WetFeet Insider Guide to Careers in Health Care 9781582073279

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Careers in Health Care

Welcome to WetFeet WetFeet, Inc. 609 Mission Street Suite 400 San Francisco, CA 94105 Phone: (415) 284-7900 or 1-800-926-4JOB Fax: (415) 284-7910 E-mail: [email protected] Website: www.wetfeet.com

Careers in Health Care ISBN: 1-58207-327-9

The WetFeet Research Methodology You hold in your hands a copy of the best-quality research available for job seekers. We have designed this Insider Guide to save you time doing your job research and to provide you with highly accurate information written precisely for the needs of the jobseeking public. (We also hope that you’ll enjoy reading the Insider, because, believe it or not, the job search doesn’t have to be a pain in the neck.) Each WetFeet Insider Guide represents hundreds of hours of careful research and writing. We start with a review of the public information available. (Our writers are also experts in reading between the lines.) We augment this information with dozens of indepth interviews of people who actually work for each company or industry we cover. And, although we keep the identity of the rank-and-file employees anonymous to encourage candor, we also interview the company’s recruiting staff extensively, to make sure that we give you, the reader, accurate information about recruiting, process, compensation, hiring targets, and so on. (WetFeet retains all editorial control of the product.) We also regularly survey our members and customers to learn about their experiences in the recruiting process. Finally, each Insider Guide goes through an editorial review and fact-checking process to make sure that the information and writing live up to our exacting standards before it goes out the door. Are we perfect? No—but we do believe that you’ll find our content to be the highestquality content of its type available on the Web or in print. (Please see our guarantee below.) We also are eager to hear about your experiences on the recruiting front, and your feedback (both positive and negative) about our products and our process. Thank you for your interest. The WetFeet Guarantee You’ve got enough to worry about with your job search. So, if you don’t like this Insider Guide, send it back within 30 days of purchase and we’ll refund your money. Call us for details or e-mail us comments at 1-800-926-4JOB or [email protected]. Photocopying Is Prohibited Copyright© 2002 WetFeet, Inc. All rights reserved. This publication is protected by the copyright laws of the United States of America. No copying in any form is permitted. It may not be reproduced, distributed, stored in a retrieval system, or transmitted in any form or by any means, in part or in whole, without the express written permission of WetFeet, Inc.

Table of Contents Quick TOC At a G l a n c e The Industry

Health Care at a Glance 1 3

On the Job

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T h e Wo r k p l a c e

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Getting Hired

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Fo r Yo u r R e f e r e n c e

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The Industry Overview The Bottom Line Trends in the Field Industry Breakdown Required Education/Training/ Certification

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On the Job Career Options Other Careers in Health Care Aides & Assistants Technicians Therapists Alternative Medicine Practitioners Day-in-the-Life Profiles

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The Workplace Lifestyle, Hours & Culture Workplace Diversity Compensation Benefits & Perks Career Path Insider Scoop & Watch Outs!

38 40 41 43 44 46

Getting Hired The Hiring Process Interviewing Tips

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For Your Reference Job Search Websites General Career Insights Professional Associations

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A G L A N C E

What Is Secondary Health Care? Secondary health care professionals play critical therapeutic roles within the traditional Western medical system, or perform primary diagnostic and therapy management roles as alternative medicine practitioners. Doctors and nurses delegate administration of the therapeutic regimens they prescribe to specialized secondary health care practitioners, or may refer patients to secondary health care practitioners with complementary medical expertise that falls outside the conventional physician’s or nurse’s purview.

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Health Care at a Glance

Growing Career Opportunities Employment within the U.S. health care industry is projected to increase by a robust 25 percent through 2010, according to the Bureau of Labor Statistics, and many of the fastest-growing fields in the industry are in the secondary health care field. Reasons for this growth include demographic shifts, economizing and managed care approaches that shift patient care responsibilities to secondary health care professionals, medical breakthroughs that prolong life and improve patient prognosis with treatment, and the growth of the home health care and integrative medicine fields. Prerequisites While some entry-level secondary health care positions require little or no formal training beyond a high-school diploma, many of the higher-paid occupations require training, and some require candidates to pass exams for certification or licensing and/or meet specific state requirements for that occupation. The bulk of the opportunities in the secondary health care field are open to candidates with two years or less of training, though some specialized occupations require four-year degrees plus additional credentials and/or graduate degrees.

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The Industry

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I N D U S T R Y T H E

Overview If you’ve been sick or injured lately, odds are you’ve spent quality time with a specialist in some secondary health care field—a lab technologist, pharmacy technician, homeopath, emergency medical technician, or occupational therapist. If you’re healthy, you probably rely on dental hygienists, dietitians, massage therapists, and other professionals in secondary health care fields to keep you that way. Secondary health care is a sweeping term that is often applied not only to caregivers and technicians with critical therapeutic roles within the traditional Western medical system, but also to alternative medicine practitioners with primary diagnostic and therapeutic responsibilities. The Primary Importance of Secondary Health Care In many cases, “secondary” health care providers perform critical, even lifesaving interventions. Without paramedics, dietitians, acupuncturists, and physical therapists, the world would no doubt be a much more dangerous, unhealthy, and painful place. So why are these important roles referred to as “secondary”? Good question. There is a long-established hierarchy of care within Western medical practice that assigns primary responsibility for a patient’s diagnosis and treatment to doctors, nurses, and other primary health care providers with specific advanced diagnostic and treatment regime management training. In many cases, though, doctors and nurses delegate administration of the therapeutic regimens they prescribe to specialized secondary health care practitioners, or may refer patients to alternative medicine practitioners with complementary expertise that falls outside the conventional primary caregiver’s purview. Many people also take their health concerns directly to secondary health care professionals outside the Western medical system, such as acupuncturists, massage therapists, naturopaths, or homeopaths.

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A Healthy Career Outlook With 11 million jobs in the U.S. alone, health care is already one of the largest industries—and it’s still growing. The U.S. Bureau of Labor Statistics (BLS) projects that employment within the U.S. health care industry will increase by 25 percent through 2010, as opposed to 16 percent in other industries. Nine of the 20 fastest-growing occupations in the U.S. economy will be in health care, and roughly 13 percent of all wage and salary jobs created between 2000 and 2010 will be in health care—that’s 2.8 million new jobs, many of them in secondary health care fields.

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T H E I N D U S T R Y

What’s more, some of the fastest-growing occupations within the expanding health care industry fall within the secondary health care field. For example, the BLS anticipates that between 2000 and 2010, opportunities for personal and home care aides will increase by 67 percent, medical assistants by 60 percent.

The Bottom Line Personality Characteristics Secondary health care provides ample opportunity for competent, compassionate people to earn a living while dramatically improving the lives of their patients—typically with far fewer years of study than it takes to become a nurse, doctor, or other primary care provider. This is an ideal way to enter the medical field if you’re more interested in practice than theory, but don’t think you can snooze through your training classes, either. Make no mistake: This is important, life-changing, and potentially very stressful and unsettling work, and you’ll need a serious dedication to helping others, a good head on your shoulders, a strong stomach, and a solid work ethic to keep up and get the most out of it. You’ll be expected to retain a lot of knowledge and apply it in hectic, high-pressure situations, where fast but careful thinking is a must. The work can be physically demanding, too: “Try lifting a 300-pound unconscious guy onto a 75-pound gurney while you’re carrying 75 pounds of equipment, and you’ll know what I mean,” says one longtime secondary health care professional. The Right Recommendations Since secondary health care requires strong people skills, whether or not you are able to land a job in secondary health care depends not only on your training credentials (see “Required Education/Training/Certification” section), but also on your personal recommendations. Insiders recommend volunteering in a health care setting, informational interviews with secondary health care professionals, shadowing a secondary health care professional during a routine day at the clinic, and offering to intern for a professional you know. This will give you a better sense of what you’re in for if you do get the job, and ideally will earn you that all-important recommendation from a respected professional in your field. If you don’t know of any friends, friends of friends, neighbors or relatives in secondary health care, locate possible mentors in your geographic area with the help of your school’s career center and an appropriate professional association—several are listed in the “For Your Reference” section at the end of this guide.

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Trends in the Field Growing Demand Although a 2001 Bureau of Labor Statistics (BLS) report noted layoffs affecting the health sector, the demand for secondary health care services is expected to continue its upward trend for some time to come. Consider the pressing public health need to address health issues and crises in underserved communities, such as impoverished urban and rural areas where adequate access to even basic health services remains a rarity. Demographic shifts are another compounding factor. The elderly population in the U.S. is growing faster than the total population, especially now that the Baby Boom generation is entering their 50s and 60s. This puts further pressure on health care providers to extend and improve their resources to meet the demands and expectations of the burgeoning 60-plus demographic. As medical technology breakthroughs prolong life spans to 80-plus, more diversified health services will be needed to preserve quality of life over a longer period of time.

Moving up the Technology Curve Besides its rapid growth, one of the most obvious trends in secondary health care is technological advancement. High-tech medical devices have given EMTs and paramedics the power to revive their patients, occupational and physical therapists the ability to chart patient improvements, and lab technicians an easy way to analyze samples and test results. While recent medical breakthroughs have contributed to an overall improvement in the prognosis of patients suffering severe trauma and illness, as the BLS notes, significant specialized attention from secondary health care professionals such as occupational therapists is often required to restore patients’ health and quality of life. So while certain technological advances may eliminate the need for some direct intervention by a secondary health care professional, technology also creates higher-level, longer-term roles for secondary health care specialists.

