The changing health care landscape has pushed hospitals to rely more on their most- and least-skilled employees, while gradually scaling back their mid-level workforce, Wall Street Journal's Ben Casselman reports.
Because of myriad factors and pressures, including technological advances and increased attention to costs and outcomes, hospitals are eliminating positions like licensed practical nurses (LPNs) and medical-records clerks, pushing them into lower-paying health care settings.
For example, more than 25% of LPNs worked in hospitals in 2002, but that percentage has fallen to 17%, according to Labor Department data released this month. The data also show that the number of vocational nurses fell by more than 10,000 in 2012 alone.
Health experts say that technological advancements—especially those that automate clerical tasks—are to blame for the drop in demand for middle-skilled jobs. In addition, the pressure to decrease costs has led hospitals to ask more of medical assistants, who make about $30,000 per year on average, Casselman writes.
At the same time, entry-level requirements for many positions—including RNs—are increasing, in large part because of a growing focus on patient outcomes. A 2010 Institute of Medicine report recommended that 80% of RNs have a bachelor’s degree by 2020.
Although the shift away from middle-skilled workers is a trend across industries, economists are especially concerned by the shift in health care, which historically has offered many job opportunities for middle-skilled Americans.
Anthony Carnevale—director of Georgetown University's Center on Education and the Workforce—notes that entry-level requirements have risen "especially fast" in health care, despite the industry's growth and stability (Casselman, Journal, 4/25).
Berkow on workforce staffing
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