Healthcare spending in the United States accounts for approximately 16% of our nation’s Gross Domestic Product (GDP). The Health and Human Services Department expects healthcare expenditures to peak at 19.5% of the nation’s GDP by 2017. The majority of each healthcare dollar spent goes toward hospital care and physician/clinical services. This is followed by pharmaceuticals, administrative costs and investments, nursing homes and other professional services, dental, home healthcare, government public health activities and other retail products. Healthcare expenditures affect healthcare careers by developing new procedure, equipment, treatment and prevention options for patients. Healthcare careers have undergone rapid change due to technological advances introducing new procedures and methods of diagnosis and treatment. These technological advances increase longevity and improve quality of life. A great portion of the growth in the healthcare industry is due to our increasingly aged population. Advances in information technology have also improved the efficiency of those in the healthcare industry.
Reduction of the healthcare expenditure has been emphasized in the recent healthcare reform bill. Overall, healthcare expenditures account for several trillion dollars a year of our nation’s GDP. According to the Bureau of Labor Statistics, healthcare careers employ over 14.3 million wage and salary workers. Hospitals employ the majority of workers at a rate of approximately 40%; another 21% are employed in nursing homes and residential care facilities; and 16% in the offices of physicians. Ten of the 20 fastest growing occupations are in the healthcare careers. The healthcare industry is projected to generate 3.2 million new jobs between 2008 and 2018, more than any other industry. The majority of these new positions will be in metropolitan areas that can sustain large medical centers and healthcare employers. The healthcare industry is indeed “recession proof,” as economic analysts forecast continued job growth for years to come in the healthcare careers.
Healthcare careers are practiced in the following segments of the healthcare industry: hospitals, nursing and residential care facilities, offices of physicians, offices of dentists, home healthcare services, offices of other health practitioners and ambulatory healthcare services. Approximately one-third of all healthcare establishments are offices of physicians. Offices of dentists account for approximately one-fifth of all healthcare establishments. Home healthcare services are one of the fastest growing segments in the healthcare industry. Ambulatory healthcare services have been emphasized, as cost containment is a key issue today in the healthcare industry and ongoing healthcare reform.
Many people are unaware of the great variety of job opportunities existing under the umbrella of healthcare careers. These careers encompass more than physicians and nurses. Professional and service occupations make up the majority of jobs in the healthcare industry, followed by office and administrative support, management, business, financial operations and other occupations. Healthcare careers encompass such occupations as physicians and surgeons, nurses and nursing aides, dentists and dental assistants, social workers, physical therapists, medical assistants, medical sales, home health aides, medical coding and billing, nutritionists/dieticians and forensic scientists. Some of the faster-growing healthcare careers are medical records and health information technicians, dental hygienists, radiologic technicians and diagnostic medical sonographers.
Most healthcare careers require 4 years or less of college-level education. Some healthcare career paths such as dentists, physicians and surgeons require a more substantive education. Healthcare careers usually involve distinct schools providing specialized training. Each career path has prerequisite coursework, required coursework, educational degree requirements and individual certification requirements. Degree levels include associate, bachelor, master’s and doctorate. Most healthcare careers have continuing education requirements, as well as career specific associations and journals. Each healthcare career path has a particular set of advantages and disadvantages.
History of the Medical / Health Profession
Modern medicine was not always the latest and greatest blockbuster prescription medicines and esoteric subspecialties. Many years ago there were no X-rays, computed tomography (CT) scans or magnetic resonance imaging (MRI). Healthcare careers have roots beginning in prehistoric times and span many centuries culminating in modern medicine.
The earliest medicine men were referred to as shamans. They were considered to have special powers enabling them to prevent, as well as cure, illness. They often used magic, prayers, charms and spells to heal the sick and injured. Through archaeological findings, we know the most primitive type of brain surgery, called trephination, began during prehistoric times. Trephination involved boring holes into the skull to release demon spirits suspected of causing illness. A few modern medicines such as digitalis and quinine have documented uses during these times.