Managed Care

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To keep pace with demand while preventing health care costs from skyrocketing, hospitals, clinics, and private practices are turning to secondary health care specialists, who can be trained more quickly and provide round-the-clock services more cost-effectively than physicians or registered nurses. This increasingly widespread managed care practice of delegating treatment responsibilities to specially trained, lower-paid secondary health care professionals is contributing to the professionalization and diversification of the secondary health care field. However, as one insider says, many secondary health care professionals are opposed to managed care approaches due to the limits it

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I N D U S T R Y

Like it or not, managed care approaches are becoming a standard in clinics, hospitals, and other health care establishments not only in the U.S., but also in profit-minded private health care institutions throughout the world and in public health care facilities in the U.K., the Cherokee nation, New Zealand, and other nations faced with health care budget crises. Efficiency measures are creating demand for secondary health care professionals in all of these locations. If you’re interested in working in secondary health care outside the U.S., seek out professionals in your chosen field and location through the appropriate professional association, and inquire about opportunities, credentials, and work visa arrangements.

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places on treatment options for their patients, and the often elaborate bureaucracies it creates.

The Home Health Care Boom The projected rate of growth for the fastest-growing health care segment, the home health care field, is a whopping 68 percent according to the BLS. Compare this to the comparatively measly 9.8 percent rate of growth for public and private hospitals, the robust but comparatively meager growth rates of dental offices and clinics (25.6 percent) and nursing and personal care facilities (21.9 percent), or even the otherwise impressive growth rates for the offices of physicians at 43.8 percent and other health practitioners at 46.8 percent. Tradeoffs There are pros and cons to landing a job in the expanding home health care field. If you’re looking for a flexible schedule or a field where opportunities abound, home health care will appeal to you. However, secondary health care professionals at the non-supervisory level in other institutional settings tend to earn more than those in the home health care segment. (See “Compensation” for comparative rates of growth in health care segments.) Hospitals and large nursing facilities also offer more training and advancement opportunities than home health care establishments, but this may change as employers compete to attract and retain qualified candidates with more training and advancement opportunities. At the moment, though, anyone considering a career in home health care should recognize the tradeoffs of pay and advancement in exchange for security and flexibility.

Integrative Medicine If your doctor recommended Echinacea for your cold or massage therapy for your sore back, you’ve already experienced the integrative medicine trend firsthand. Integrative medicine combines traditional Western medical practices of

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treating health problems with drugs and surgical interventions with nontraditional, “alternative” approaches such as herbal remedies and massage. After decades of grappling with a range of such pressing, persistent health concerns as cancer, AIDS, depression, repetitive stress injuries, flu, and the common cold, some hospitals and clinics are incorporating select alternative practices deemed complementary to Western medical interventions into their treatment regimens. Although some inroads are being made with primary care providers in general practice (as in the treatment of colds and sore backs), integrative medical approaches are currently concentrated in centers for physical rehabilitation, terminal illness, preventive care, and chronic pain management. In hospitals and clinics, patients usually must obtain a referral from their primary care provider to gain access to these complementary health care services—and this isn’t always a simple matter. Some primary care providers feel the available research on certain complementary therapies is insufficient in demonstrating their efficacy, and are reluctant to recommend these therapies to patients. But other primary care providers see the value of complementary therapeutic approaches for their patients, and some in private practice are even partnering with dietitians, acupuncturists, naturopaths, and other specialists in complementary therapies.

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I N D U S T R Y

Roles within the secondary health care field are often lumped into one of two broad categories: “professional” occupations, and “paraprofessional” or “service” occupations. But these categories are as misleading as they are vague. First, all secondary health care occupations are “service” occupations—whether you’re analyzing a patient’s blood sample, changing a patient’s bed linens or cleaning a patient’s teeth, you are providing a valuable service to a patient. “You have to be service-oriented in our profession, because a patient’s health and welfare is always your end goal,” says one experienced secondary health care professional.

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Industry Breakdown

Secondly, almost all secondary health care occupations are increasingly professionalized. Even entry-level health care roles that may have only required a comforting bedside manner back in the early 20th Century now may also require knowledge of medical technologies or specialized certification. Furthermore, secondary health care roles are becoming so diversified and specialized that they just don’t fit into two categories anymore. Secondary health care roles are perhaps more accurately grouped into four broad but distinct categories, according to scope of responsibilities, patient interaction, expertise, and training. These are defined here as aide/assistant, technician, therapist, and alternative medicine practitioner.

Aide/Assistant The primary responsibilities of professionals in these secondary health care positions is to provide patient care and give hands-on support to primary care providers. Professionals in these positions typically have the most direct contact with patients. They are responsible for carrying out prescribed treatment regimes, but also provide patient insights and observations that help primary care providers make accurate diagnoses and prescribe appropriate treatments. Required training ranges from minimal training for orderlies and home health care aides to a year or more for dental and medical assistants and nursing care aides.

Technician The main role of these secondary health care professionals is to use specific technological tools and/or specialized training to help diagnose and treat patients more effectively. They often have only minimal interaction with patients, and spend the majority of their time in specialized tasks (such as emergency medical technicians or dental hygienists) or lab work (such as

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medical laboratory or radiologic technicians). Due to the technical nature of these positions, more specialized training and certification/licensing is typically required than for aide/assistant positions. Requirements for these positions often entail a high school degree plus a one- or two-year specialty training program and/or appropriate certification.

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Therapist This category of secondary health care professionals covers specialists that design and deliver treatments to address a specific, chronic health concern or condition (such as high cholesterol, occupational injuries, or speech impediments). Their diagnostic roles may be limited at hospitals and clinics, which often require primary providers to make a preliminary diagnosis and referral. But some expert specialists, especially those in private practice, may take on primary responsibility for the therapeutic approach to address the patient’s condition in addition to managing that patient’s treatment regime. A four-year degree plus a year or more of additional training and state certification is often required for these positions.

Alternative Medicine Practitioner Professionals in these secondary health care roles provide diagnostic approaches and treatment options that fall outside the traditional purview of Western medicine. They often spend significant time with patients in diagnosis and treatment, offering understanding, diagnosis, and treatment of medical conditions that are completely distinct from Western medical practice. The therapeutic approaches they prescripe may complement Western drug therapy, physical regimens, and surgical procedures. States have varying guidelines regarding licensing and certification for alternative medicine disciplines, but training can range from one to two years of specialized training for a massage therapist to a bachelor’s degree plus three years and a residency program and state certification for an acupuncturist.

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I N D U S T R Y

Training requirements for secondary health care occupations range from almost no formal training prerequisites to a four-year degree plus specialized training and/or a graduate degree. In some cases, minimal training plus a solid grounding in high school science is sufficient to land a job in secondary health care. According to the Bureau of Labor Statistics (BLS), 56 percent of those working in nursing care facilities and 25 percent of those in hospitals have a high school diploma or less. But more specialized fields typically require more training: dental hygienists and radiologic technologists complete two-year programs resulting in certificates or associate degrees, and most therapists have at least a bachelor’s degree plus specialized training.

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Required Education/ Training/Certification

Learn Fast, Earn Fast According to the BLS, the majority of jobs in the health care industry require less than four years of college education—which means you’ll be earning a living in your field while your friends who want to be doctors are still slogging their way through organic chemistry. Now for the not-so-good news. As one insider puts it, “There’s a lot to memorize, and sometimes it can feel like you’re squeezing all the learning of an MD into just a few semesters of training.” One small detail in your training could make all the difference in a life-or-death decision, and as one practitioner says, “You’re only going to get that information once, so you really have to pay attention. When your training is two years or less, they don’t have time to drill the facts into you like they would if you were becoming a doctor or registered nurse.”

Testing, One, Two … Then there’s the testing. Most specialized secondary health care fields require you to pass a certification or licensing exam in addition to your formal training to qualify for a job. Over time, you may also have to take additional exams to renew and expand your credentials, so you have to stay on top of the developments in your field.

Lifelong Learning Keeping up with all of the new treatments, research, approaches, and technologies in your secondary health care field will be a constant challenge. For example, nursing aides in certified nursing facilities are expected to submit to a state-approved training and competency evaluation program and complete a minimum of 12 hours of service education every year. But

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experienced professionals in secondary health care report that ongoing learning is also part of the excitement and growth opportunities in this field. Says one secondary health care practitioner, “The lifelong learning I’ve found in this career is a great source of personal satisfaction for me.”

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On the Job

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Career Options The occupations covered in detail in this section provide a broad sampling of the many career options available in secondary health care. Other secondary health care occupations you might consider include: > > > > > > > > > > > > > > > > > > > > > > > > >

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Alcohol and drug counselors Anesthetist technicians Art therapists Audiologists Cardiovascular technicians Chiropractor’s aides Dental assistants Dental laboratory technicians Diagnostic medical sonographers Diabetes counselors Dietitians and nutritionists EKG (electrocardiograph)/EEG (electroencephalograph) technicians Licensed practical nurses Movement therapists Nuclear medicine technologists Ophthalmic laboratory technicians Opticians Paramedics Physician’s assistants Psychiatric aides Prosthetists Recreational therapists Respiratory therapists Sonographers Surgical technologists

Where available, professional association resources for select fields are included in the “For Your Reference” section.

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Other Careers in Health Care

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There are many opportunities in the health care industry that do not fall within the secondary health care field. This guide does not cover: > The primary health care field, which typically refers to Western medical practice with primary diagnostic or treatment management responsibilities and requiring advanced medical degrees. This includes doctors, registered nurses, osteopaths, psychiatrists, dentists, pathologists, nurse practitioners, pharmacists, chiropractors, podiatrists, psychologists, optometrists, and radiologists. (WetFeet.com offers profiles on some of these primary health care careers.) > Veterinary medicine or social work, which are defined disciplines with specific training, qualifications, work settings, and industry outlooks distinct from those in most secondary health care occupations. > Information technology fields within the health care industry, such as medical records database management, medical transcription, and medical secretarial.

