ago to pay for this kind of training, more than 70% of the people who completed the certification program remain unemployed. It’s a dying field.

But health IT is another story. Coincidentally, this week Ezekiel Emanuel, health policy professor at the University of Pennsylvania and Senior Fellow at the Center for American Progress wrote an op-ed for Reuters that gushes about the success of the government’s HITECH program that as part of the Recovery Act offers physicians and hospitals payments to adopt electronic health records systems. Among office-based doctors, the use of EHR has “nearly doubled to 34 percent with e-prescribing exceeding 40 percent. Over 41,000 physicians have received more than $575 million in incentive payments,” writes Emanuel. For hospitals, he continues, “35 percent have adopted EHRs, and nearly 2,000 of the 4,700 hospitals have, collectively, received more than $2 billion in incentive payments. Every month has surpassed the previous month as measured by the number of physicians and hospitals that have signed up with the government for the EHR program, suggesting that these numbers will continue to rise.”

And what about Peter’s advice that health IT is where we unemployed will find lucrative work? Emanuel writes, “over 50,000 high-paying health IT jobs were created between 2009 and 2011. Additionally, the Bureau of Labor Statistics estimates that the number of health IT jobs will increase by 20 percent from 2008 to 2018 — faster than any other occupation.”

I look around the room and wonder, realistically, how many of us here will be entering this brave new world? The vast majority of the unemployed in Brooklyn (as in New York City as a whole and throughout much of the rest of the country) have a high school education or below. Most do not possess the skills to take advantage of this “job boom” in high-paying health care fields; they have lost jobs in construction, maintenance, secretarial and reception, retail stores and at small local businesses.

In November, the Fiscal Policy Institute issued a report entitled “The State of Working New York 2011” that found that since the recession officially began leveling off in mid-2008, New York lost 500,000 “employment opportunities.” Net job gains have been recorded only in low-wage industries, according to the report, where average annual wages are under $45,000.  For workers over 50 the situation is even bleaker; the Fiscal Policy report found that the under-employment rate for older workers rose from 9.7 percent to 13.4 percent since the economy started to recover after 2009.

Meanwhile, it was 10:30 and my mandated job counseling session was winding down. Peter stops talking about Health IT and six-figures jobs, he stops talking about the fantastic guy who leads the advanced resume writing workshop who found an executive from a recently closed Brooklyn Pfizer plant a job paying $230,000. A woman in the front row asks about other opportunities in health care; she’s thinking about enrolling in a training program for home health aides. Other people in the group seem interested in the answer. Peter tells us that yes, there is a real demand for home health care workers, that there are dozens of agencies just within walking distance of the downtown Brooklyn Labor department. But, he says, these jobs only pay $24,000 to $35,000 a year, often provide no benefits or overtime, and this may be hard to live on. “Make sure you get certified as a phlebotomist and medical assistant, even in billing and coding too,” he warns.

The truth is that the growth in health care jobs is not going to solve the unemployment problem or the growing divide between the haves and have-nots. Sure, some savvy, young college graduates will score those coveted six-figure jobs in Health IT. Others might get lower-paying positions in data entry or support. But most job-seekers who pursue health care employment will end up in far less lucrative positions; employed as home health aides, community health workers, medical assistants and in similar jobs that barely keep them above water financially. The trend in health care is to save money by moving patients out of hospitals and nursing homes and into community programs where care is provided by these lower paid workers.

For me, as directed,  two months ago I sent my resume along to be matched with NYDOL’s “extensive confidential database of jobs (nearly every type of industry is represented here).” So far I haven’t received any of the “regular updates” listing jobs that fit my objective and skills as promised by the job counselor.

But as I walked home from my session I began thinking about what it would take to become an Emergency Medical Technician—another job recommended by the ebullient Peter Andrews. Seems like a good, practical skill set to learn and it would be exciting to ride around in an ambulance saving lives…if only I could just get over my fear of blood and gore I might have a chance to work in the booming health care field.