Ancient Egypt has long been identified as the cradle of traditional Western medicine. During this time, practitioners typically had dual roles as physicians and priests. The duality most likely came from Egyptian beliefs of sickness being influenced by the gods. The most famous physician of Egyptian times was Imhotep. The Egyptians mastered human anatomy and organ function, as a result of their traditional practice of human mummification. Formalized surgery has also been traced to these times. Other healthcare careers such as dentistry, midwifery, obstetrics and gynecology and pharmacy have been traced to Egyptian times. Egyptian pharmacists had access to, or could manufacture, hundreds of standardized prescription medicines.
Ancient Greece continued to formalize and refine medical treatment. Greek physicians attributed illness to an imbalance of the four “humors” (blood, phlegm, yellow bile and black bile). Famous physicians during this time included Aesculapius and Hippocrates. Aesculapius was later worshipped as a Greek god. Hippocrates wrote many medical textbooks and is honored with the Hippocratic Oath, the professional ethical standard followed by modern day physicians. The first acknowledged formal medical school was established during Greek times.
The Romans continued the medical tradition of the Greeks. The most influential physician of the Roman era was Galen. He, like Hippocrates, wrote volumes of medical textbooks. During this time, we see the advent of the military medical corps and advances in the treatment of trauma. Army surgeons used instruments very similar to modern day scalpels, forceps and catheters. Hospitals were commonplace during this time. Sedatives such as morphine were common in surgery, as was quasi-sterilization of surgical instruments. During the Roman era, public health was also fostered with the advent of water and sewage systems.
The 17th and 18th centuries were a great time of medical innovation. Anton van Leeuwenhoek refined the microscope and was the first to discover red blood cells and observe microorganisms such as bacteria and protozoa. William Harvey was the first to describe how blood is circulated throughout the body. Gabriel Fahrenheit developed the mercury thermometer. James Lind discovered that citrus fruit could prevent scurvy—hence, the advent of vitamins. Edward Jenner invented vaccinations after observing exposure to the cowpox virus protected patients against the deadly smallpox virus. Humphry Davy was the first to describe the anesthetic properties of nitrous oxide. The healthcare careers of pathology and histology were founded by Giovanni Margagni and Marie Francois Bichat.
The scientific basis of modern medicine was developed during the 19th century. Rene Laennec invented the stethoscope. Joseph Lister began disinfecting surgical instruments, which greatly decreased the incidence of death from postoperative surgical infections. William Morton refined anesthesia and made surgery virtually painless. In the 19th century, Elizabeth Blackwell became the first woman to receive a medical degree. Louis Pasteur and Robert Koch established the germ theory of disease. Alexander Wood invented the hypodermic needle. The first vaccines for anthrax, rabies, tetanus, typhoid and plague were developed. Willem Einthoven discovered the electrocardiogram (EKG). Wilhelm Conrad Roentgen discovered X-rays. Felix Hoffman discovered and patented aspirin, the most widely used medicine in the world. Other healthcare careers such as physiology, cellular pathology, microbiology and bacteriology were founded by Jakob Henle, Robert Virchow, Louis Pasteur and Robert Koch.
The 20th century saw further advancements in medicine. Karl Landsteiner characterized the existence of different human blood types. The process for synthesizing insulin was invented. The first vaccines for diphtheria, pertussis, tuberculosis and tetanus were developed. Alexander Fleming invented penicillin. Jonas Salk developed the polio vaccine. The double helical structure of DNA was first characterized in the 20th century. The first vaccines for meningitis, measles, pneumonia, mumps and rubella were developed. Giorgio Fischer invented liposuction. Also in the 20th century, the first test-tube baby was born. Godfrey Hounsfield and Allan Cormack invented the computed tomography (CT) scan. Raymond Damadian invented and patented the magnetic resonance imaging (MRI) device. Human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS), was identified. The human genome was completely mapped and this innovation continues into the new millennium.