Aides and Assistants Dental Assistant The Bureau of Labor Statistics (BLS) reports that in dental offices and clinics, more than a third of the staff are dental assistants and other medical support staff—and the field is growing rapidly, due to increased reliance on dental assistants and staff turnover. Flexible work schedules are a major attraction of this field; the BLS notes that in 2000, two out of five dental assistants worked part-time. The BLS also reports that median hourly earnings of dental assistants were $12.49 in 2000. According to the American Dental Association and the BLS, the responsibilities of dental assistants are to assist with treatment procedures, control infection by establishing protocols and preparing and sterilizing equipment, prep patients and ensure their comfort throughout their visits, perform office tasks, instruct patients in oral hygiene and aftercare following surgery, and handle contacts with patients, dental suppliers, insurers, business contacts, and other health professionals. Advancement opportunities within the field are limited, but dental assistants may go on to manage offices, teach dental assisting, become dental product sales representatives, or return to school to pursue better-paying careers as dental hygienists. Copyright 2002 WetFeet, Inc.™

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ADA-accredited dental assisting training programs take at least one year to complete, and are available in some 250 community and technical colleges throughout the U.S. But some state licensing programs take only ten months to complete, and unaccredited dental assisting programs at private vocational schools often take only four to six months. It’s possible to become a dental assistant with only a high school diploma and high school science background, usually through internships or other on-the-job training programs (including Armed Forces training). Home Health Care Aide The BLS reports that home health care is the fastest-growing segment of the health care industry, and half of all positions in this expanding field are occupied by home health care aides and personal care aides. Home health care aides also enjoy more flexible schedules and part-time positions, which may appeal to students and those with significant family responsibilities. The starting salary for a certified home health aide is $9 to $10 per hour, among the lowest hourly wages in the entire health care industry. Opportunities for advancement in home health care settings are also far less common than in hospitals or large nursing care facilities. The main responsibilities of home health care aides are to assist patients with bathing, eating, personal hygiene, and other daily activities. Vocational training schools offer certification training programs for home health care aides that take less than a year to complete. Certification isn’t always necessary to enter the field, so check with your state’s health department to find out about requirements for home health care aides in your state.

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Medical Assistant The BLS predicts that medical assisting will remain among the fastest-growing occupations in health care through 2010. Median annual earnings for medical assistants in 2000 according to the BLS were $23,000, with the highest median earnings at medical doctor’s offices and clinics ($23,610) and in hospitals ($22,950) and lower earnings at the offices of osteopathic doctors ($21,420) and other health care practitioners ($20,860). Most of the 329,000-plus medical assistants working in 2000 worked a regular 40-hour week, and 60 percent of medical assistants were employed in physicians’ offices. Medical assistants are frequently the first line of contact for patients, since they often schedule and help prepare patients, administer medications as directed by a physician, record patients’ medical histories, and may talk patients

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O N T H E J O B

through treatment procedures and exams. Other clinical support roles they perform include basic lab work, instrument sterilization, and specimen preparation. They are also often assigned a broad range of administrative duties, from answering phones and record keeping through billing, purchasing, and patient scheduling. Experience as a medical assistant may lead to a job as an office manager, or with additional training to a nurse or medical lab technician. Formal training isn’t always necessary to obtain a medical assisting job, but completing a one-year training program at a vocational school or community or junior college improves a medical assistant’s job prospects. Some medical assistants may choose to specialize in podiatry or opthamology, and these specialists tend to earn higher salaries. There are some 500 accredited programs in medical assisting, and these typically require students to complete an internship in a physician’s office or hospital. Medical assistants should not be confused with physician’s assistants, who earn a four-year degree to learn how to examine and treat patients, provide preventive care and perform diagnostic tests under the direction of a doctor. Nursing Care Aide Growth in the nursing care field is assured by federal mandate. According to federal law, nursing facilities are required to have capable, licensed staff on hand 24 hours a day to provide adequate care. Yet despite the demand for nursing care aides—especially certified nursing care aides—this is one of the lowest-paid occupations in the secondary health care sector. The BLS categorizes nursing care aides with somewhat lower-paid orderlies and attendants, and lists the 2000 median salary for this grouping as $8.83 an hour. Nursing care aides work under the supervision of a nurse to administer therapies and note changes to patients’ condition, as well as attending to the overall health, cleanliness, and welfare of their patients. Many positions require certification to meet federal requirements, and certification for nursing care aides takes up to a year. Some states require yearly certification renewals, so you’ll need to check the requirements for your state. Pharmacy Aide According to the BLS, opportunities for pharmacy aides are expected to grow as fast as other occupations on average. Their responsibilities are mostly clerical, ranging from answering calls and serving as a cashier to handling insurance paperwork and patient record keeping. Occasionally their jobs overlap with those of pharmacy technicians, who are trained to perform more clinical tasks but may also assist with clerical duties. Pharmacy aides may work

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nights, weekends, and holidays, and are often on their feet for the duration of their shift. The median earnings for pharmacy aides were $8.52 in 2000, with higher median earnings in hospital settings ($11.17) and lower median earnings in grocery stores ($8.47). The BLS also notes that as of 2000, four out of five pharmacy aides were employed in retail pharmacies. Employers tend to prefer pharmacy aide candidates with a high school diploma, but many are willing to provide on-the-job training to promising candidates with good math skills and sufficient manual dexterity. This position is a good way to learn more about related careers ranging from pharmacy technology to pharmaceutical sales. Orderly The BLS lumps orderlies in with nursing aides and attendants, and puts this combined occupational category near the top of its list of fastest-growing occupations though 2010 with a projected 24 percent growth rate. The median wage for orderlies, nursing aides, and attendant category in 2000 was $9.18 an hour or $19,100 a year. Orderlies provide hands-on care to patients, and they are often the ones who transport, groom, bathe, and dress patients. These tasks tend to be physically demanding, so orderlies have to take extra precautions not to incur workplace injuries. Part-time employment is often available, and a good bedside manner and physical strength are often the only required qualifications for this job (though a high school diploma or GED is always desirable). These positions are often located in hospitals and large nursing care facilities, where on-the-job training programs may be available. Physical Therapist Assistant If a career helping people recover from illness or injury sounds rewarding to you, but the more than four years of training required to become a practicing physical therapist seems daunting, consider becoming a physical therapist assistant. These professionals carry out treatment for chronic pain and movement problems. They are typically paid $14 an hour to start, and the median salary for physical therapy assistants was $33,870 in 2000. They typically work in the offices of physical therapists in private practice, hospitals, sports medicine, and nursing care facilities.

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The required training for physical therapist assistants is typically a two-year associate’s degree. Some physical therapist assistants get their start as physical therapy aides, who perform clerical tasks and basic patient support and prepare the treatment area for patients without a need for training. The BLS observes that, in 2000, physical therapist aides earned a median salary of $19,670.

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Dental Hygienist A career as a dental hygienist has much to recommend it: remarkable career growth, flexible hours, and robust salaries. The dental hygiene field is projected by the BLS to be one of the 30 fastest-growing occupations in the U.S. through 2010. According to the American Dental Association (ADA), dental hygienists screen patients, instruct patients in good oral hygiene, apply fluoride, sealants, and other materials to the patient’s teeth to prevent decay, and remove plaque build-up and soft deposits from the teeth. Dental hygienists’ median hourly wages were $24.68 in 2000 according to the BLS, although the lowest tenth percentile earned only $15.53 an hour and the highest 10 percent earned upwards of $35.39 an hour.

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Technicians

Flexible work schedules and part-time positions abound in this field, which makes it an attractive choice for students, professionals with significant family responsibilities, and people holding down more than one job. Dental hygienists typically work in dentists’ offices, but they might also work for public health agencies, schools, and community clinics, or branch off into dental equipment research and sales. Dental hygienists usually complete two-year associate’s degree programs, though some combine coursework in the classroom or online with on-the-job training. There are 250 ADA-accredited dental hygiene programs to choose from around the U.S. in community and technical colleges as well as dental schools and universities. Emergency Medical Technician This occupation is expected to grow faster than average through 2010, according to the BLS. Emergency medical technicians (EMTs) provide emergency medical care at accident scenes and to people in critical condition, and transport these patients to emergency rooms for care. This work can be physically demanding and stressful, since it’s an EMT’s job to manage highpressure scenarios and make life-or-death decisions. The BLS reports median earnings for EMTs and paramedics of $22,460 in 2000, with significantly higher median earnings in the top tenth percentile of more than $37,760. Shifts can be long, and entry-level EMTs are often required to take on undesirable night shifts or pull long hours. EMTs are in demand not only in private emergency care and transport services and hospitals, but also in

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fire stations, police departments, and nursing care facilities. At $24,800 per year, median wages tend to be higher for EMTs employed by local government (usually in police or fire stations) than for hospitals ($23,590) or transport companies ($20,950). EMTs are typically required to complete training programs of one to two years and obtain certification, but some states and localities have additional requirements. Two-year training programs prepare EMTs to become EMT-paramedics, who are authorized to dispense drugs and may segue into operational roles such as supervisor, operations manager, administrative director, or executive director of emergency services. Through their daily close collaborations with nurses, doctors, and medical specialists, some EMTs may become attracted to these primary care fields and pursue the additional training necessary to fill one of these roles. Medical Laboratory Technician Ask any of the quarter of a million people who currently work in the growing field of medical laboratory services, and they’ll tell you: Recent breakthroughs in genetic testing, bioengineering, and tissue research are only the beginning. If you want to participate in these developments and have an aptitude for technology, you might consider a career as a medical laboratory technician. The BLS predicts above average growth for this field through 2005. In your role as a medical laboratory technician, you’ll use advanced medical technologies and sophisticated instruments to run tests on patient blood, tissue, and body fluid samples. No matter where you work—a hospital, clinic, commercial lab, or nursing or health care facility—your contact with patients will probably be minimal, since you’ll be spending most of your time in the lab. Your expertise as a medical laboratory technician helps doctors, pathologists, and nurses diagnose illnesses and provide more appropriate treatments. With starting salaries of $13 to $17 per hour and a national salary average of $26,800, pay for medical laboratory technicians isn’t too shabby, either.