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  1. Naomi —

    Very compelling post. The interface between all those aggregate statistics and the personal realities of individuals is a striking contrast. I hope you find something worthy of your talents. I’m still upset that the new management at The Century Foundation stupidly canned HealthBeat. You and Maggie Mahar really were widely influential and did considerable good.

    Keep your chin up. And blood and gore really isn’t that difficult to deal with. When it’s really happening, you don’t see the blood — you see the person bleeding. I think you’d be good at caring for that person.

    • Thanks Chris, I appreciate your comments. Also agree that EHR will improve quality of care and coordination of treatment before realizing promised cost savings. Right now there are a lot of disparate EHR programs that don’t necessarily communicate with each other so the emphasis is moving toward creating large statewide or even national networks.

      • I miss HealthBeat, too. It was at the top of my list of “Favorites” for regular health blog and website reading. Regardless of where your job search leads you, Naomi, please keep writing. As for the various job possibilities in health care, if you do pursue such a path I hope that it leads you in unexpected directions that enable you to write about topics you would otherwise never have known first-hand. Sincere best wishes.

  2. lhf permalink

    Application of IT to health care appears not to be the holy grail of cost reduction – per an article in yesterday’s Washington Post:

    So those high paying jobs, if they exist, might disappear

  3. I’ve always thought of EMR and other healthcare IT things as more important as improvements to patient care than as huge cost savers. I’m sure there are savings there, but perhaps more in blunting the seemingly inexorable rise in costs than reducing them much outright. For one thing, there are immediate costs of the technology to recoup before you can start saving anything.

  4. FWIW I was trained to be an x-ray tech as a draftee in 1965, serving a couple years in the Army Medical Service Corps. When I was discharged my hope was to use that training to help pay for finishing college, but to my dismay the only way to get hired was to first become “certified.” Yep, two years more training, so my working life took a different path in the food business.

    When I took early retirement about ten years ago my first instinct was to look again at being an x-ray tech since I needed insurance for myself and my wife until we could graduate to Medicare. Again, to my disappointment, I was looking at two years that had to be paid for. My hope that I might earn part of the amount by getting paid for the clinical portion of training turned out to be just that — hope. I was in no position to drop out of sight for two years and become the oldest Certified Radiologic Tech in North America so I went with hospital-related food service instead. Less money but I had insurance.

    What I found out along the way was that certification was only the beginning of a field that could take many tracks… nuclear medicine, CT scans, anything to do with imaging, even traveling. Traveling is an overlooked area because when technicians have vacations due it’s not always possible to find a certified replacement, so there are agencies that specialize in finding and connecting specialties in other places for temporary assignments. Typically expenses are paid and the compensation goes to the person’s bank account pretty much intact. Hourly compensation can start at the twenty-dollar range and up, sometimes with a sign-up bonus. Like most jobs the serious money comes with experience, but it can really add up.

    Unfortunately this is not a viable option for someone later in life, but the health care field remains fertile ground for someone just starting the journey. EMT sounds like an exciting possibility if the training can be either brief or on-the-job while getting paid. It would give you a view of health care unmatched by all the reading and studying in the world. Don’t worry about the blood and other stuff. Unless you have some visceral problem that borders on clinical phobia that can all be overcome. I was amazed as an Army Medic how quickly we all got over the squeamish part after seeing a few training films and seeing some real live examples of what is involved.

    The learning curve doesn’t go away like hair color and smooth skin. Those with open minds and a good attitude can surprise themselves with what new information and skills can be added to their toolbox. A year ago I had never seen an ostomy bag but after taking care of someone for almost a year I’m an old hand at replacing an old one with a new one. When you think about it, it’s not that different from what mothers do with babies, except the age and location is different. The main adjustment is the way we see the need and our place in meeting it. Go for it. You’ll make a helluva an EMT. (And after a few months your credentials as a health policy analyst will become more three-dimensional.)

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