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To qualify as a medical laboratory technician, you’ll need to complete a twoyear associate’s degree in applied science. There are about 200 community colleges nationwide that offer accredited training programs for medical laboratory technicians. This technician role is not to be confused with that of a medical laboratory technologist, a more senior position with advanced training requirements, more authority, and higher pay (from an average of $27,000 to start to $56,000 for experienced technologists). As a medical laboratory technician, you may work under the supervision of a medical laboratory technologist. You may decide to advance by earning your baccalaureate degree and

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O N T H E J O B

attending an accredited medical technologist program to become a medical laboratory technologist, or to get certified as a medical laboratory technician. You may also decide to specialize in lab research fields such as phlebotomy (blood analysis) or cytotechnology (cell research), or assume senior administrative roles as a lab supervisor or program director. Pharmacy Technician The BLS foresees a bright career outlook for pharmacy technicians— particularly those with certification and work experience behind them—predicting a much faster growth rate for this field than the average for other occupations. Your job as a pharmacy technician (or “pharm tech”) will entail packaging and labeling medicines, managing inventory, ordering supplies, and performing other duties under the supervision of a licensed pharmacist. Pharm techs are expected to be independent workers, but they are usually expected to refer non-routine patient questions to pharmacists, and the scope of their responsibilities may be limited according to specific state laws. Pharm techs start at about $10 an hour. Expect to work some evening, holiday, and weekend shifts—and most of that time will be spent on your feet. The BLS reports slightly higher median wages of $11.44 at hospitals and lower median wages at department stores ($8.75). The BLS also notes that two-thirds of all pharm techs work in retail pharmacies (such as Walgreen’s or Rite-Aid), and that part-time jobs are often available in both retail and hospital settings. Only a few states require formal training or certification for pharmacy technicians, so some pharm techs learn their trade on the job—although many employers prefer to hire those with specific certification or formal training from hospitals or community, vocational, or technical colleges. Some of these one-year programs include internships, which can help you get your foot in the door at a pharmacy and may result in a certificate or associate degree. For added appeal to potential employers and earn higher pay, you might also decide to take the National Pharmacy Technician Certification Examination to earn the title of Certified Pharmacy Technician (CPhT). To keep this title in working order, you’ll have to be recertified every two years. And while this may go without saying, you cannot become a pharm tech if you have a prior history of drug or substance abuse. Radiologic Technologist Radiologic technologists are authorized to operate a variety of X-ray equipment to help diagnose patients’ medical problems, process X-ray film, and assist physicians in fluoroscopic examinations. According to a 2001 study conducted by American Society for Radiologic Technology (ASRT), 80 percent

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J O B T H E O N

of radiologic technologists gave their career positive marks. One reason for this high level of satisfaction is the pay. In the ASRT study, the average wage listed for full-time radiologic technologists is $20.74 per hour—a sizable 22 percent increase over their average salary in 1997. Raises are common in this field, too; 88 percent of respondents reported receiving a raise in the previous 12 months, and the average raise was 5.32 percent. Salaried and part-time positions are not as common in this field as in other secondary health care occupations. Most radiologic technologists (84 percent) surveyed were paid on an hourly basis, 87 percent held full-time positions, and 78 percent work 40 or more hours a week. Most practice in a hospital setting, but the ASRT reports opportunities in private clinics and mobile facilities, too. Radiologic technologists must complete either a two-year associate’s degree in applied science or complete a 24-month radiography program in a hospital, and several states also require radiologic technologists to meet specific licensing criteria. To become a registered radiologic technologist (which is not a requirement for most positions, but is certainly an asset), you must pass a national certifying exam. The ASRT study showed that a growing number of radiologic technologists also hold credentials in specialty fields, such as medical resonance imaging (MRI) and cardiovascular intervention technologies.

Therapist

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Dietitian The BLS predicts stable, steady employment for dietitians consistent with the industry average through 2005. Dietitians improve and enhance their client’s health and well-being by developing and overseeing nutrition care plans and providing expertise on food selection and preparation. Registered dietitians have a wide range of workplace options open to them. They may work in health care settings, food and beverage companies, schools, restaurants, government, fitness centers, or private practice. According to the most recent salary survey of the American Dietetic Association (ADA), registered dietitians earned entry-level salaries ranging from $25,000 to $45,000 a year, with the bulk of entry-level salaries falling in the $25,000 to $35,000 range. More senior registered dietitians received higher salaries, with those in business or private consulting practices earning salaries upwards of $50,000. This position requires a minimum of a four-year college degree. To become registered, dietitians must also complete additional course work and a practice

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O N T H E J O B

program approved by the Commission on Accreditation for Dietetics Education of the ADA, pass a national examination administered by the Commission on Dietetic Registration (CDR), and maintain registration with continuing educational coursework. Registration is not always a strict job requirement, but some settings (particularly hospitals, schools, and government settings) require the registration credential. Some dietitians may also pursue specialized certifications within their field, such as diabetes education or pediatric nutrition. To enter the nutrition field without such lengthy training, you might consider a career as a dietetic technician, a position that requires a two-year associate’s degree in applied science and offers starting pay of $13 to $15 per hour. Under the direction of a registered dietitian, dietetic technicians help assess food service plans and outline appropriate nutrition plans. Some work environments require dietetic technicians to be registered. To become a dietetic technician, registered (DTR), you’ll need to log 450 hours of supervised practice experience, pass a written exam administered by the CDR, and maintain your registration by meeting continuing professional educational requirements. The ADA cites entry-level salaries for full-time DTRs as ranging from $20,000 to $40,000, with the bulk falling between $20,000 and $30,000. Occupational Therapist The BLS predicts that, as the bulk of America ages, the demand for occupational therapists will continue to grow. Occupational therapists help people with mental, physical, emotional, or developmental disabilities enjoy greater independence and better quality of life through educational, vocational, and rehabilitational techniques. The American Occupational Therapy Association (AOTA) 2000 Salary Survey revealed a median salary for full-time occupational therapists of $45,000. This report showed that the largest number of occupational therapists is employed by school systems, and that one in five is self-employed. As of 2002, new occupational therapists are required to receive a four-year degree plus specialized post-graduate education. Those with higher training tend to get more pay, up to an average of $63,254 for occupational therapists with a doctorate. Those with an interest in occupational therapy but without the immediate resources to pursue longer-term training may consider careers as occupational therapist assistants or aides. Occupational therapist assistants must complete an associate’s degree program, while occupational therapist aides learn most of their trade on the job under the direction of assistants and/or occupational therapists. In 2000, the BLS reported median earnings of $34,340 for occupational therapist assistants and $20,710 for occupational therapist aides.

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In collaboration with an occupational therapist, occupational therapist assistants may develop and help implement and monitor treatment plans that help people disabled by an accident return to the workforce, or impart basic living skills like cooking and map reading to developmentally disabled adults. Occupational therapist aides are not licensed and thus are much more limited in their scope, which covers clerical tasks, treatment preparations, and paperwork. Physical Therapist The American Physical Therapy Association (APTA) cites an unemployment rate of 1.1 percent for physical therapists, and the BLS predicts continued career growth. The BLS projects that opportunities in physical therapy will increase much faster than average due to the growing number of elderly and middle-aged Americans and medical technologies enabling recovery for trauma victims. According to the APTA, there are more than 120,000 licensed physical therapists in the U.S. today, and they earn a median salary of $52,000. Physical therapists develop and supervise treatment therapies to treat disease, injury, and chronic pain that may combine targeted exercise programs and applications of heat, light, and massage. They address patients’ immediate physical problems, but also help them become stronger, healthier, and prevent recurring injury through careful exercise and treatment. Nearly 80 percent of all physical therapists practice outside a hospital setting, such as in outpatient clinics, fitness centers, nursing care or rehabilitation facilities, or private or group health care practice. Required training for physical therapists is a specialized post-baccalaureate degree from an accredited program, such as a master’s degree in the field or Doctor of Physical Therapy (DPT) degree. These educational programs are available from some 200 colleges and universities nationwide. Once they’ve completed this training, physical therapists must also pass a state-administered national exam in physical therapy. Licensing requirements differ from state to state, but you can find the specific requirements for your state by consulting APTA.

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Speech-Language Pathologist Speech-language pathologists (SLPs) administer therapies to help their clients recover speech after a stroke or brain trauma, eliminate stutters, and help those with language disorders to communicate effectively. According to the American Speech-Language-Hearing Association (ASHA), SLPs work in schools, nursing care facilities, rehabilitation centers, research laboratories, hospitals, and private or group practices.

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O N T H E J O B

The BLS groups SLPs with audiologists and predicts faster-than-average employment growth for this combined category over the next five years. But while audiologists (who specialize in hearing and balance-related concerns) may indeed experience growth commensurate with America’s aging population, as the BLS states, SLP industry insiders say that job prospects in the field are actually on the decline due to the elimination of SLP benefits for many patients due to changes in federal Medicare policy and as a cost-saving managed care measure in private hospitals and other health care facilities. The BLS recorded median annual earnings for full-time speech-language pathologists of $46,640 in 2000, while the ASHA’s 2000 salary survey cited a median salary for full-time certified speech language pathologists of $44,000. SLPs typically need a master’s degree in speech-language pathology, which can be earned at one of about 242 colleges and universities offering graduate programs in the field. Some SLPs may choose to pursue additional credentials, such as the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) offered by the ASHA or a PhD.

Alternative Medicine Practitioner Acupuncturist Acupuncture is a health care field with 2000 years of history in China and has over the past two decades enjoyed significant growth in the U.S. The U.S. Food and Drug Administration (FDA) estimated in 1993 that Americans spent some $500 million on acupuncture treatments and made nine to 12 million visits per year to acupuncture practitioners. A recent report from the National Institute of Health (NIH) cited a figure of 10,000 nationally certified acupuncturists practicing in the U.S. as of 1995, and predicted that this number would double by 2000 (though findings are not yet available to confirm this prediction). This study also reported that by 1996, 70 to 80 percent of insurers covered some acupuncture treatments in accordance with the growing demand for acupuncture therapy. Acupuncturists stimulate the body’s natural healing and immunity systems by inserting needles into specific points on the patient’s body. To complement these treatments, they may also prescribe herbal medicines, dietary adjustments, and lifestyle modifications or apply heat, pressure, and electrical stimulation instead of needles to the acupuncture points. In 1996, the FDA approved acupuncture needles for use by licensed acupuncturists.

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The World Health Organization has identified 40 conditions treatable by acupuncture, including concerns related to musculoskeletal conditions, digestive disorders, athletic performance, gynecological functions (including infertility), immune system disorders, respiratory ailments (including the common cold), high blood pressure, neurological disorders (such as migraines), eye-ear-nose-throat ailments, drug and alcohol addictions, chronic fatigue, and stress. A 1997 NIH panel also confirmed acupuncture’s effectiveness in treating nausea caused by cancer and the use of anesthetics and for alleviating pain after dental surgeries, and that it can be an effective complementary medical approach for a range of chronic ailments including headaches, menstrual cramps, tennis elbow, osteoarthritis, lower back pain, carpal tunnel syndrome, and asthma. To qualify for their licenses to practice, acupunturists are expected to have four-year degrees plus advanced training and residency hours, pass a rigorous examination and in certain states meet additional state guidelines. According to an NIH study of acupuncture practice, licensed acupuncturists typically charge between $30 and $100—sometimes more—and the third of all acupuncturists who also hold an MD tend to charge more than practitioners without MDs. Many acupuncturists function as independent contractors in hospitals or chiropracters’ offices, but some are in private or group practice. Independent contractors typically pay a set percentage of their fees to the hosting institutions, while private practitioners must cover rent and other overhead costs with theirs.

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Herbalist/Naturopath With the growing momentum behind integrative care approaches to medicine, naturopathy has gained much mainstrain credibility and popularity in the U.S. over the past decade. As the American Association of Naturopathic Physicians (AANP) notes, credentialed naturopaths (sometimes called herbal medicine practioners or naturopathic physicians) are collaborating more closely than ever with their colleages at conventional medical schools and research institutions. Naturopaths are increasingly consulted on research in integrative medicine and have recently been invited to sit on prestigious committees at the National Institutes for Health (NIH). Naturopathic approaches and remedies (such as Echinacea, stinging nettles, and St. John’s Wort) may be applied to a range of ailments including hayfever, upper respiratory infections, and depression. According to the AANP, the role of a licensed naturopathic physician, or ND, is

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O N T H E J O B

to apply a holistic approach to patient care emphazing overall wellness and disease prevention. This approach may incorporate nutrional advice, acupuncture, counseling, and nontoxic botanical and homeopathic remedies. NDs earn their credential by attending an accredited four-year graduate level naturopathic medical school that covers all of these alternative medical treatment areas in addition to the same science courses as their MD counterparts. NDs are qualified to take a licensing exam, which is currently offered in 11 states. Industry insiders say that charges for treatment by NDs are roughly equivalent to those for credentialed acupuncturists, who earn $30 to $100 and up for a treatment. Homeopath According to the the American Institute of Homeopathy, homeopathy is a time-honored medical specialty emphasizing a holistic and preventative care as codified by its German-born founder, Dr. C. F. Samuel Hahnemann more than 200 years ago. This expertise is contained in the U.S. FDA-recognized Homeopathic Pharmacopœia of the United States. Of the many ailments treated by homeopaths, some of the most common are hypertension (6.9 percent), asthma (4.9 percent), upper respiratory infection (3.9 percent), depression (3.5 percent), otitis media (or inner ear infection, at 3.5 percent), diabetes (2.9 percent), allergies (2.8 percent), dermatitis (2.6 percent), and arthritis (2.5 percent). Practitioners of homeopathy are doctors and osteopaths who apply this body of knowledge to their practice of medicine, so they hold MDs and DOs and earn doctors’ and osteopaths’ salaries. Practitioners of homeopathy with three years of experience may apply to take an exam for certification administered by the American Board of Homeotherapeutics, which was founded in 1960. Those who pass are awarded the designation Diplomate of the American Board of Homeotherapeutics (or DHt), and maintain this status by contributing research in the field of homeopathy. Massage Therapist As it gains professional recognition and mainstream popularity, the demand and earnings for massage therapists are on the rise. A July 2000 survey commissioned by American Massage Therapy Association (AMTA) revealed that 16 percent of Americans reported having a massage from a massage therapist in the previous 12 months, which is twice as much as the 8 percent that had a massage during a similar period in 1997. Eleven percent of all HMOs covered massage therapy as of 1999, including Aetna, US Health care, Kaiser Permanente, and United Health Care. According to the AMTA, a massage therapist may charge clients $35 to $60 an hour in a major U.S. metropolitan area and $25 to $50 elsewhere. Massage therapists who get paid on an hourly basis by an employer earn less, but do not have as many overhead

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J O B T H E

The role of a massage therapist is to help clients relax, manage pain, reduce stress, recover from specific injuries, and enhance their overall well-being. Experienced massage therapists find their work to be a rewarding balance of technical expertise, manual dexterity, therapeutic acumen, and interpersonal skills—but they are also careful to pace themselves to avoid fatigue, repetitive stress, or injury. Most massage therapists work less than 40 hours per week, due to the physical demands of their jobs.

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expenses as most of those in private practice.

Many massage therapists are self-employed, either in private practice or more commonly as independent contractors at hospitals, chiropractor’s offices, sports team offices, nursing homes, the homes of private clients, health clubs and spas, and even shopping malls and airports. One of the perks of being a massage therapist is the opportunity to work in a soothing environment such as a spa, resort, beauty salon, or health club. But you may have to work in more than one place until you get a steady client roster, which can mean a lot of shuttling back and forth and a hectic schedule. In some contracting arrangements, you may be expected to split your fees with the business or facility that extends your services to their clients. You’ll need business skills as well as a good bedside manner to build a steady business for yourself as a massage therapist. While training isn’t strictly necessary in all states, the American Massage Therapy Association notes that 25 out of 50 U.S. states now require massage therapists to complete a minimum of 500 hours of training in state-recognized training programs and/or pass a state or national certification exam. Accreditation programs are also available in some 70 schools around the country. Some practitioners may choose to specialize in massage therapy for athletes or dancers, the elderly, pregnant women, or office workers. They may also pursue a particular technique or modality, such as Shiatsu, deep tissue, or Swedish massage.

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T H E J O B

Once you’ve completed the obligatory training and pored over your textbooks, you may think you’re 100 percent prepared to handle whatever a day’s work as a secondary health care professional has in store for you. But you’d be mistaken. As any secondary medical care professional will tell you, your textbooks can only begin to describe what a day on the job is like. “Each new patient puts your knowledge to the test, to find the approach that best fits that patient’s needs,” says one seasoned professional. “That takes sharp instincts and a clear sense of your options and limitations. You’ll be thrown into situations where by-the-book procedures aren’t the best choice or aren’t even possible, and it’s up to you to find an effective workaround.”

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Day-in-the-Life Profiles

The hands-on learning you get by applying your expertise in the field will often be your best preparation for a distinguished career in secondary health care. That’s why many accredited training programs require you to perform some kind of internship or residency, and state licensing boards expect you to put in a given number of work hours before your license is granted. But most professional associations wisely urge that even before you invest time and money in training, you should “job shadow” a professional in your chosen field. You wouldn’t want to find out after taking out student loans and studying for a year or more that you can’t handle the pace or physical requirements, or that your stomach just isn’t as strong as you’d hoped when it comes to dealing with blood, smells, wounds, death, or disease. To give you an idea of what you may discover out in the field, below are three sample daily routines of secondary health care professionals. Please note that although these profiles are composites drawn from interviews with working professionals to give you insider insights into the profession, your experience on the job may vary according to your years or experience, work setting, certifications, educational background, and areas of specialization.

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5:00

Time to wake up. I’ve learned that to be alert on the job and have sharp reflexes, you need to be awake a couple of hours before going into work. So I get up, have a decent breakfast, pack a lunch, and sometimes work out before I head into work. I’ve been in the field for a few years now, and since I have seniority I usually get to do day shifts instead of the 12-hour graveyard shifts you usually have to do when you’re just starting out.

7:00

Pick up ambulance, partner, and gear and do a thorough equipment check. The last shift is supposed to do this too, but you don’t want to run the risk of equipment malfunctioning on you. I put on my uniform and protective gear (latex gloves, goggles, etc.). I may take some of it off during the day when I’m between calls, but keeping it on when you’re dealing with patients really helps prevent you from getting injured or infected on the job.

8:00

Head out to the ten-square mile area assigned to my partner and me by the dispatcher and find a place to wait for a call to come in—typically in a parking lot or outside a coffee shop, so we can grab a bite to eat.

9:30

First call comes in. When I get a call to pick up a patient, the adrenaline kicks in—you have to be careful not to start driving through traffic like crazy at 90 miles an hour. You need to keep calm and focused, ready to carry out an effective plan of action.

9:50

Arrive at the scene, check to make sure scene is secured (e.g., no one is there waving around a gun, and the building isn’t on fire), check out the patient and provide any necessary immediate care, and help my partner prep the patient for transport. I always have to be prepared for the worst—sometimes CPR is needed or I may have to stop the blood flow on an open wound.

10:20

Take patient to hospital and wait with the patient until he is either admitted for treatment, or a medical staff member in a senior position (such as a paramedic, nurse, or doctor) accepts responsibility for the patient. You can spend between 30 minutes and two hours in the hospital with your patient, taking care of that patient as needed.

J O B O N

T H E

A Day in the Life of an Emergency Medical Technician (EMT)

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Lunch in ambulance interrupted by a call (you learn to eat quickly on this job). The whole process repeats itself; drive to scene, check scene, assess patient and treat if needed, prep patient for transport, either attend to patient in transit or drive ambulance to care center, wait with and attend to patient, return to posting area.

1:45

More calls, ranging from one to three hours each. On a typical day, I’ll respond to between two and nine calls, though I’ve had shifts where I’ve gotten no calls. Those are the worst—they’re boring, and you have to find ways to keep yourself alert so you can be on your toes when a call comes in. You might read, listen to the radio, or talk with your partner.

5:30

Head back to base, and pack it in for the day. Run equipment checks, drop off gear, change clothes, and check out. I may log some overtime when I’m feeling up to it, or work longer shifts for a few days so I can finish work for the week quickly and have a three-day weekend. But, at the end of a hectic day, it’s good to leave at a reasonable hour and go r relax at home, where life isn’t such an emergency.

J O B

12:45

T H E

Head back out to posting spot to wait for the next call. Trade off with my partner so that each of us gets equal time driving and working in the back with the patient.

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11:30

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J O B T H E

7:30

Arrive at the hospital where I work. Look over my schedule for the day, and review patients’ charts. I need to familiarize myself with their medical history, diagnosis, test results, and medications they’re taking to ensure the best course of treatment. My patients are referred to me by physicians in the hospital due to some condition or injury that limits their mobility, affects their functionality or causes them pain. If I have questions, I consult the referring physician. This helps me determine appropriate therapies and coordinate my efforts with those of the appropriate doctors and nurses.

8:30

First appointment arrives. I work in a hospital setting where patients are usually in a bad way, and need my help with everything from rolling in bed to getting out of bed, from ambulating to using assistive devices. Other physical therapists I know specialize in areas like sports medicine, bladder control therapy, and pediatric physical therapy, but I prefer to see a wide variety of patients and diagnoses.

8:40

After I spend some time interviewing a patient (and possibly a close relative of the patient who serves as a caregiver), I may determine that specific physical or lab tests are needed to identify appropriate therapies. I may also share my findings with referring physicians and consult about appropriate medications and long-term prognosis. Treatment plans might involve some combination of exercise, electrical stimulation, massages, ultrasound, application of hot and cold packs, traction, whirlpools, or paraffin baths. However, some tests and therapies are not covered by the patient’s insurance plan, so I’m not always able to treat every patient as I would like—this is a major source of frustration for me and for most health care professionals. As soon as I’m able to develop an appropriate treatment plan, I’ll return to the patient with my recommendations, a treatment schedule, and the necessary forms for lab tests.

9:00

Between patients, I try to get as much paperwork as possible out of the way, including completing patient logs and noting treatment adjustments. An assistant helps out with the insurance and worker’s comp paperwork, but as the physical therapist I sometimes have to sign off on it. Signatures may also be needed from the referring physician, too. Hospitals may be more bureaucratic than private practices, but at least I don’t have to handle the business side, pay for overhead, or drum up business for myself. I like to spend as much time on patient care as possible, since that’s the most personally rewarding aspect of my work.

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A Day in the Life of a Physical Therapist

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See patients, consult with doctors and nurses, develop treatment plans, schedule treatments, oversee therapy treatments, adjust treatments, and do my paperwork. I grab lunch and coffee when I can, usually with colleagues.

5:30

Head to the gym downstairs and then go home for a sit-down dinner and a decent night’s sleep. Physical therapists know the importance of being well-rested.

J O B

10:15

T H E

Check in on an elderly patient receiving ambulatory therapy. The physical effort involved isn’t easy for the patient, but she is very determined to overcome her difficulties. Patients like this can be inspiring, and both the patient and her daughter are appreciative of the help provided by the physical therapy assistant, aide, and myself. This is the kind of thing that makes my day. I check to make sure the aide is providing appropriate support, note the progress logged by the physical therapy assistant, and adjust therapies and treatment schedule as needed.

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9:15

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J O B T H E

7:00

Arrive at my office, where I work in an integrative medicine group practice with three other alternative medicine practitioners. I make the beds, turn on background music, and make sure the rooms are clean and ready for patients. I go over my schedule for the day, get out charts, and check messages for patient calls and cancellations. Then I do insurance claims paperwork until my first patient arrives. Most practitioners I know don’t take insurance because of the paperwork involved and patients don’t necessarily mind paying for treatment out of pocket, but processing insurance and worker’s comp claims broadens your potential client base.

8:15

Patient is late—there is some variability about patients showing up on time. I usually spend about 10 to 20 minutes talking with a patient and checking out their symptoms. With returning patients, I’ll ask: “How have you felt since I saw you last? Are you taking the prescribed herbs, doing the stretches, or making the lifestyle modifications we’d discussed?” Sometimes a fair amount of their healing happens in letting them talk through their health concerns and possible causes and remedies for 20 minutes. I may have to spend some time explaining my diagnosis, since many patients are not as familiar with traditional Chinese medicine approaches and treatments as they are with Western medicine. People are often surprised by the amount of time, attention, and explanation they get from an acupuncturist, because they’re not used to that from their experience with Western medical doctors.

8:30

After I’ve made a diagnosis and identified the appropriate course of acupuncture treatment, I’ll administer the treatment. This means applying needles to key points in the patient’s body and keeping them there for about 20 minutes. During these 20 minutes, I may enter my patient log into my computer database and research any herbal treatments I might prescribe for contraindications with any drugs the patient may be taking. If I have patients scheduled back to back, I may take this time to consult with another patient and administer an acupuncture treatment.

8:50

I remove the first patient’s needles and discuss any responses to the therapy with that patient, herbal medications I’m prescribing, lifestyle modifications the patient should make, and follow-up sessions as needed. Some injuries can be treated effectively in just a couple of

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A Day in the Life of an Acupuncturist

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sessions, while chronic pain or illnesses may require longer courses of treatment. Then I take the patient’s payment and any insurance information—I always leave time to explain how payments/fees work, because some patients may not be used to paying for health care out of their pocket. I put down fresh sterile paper and sheets on the bed, get new disposable equipment ready and make sure the room is ready for the next patient. .

9:30

Repeat the cycle outlined above. On a good day, I’ll have patients scheduled so that a new one rotates in every half hour, and I’m working two rooms at a time. These days fly by, and you don’t have much downtime to return patient calls, make appointments, keep legal records and charts, place orders for herbs, catch up on billing, or fill out worker’s compensation reports for patients receiving treatment for injuries. On slow days I can get through a lot of the administrative tasks that come with being an entrepreneur, such as expenditures, taxes, invoices, inventory, and ordering supplies. I’ve got a system down so that I spend one hour per week on business finances, 15 percent of my time on insurance, and a fair chunk of time marketing my practice. Once you’re established, marketing may only account for about 2 percent of your time, but when you’re just establishing your practice it can take as much as 60 percent of your time.

6:00

Do my accounting for the end of day and finish entering any patient logs, throw the sheets in the laundry, switch off the computer and the lights, and call it a day.

J O B

I return to the other patient I’ve already diagnosed, invite the next patient in, or take care of administrative responsibilities.

T H E

9:10

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The Workplace

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W O R K P L A C E T H E

Lifestyle, Hours, and Culture Ask secondary health care professionals what their workplace is like, and you’ll get one of about half a million answers. The Bureau of Labor Statistics (BLS) counts 469,000 health care establishments in the U.S., not to mention the patient’s homes, spas, and alternative health care offices where you could also work as a secondary health care professional. Although employment in these nontraditional settings is growing rapidly, the majority of salaried positions in health care are still in hospitals. According to the BLS, hospitals account for only about a modest fraction of the total number of health care establishments but employ about 45 percent of the entire health care workforce (see chart following). Two-thirds of all hospital workers work in large institutional settings of 1,000-plus employees, while half of all non-hospital health care settings have only less than five employees. The BLS also counted some 383,000 selfemployed health care workers in 2000, but this is probably an underestimation, since the BLS is ambiguous about classifying alternative medicine practitioners as health care providers.

Distribution of Wage and Salary Employment in 2000* Establishment Type

Establishments (%)

Employment (%)

100.0

100.0

1.6

39.3

Total, health services Hospitals, private Offices of physicians including osteopaths Nursing and personal care facilities Offices and clinics of dentists Home health care services Offices of other health practitioners

41.1

19.7

4.5

17.9

23.8

6.8

3.1

6.3

19.2

4.4

3.3

3.5

3.5

2.1

(e.g., chiropractors, optometrists, podiatrists, occupational and physical therapists, psychologists, audiologists, speech-language pathologists, dietitians)

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Health and allied services, not elsewhere classified (e.g., dialysis centers, drug treatment clinics and rehabilitation centers, blood banks) Medical and dental laboratories * Includes primary health care providers. Source: Bureau of Labor Statistics

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W O R K P L A C E

While some secondary health care professionals work 9:00 to 5:00 in the private or group practices of physicians, dentists, or other practitioners, secondary health care isn’t your average office job. Health care is a 24/7 industry, and as a secondary health care professional, you may find yourself working unusual hours in unusual settings. This isn’t necessarily a drawback; many secondary health care professionals say that they welcome the opportunity to work out in the field, away from the drudgery of desk jobs.

T H E

Goodbye Desk, Hello Clipboard

True, many secondary health care professionals (especially entrepreneurs) face an increasing amount of paperwork with the rise of managed care and increased documentation for insurance claims—one alternative medical practitioner reports spending up to 30 percent of her day on paperwork. But experienced caregivers say that patient care outweighs these bureaucratic tasks. “Some people spend their entire lives pushing paper, but you’re out there making life or death decisions,” says one. “It’s heady stuff. You can get really tired when you’re on call, just waiting around—but when that call comes, the adrenaline kicks right in.”

Flexible Hours The flexible hours and part-time schedules that are common in secondary health care can be especially attractive to people raising a family or attending school. According to the BLS, part-timers accounted for about 15 percent of all health care workers (including primary care providers), 36.8 percent of employees in dental offices, and 18.8 percent of those in physician’s offices. Home health care providers clocked the least hours per week at an average of 29.5.

Calling All Night Owls If you’re a morning person in a secondary health care field, your workweek may not match your biological schedule. At some point in your career, you may be expected to work nights, be on call at all hours, or asked to pull 12-hour shifts. While you may appreciate the boost in pay that usually comes with graveyard shifts or overtime, some insiders say that adjusting your schedule to the demands of a career in secondary health care isn’t always easy. “There was a time when I hardly ever saw my wife and kids,” says one professional who initially worked long night shifts. “Usually the shifts get better once you get some more seniority and expertise, but not always. Those Friday nights can be a killer in a hospital, too—they’re usually busy, and you’re so tired all day Saturday that you sleepwalk through half your weekend.”

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W O R K P L A C E T H E

Workplace Diversity Secondary health care can be hard to characterize. According to the BLS, health care providers are usually older than workers outside the health care field. The most health care jobs are located in population centers, specifically California, New York, Florida, Texas, and Pennsylvania, so the overall industry demographics tend to reflect the ethnic makeup of those areas. As in most service occupations, secondary health care has historically employed a disproportionately large number of women—but many of the most physical jobs (such as EMTs or orderlies) are more often held by men.

Inroads and Setbacks for Women As is typical of U.S. industries, upper management positions and higher salaries in the health care industry are disproportionately held by white, European American men. By all accounts, recent affirmative action setbacks have also negatively impacted the health care industry’s efforts to hire and promote women and people of color to management positions. But in hospitals (which account for the majority of health care jobs), women are making inroads into senior and upper management positions, according to a major 1997 study on diversity in hospitals conducted jointly by the American College of Healthcare Executives, the Association of Hispanic Healthcare Executives, the Institute for Diversity in Health Management, National Association of Health Services Executives. However, this same report notes that white (European American) women are much more likely than African American women to hold senior management positions, and the gap between white and African American women’s salary increased between 1992 and 1997.

Uneven Job Satisfaction

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Job satisfaction is slightly on the rise for white women, but for African American men and women job satisfaction has gone down due to dissatisfaction with pay and fringe benefits. With more African American men entering senior-level positions, the gap in pay between white and African American men in hospitals narrowed between 1992 and 1997, but remains a significant 12 percent. African American women also cited non-salary reasons for dissatisfaction, including sanctions from superiors, and a lack of respect, security, and autonomy.

Room for Improvement Differences in job satisfaction may be one cause of the apparent complacency among whites about the need for stronger relationships between white and ethnic minority professionals in hospital settings. While two-thirds of Asians

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T H E W O R K P L A C E

and Hispanics and 80 percent of African Americans perceived this need, only 44 percent of their white colleagues saw that their relationships with ethnic minority peers required improvement. But the ACHE study and other professional efforts are helping to make it obvious that improved professional relationships benefit everyone. Better working relationships translate to improved professionalism and patient care, and informal networking over lunch and social interactions have been shown to increase career prospects.

Compensation How much you get paid as a secondary health care professional depends on what you do and where you work. Hospitals tend to pay more than other health care establishments (see chart following), and they’re also more likely to offer extra pay for working overtime, late shifts, weekends, and holidays. Larger organizations also tend to pay more, including group practices and major hospitals. Salaries vary by geographic location, too: You’ll probably get paid more in urban centers, where costs of living are higher and health care institutions have to compete to attract qualified secondary health care professionals.

For Nonsupervisory Workers in Private Health Services in 2000*

Industry Segment

Weekly Salary ($)

Hourly Salary ($)

Hours/ Week

Total, private industry

474

13.74

34.5

Health services

488

14.75

33.1

Hospitals

577

16.49

35.0

Offices and clinics of medical doctors

507

15.46

32.8

Offices and clinics of dentists

436

15.58

28.0

health practitioners

401

13.15

30.5

Home health care services

367

12.44

29.5

Nursing and personal care facilities

349

10.72

32.6

Offices and clinics of other

* These are average earnings and hours. Source: Bureau of Labor Statistics

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W O R K P L A C E T H E

It Pays to Specialize Although the BLS notes that non-supervisory workers in the Health care industry earn more on average than non-supervisory workers in other industries, those who specialize, take on additional responsibilities or receive advanced training or certification are more often rewarded with higher-level positions and salaries. The table below will give you a sense of the range in pay among secondary Health care jobs with fewer training prerequisites, such as home health aides, and those requiring more extensive credentials, such as dental hygienists.

Median Earnings in Health Services in 2000 Occupation*

Hourly Salary ($)

Medical and health services managers

27.12

Dental hygienists

24.70

Radiologic technologists and technicians

17.25

Dental assistants

12.47

Medical assistants

11.07

Nursing aides, orderlies, and attendants

8.83

Home health aides

8.10

* A sampling of some of the largest occupations in health services. Source: Bureau of Labor Statistics

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The odd hours, hectic pace, and modest starting salaries of a secondary health care career may not be for everyone, but longtime professionals claim the personal rewards are well worth the necessary adjustments. “There’s nothing, nothing in this world that beats knowing that you’ve helped someone get better, or eased a patient’s pain,” says one insider. Says another, “Some days it seems like my job is a thankless task—patients don’t always appreciate what you’re trying to do for them, and doctors may bark orders at you. But then patients or their loved ones will tell you how much it meant to have your help, or a colleague will commend you for your work with a patient. That’s a bond of respect you’ve formed, and that’s an amazing feat.”

W O R K P L A C E

All in a Day’s Work

T H E

Benefits and Perks

Added Perks At the risk of stating the obvious, if you’re working full-time (and in some cases, even part-time) for a health care organization, you’ll probably get decent health care coverage. Larger organizations tend to offer extra perks, such as bonuses and profit-sharing. Nursing care facilities, hospitals, and other health care establishments that offer round-the-clock care may offer extra incentives for employees to take on late shifts or overtime.

Advanced Placement According to the BLS, hospitals are the best place to be if you’re looking for on-the-job training and cross-training programs, tuition assistance, and advancement opportunities. In these settings, specialists who add clinical expertise to their resume and experienced managers can rise within their departments to upper-management jobs. Some nursing facilities offer in-house training and advancement opportunities too, though larger organizations tend to offer the best range of opportunities.

Union Workers To make sure they aren’t overworked and to help them negotiate for improved benefits, salaries, and working conditions, some health care workers join unions. The BLS reports that as of 2000, 13.8 percent of hospital workers and 10.1 percent of workers in nursing care facilities belonged to unions or worked under union contracts. But not all health care establishments support union membership, and the overall percentage of union workers in many health care establishments remains well below the 13.5 percent average for private industry.

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W O R K P L A C E T H E

Career Path On average, you’ll be out on the job market earning a living years sooner in a secondary health care profession than you would be if you were to become a registered nurse, physician or other primary care provider. What’s more, you’ll save yourself untold thousands of dollars in student loans in the process. Below are some of the opportunities open to you according to your level of training. Once you’re in the field, you may find you wish to pursue additional certifications and training to advance in your field or attain the position you desire. With Limited Training (One Year or Less) Secondary health care careers at this level tend to be more physically demanding and pay less than positions requiring further study, but they also yield the most immediate rewards. You’ve probably seen vocational schools’ TV commercials claiming that you could be helping patients in a matter of months—and, for once, there’s some truth in advertising. There is a high demand for qualified professionals to fill these positions, in part because people in these positions advance to other, more specialized positions within secondary health care. But be warned: One reason for this turnover is that burnout is common in these stressful positions, and you may not be able to advance without additional credentials. Training for these positions is brief but intensive, and you’ll be expected to apply it and keep learning—stat!—on the job. Positions open to professionals with one year of training or less include:

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> > > > > > > >

Dental assistant Home health care aide Nursing care aide Medical assistant Orderly Pharmacy aide Physical therapist assistant Massage therapist

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T H E W O R K P L A C E

With Training of One-Plus Years and/or Specialized Certification With a little additional training, you could achieve a more specialized position within secondary health care. This usually means higher pay, less hectic schedules, and a more focused workload. But before you jump into a specialized training program, spend some time in the field with a working professional in your chosen field to be sure that it’s right for you. Specialized certifications at this level aren’t necessarily transferable to other fields, and the cost of training can add up, so you should be certain that your enthusiasm for the field is going to outlast your school loan payments. Positions open to professionals with one-plus years of training or less include: > > > > >

Dental hygienist Emergency medical technician Medical laboratory technician Pharmacy technician Radiologic technologist

With Four-Year Degree and Supplemental Training Positions in secondary health care requiring advanced degrees and other credentials tend to command the most authority, professional respect, and pay. Industry insiders say that with this higher salary and authority come additional responsibilities, professional accountability for patients, and paperwork. Experienced, credentialed professionals with advanced degrees in specialty niches may opt to enter private or group practices, where they manage their own workloads and schedules. But being an entrepreneur means absorbing additional tasks and expenses, such as billing, marketing, and liability insurance. “You have to be careful not to let yourself get buried in paperwork,” says one secondary health care provider who is a partner in group practice. Positions open to professionals with four years degree plus additional training include: > > > > > > >

Dietitian Occupational therapist Physical therapist Speech-language pathologist Acupuncturist Naturopath Homeopath

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W O R K P L A C E

Insider Scoop: What Employees Really Like

T H E

Moonlighting. It’s an open secret in the secondary health care field that many secondary health care professionals are pursuing more than one career at a time. Many are also students on their way to earning advanced certification in a related or entirely different health care field. In fact, some hospitals and larger nursing care facilities actively encourage this kind of crosstraining and offer tuition reimbursements. In private health care practices and home health care settings, supervisors are often willing to accommodate students with flexible and part-time schedules. Entrepreneurial Opportunities. Other secondary health care professionals are making use of their job experience to gain the necessary skills to launch careers as entrepreneurs or freelance educators. Drawing from their on-the-job experience, they may teach vocational courses at night or identify an untapped industry niche and develop a specialty service or tool to address it. And although “stealing clients” is officially frowned on in the industry, secondary health care specialists who move away from their umbrella organizations to start their own private practices often take clients with them. Greater Job Security. Still other professionals take part-time positions in secondary health care as a way of balancing their work portfolios. Parents who want to spend time with their kids while maintaining their professional credentials may opt for one of the many part-time jobs available in secondary health care. Careers in this field are relatively secure, so risk-averse people working part-time in other, less stable industries such as the restaurant business or real estate may choose to manage their professional risks by branching off into secondary health care. Part-timers in the field may also be holding down two or more part-time positions to earn extra money. As many as half the people in some secondary health care fields, such as dental assisting, have more than one job.

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W O R K P L A C E

Mind Your Own Health. Among the greatest downsides of a career in secondary health care is the potential for infection and injury. The BLS reports that in 1999 occupational injury and illness affected 6.3 out of every 100 workers in private health care practices, 9.2 out of every 100 full-time hospital workers, and 13.5 out of every 100 workers in nursing care facilities. Reported risks run the gamut from back strains and chemical burns to exposure to radiation, HIV, tuberculosis, hepatitis, and other infectious diseases.

T H E

Insider Scoop: Watch Outs!

Cleanliness … Next to Godliness. Since secondary health care professionals are exposed to a broad range of patients and illnesses on a daily basis, diligent precautions are required to all manner of mishaps and the spread of disease. Cleanliness is closer to godliness in health care settings than anywhere else; equipment is constantly being disposed of or disinfected. The facilities must be kept clean and disinfected down to the last doorknob—and this includes you, too. If you’re fashion-conscious, be advised: Secondary health care professionals are often outfitted in disposable protective gear from their shower cap-like head coverings and goggle-covered eyes to the tips of their latex gloves and on down to their shoe coverings. But there is a valid health reason for every one of these articles of clothing. Says one health care professional, “Sometimes in the heat of the moment, you forget to put on your goggles—and of course that’s when your patient sneezes, a tiny drop of spray gets in your eye, and you catch a horrible flu.”

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Getting Hired

49

G E T T I N G

H I R E D

The Hiring Process The hiring process for secondary health care is a lot like the hiring process for any other industry. First you do your research, then you tap your personal and professional networks until you land that all-important interview that gets you the job. Below are some tips for each of these steps towards a career in secondary health care.

Research Before you ever apply for a job in secondary health care, make sure you’ve done your research. Here are three perfectly good reasons why: > Research puts you in the driver’s seat. You’ll have a better idea of the positions available to you, instead of just taking the first job that comes your way or investing your time and money in unnecessary credentials. Knowing industry standards for salary and benefits will put you in a better negotiating position, too. > Research boosts your confidence. When you do land that interview for the job of your dreams, you’ll go into the interview prepared with a solid understanding of the industry and specific, insightful questions that display your professionalism and preparedness—two key criteria for any position in secondary health care. > Research will keep you on track with your personal goals. Whether you’re aiming for part-time employment or planning to be an entrepreneur, research can help you make the right choices to speed you along your chosen path. You may find you need additional credentials or more capital than you expected, but as long as you do your research in advance, you won’t have to find out the hard way.

Find Your Match

50

Where do you begin your job research? If you’re reading this guide, you’re already well on your way. By the time you reach this chapter, you should have a sense of which positions in secondary health care appeal to you. To get a sense of the long-term career outlook and required credentials in your state for your preferred secondary health care professions, try running keyword searches on a Web search engine (such as www.google.com) with the title of a position (such as “occupational therapist” or “pharmacist technician”) and the keyword “careers.” This search should yield professional resources and in-depth articles that will provide you with added industry insight—and an edge over the

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Explore Your Options

H I R E D

Once you’ve identified what secondary health care profession is the best match for your interests, location, salary needs, and professional credentials, find out what positions are available in that field. Check out classified ads, career websites, and your school’s career center—but don’t stop there. Look into local career placement services and temp and locum tenens (health care industry jargon for “contract positions”) agencies in your area that could help you find a position in exchange for a fee or a set percentage of your earnings. Their reputations and terms may vary, so be sure to shop around. And most important, start making use of your personal network and professional associations—the connections and advice you gain will benefit you throughout your career.

G E T T I N G

competition. Any information you can gather about skills and experience that are in demand in your chosen profession will help you tailor your resume for success.

Tap Your Network You may not have a friend or relative who works in your chosen secondary health care profession, but the odds are you know someone who knows someone who does. In social situations, mention your professional interests to anyone who asks what you’re up to these days (although you may want to tread carefully around your current boss and colleagues, so it doesn’t disrupt or endanger your present job). You might also e-mail your friends, relatives, and acquaintances to see if they know anyone in your desired line of work who might be willing to let you take them out for lunch (your treat, of course), and talk about their personal experience in the field. Try your alumni association and professional associations, too; they probably have listings of professionals in your area. On the off chance that all these approaches fail, you can always dig up a few names in the yellow pages of your local phone book.

Make Connections Once you’ve approached your industry insider contact and set a date for lunch, do some research on that person’s organization, interests, and background in the field, and give some thought to the questions you’re planning to ask. Don’t ask questions about the industry you could find answers to elsewhere, such as necessary credentials—this makes you appear ill-informed and unprofessional. Instead, ask your contact about his or her best and worst days on the job, pros and cons of that particular line of work, and how he or she became interested in the area of specialization and got hired by his or her organization. These questions give you insight about the industry, and about the person who’s sitting across the table. You may find you have a lot in common, in which case this lunch could yield a lasting personal and professional connection.

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H I R E D G E T T I N G

Listen not only to what your lunch guest is saying, but also to how that person is saying it. You could become this person in ten years; if he or she sounds bitter about past work experience, you may want to think twice before entering the same field—or at least seek a second opinion from others in the field. If you find your lunch guest to be rude or unpleasant, be polite but don’t feel obliged to initiate further contact. You may not want this person as your advocate in the field.

Follow Through Be sure to send a personal note to your lunch guest thanking them for sharing his or her time and expertise with you. Mention something you learned from the lunch, and refer to any common interests or acquaintances (“maybe I’ll see you at that basketball game in Dolores Park next Saturday,” or “say hi to Julie for me”). If your lunch partner offered to help you in some way, mention that you’d like to take him or her up on that advice. But be tactful—there’s a fine line between gently reminding someone to send you contact information for a potential employer and hounding that person for help. Being demanding may help you get your foot in the door, but it may ultimately damage a relationship that could provide you with support, job referrals, advice, and professional recommendations throughout your career. Try not to think solely of winning short-term gains, but rather building a long-term relationship with your contact. You might wind up with a trusted colleague or even a good friend.

Consult Professional Associations Professional associations provide a wealth of insider information and career resources. They are a particularly good resource for the following: > > > > > >

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Salary surveys Mentoring and internship programs Networking opportunities with professionals in your chosen field Listings of health care establishments in your geographic location Articles covering hot issues in your intended field Job referrals and position listings that you won’t find anywhere else

To find the professional association in your chosen secondary health care occupation, refer to the “For Your Reference” section at the end of this guide. You can also run a Web keyword search on the subject, and ask professionals in the field which associations they’ve joined.

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H I R E D

In the end, all your research and networking in the secondary health care field boils down to the moment of truth: the job interview. To make the most of this opportunity, you’ll need to pay attention to three things:

G E T T I N G

Interviewing Tips

Preparation. This means doing your homework on the organization, position, and (if possible) the person you’re interviewing with, but also doing some soulsearching about your motivations, values, and drive. Ask yourself these questions: > What is it about this line of work that most appeals to you? > What are your personal strengths that would help you excel at this job, particularly in handling some of the more difficult, stressful, or complex tasks? > What is your personal approach to patient care, and how does it match the philosophy of the organization you’re applying to join? > Are there any areas of your health care field you might find objectionable for personal or religious reasons (e.g., are you squeamish about blood, or are you categorically opposed to abortions)? > Where do you see yourself in two years? Five? Ten? > What kind of salary are you willing and financially able to accept? > Why do you merit this salary? Professionalism. Make sure when you show up for your interview, you arrive: > On time or early > With cordial greetings to the front office staff, who may later be asked to give their impressions of you by the person who’s responsible for hiring > Attentive and alert but calm and collected (desired attitudes in a secondary Health care professional) > Clean and dressed professionally and practically—typically a suit for men, and for women a pant suit or dress with a jacket, stockings, low heels and minimal makeup, perfume and jewelry > Offering a firm handshake, direct eye contact and a smile > With kind words about previous employers where possible, or at least able to refrain from airing your complaints > Prepared to ask specific questions about the organization or position > With extra copies of your resume > Confident about your worth as an employee

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H I R E D G E T T I N G

Personal Impression. This means not only your prospective employer’s impression of you, but also your impression of the position, organization, work setting, and future boss (if that’s who’s conducting the interview). You and your interviewer both want the same thing: a good fit. So be professional, but let your natural warmth and personal strengths shine through. At the same time, be sure to ask plenty of questions about day-to-day duties, organizational philosophies, team members you’d be working closely with, patient load, available equipment, work schedules (including overtime, late shifts, and holiday and weekend hours), and required paperwork. Make mental notes as you walk through the workplace, too. Does it seem comfortable and relaxed, or ill-equipped and stressful? Do the people who work there seem friendly and approachable, or overworked and pressed for time? This should give you added insight about what it would be like to work there. Afterwards, you should send a personal follow-up thank-you note to reinforce your interest in the position and express your appreciation for your interviewer’s time and insights. This way, even if you don’t land the position, you at least keep the door open to other positions in that organization.

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For Your Reference

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R E F E R E N C E Y O U R F O R

Job Search Websites HealthcareSource: America's Healthcare Job Source (www.healthcaresource.com) MedCAREERS.com (www.medcareers.com) For referrals to hospital human resource departments about opportunities in health care careers in your location, contact: American Hospital Association/American Society for Hospital Human Resources Administrators One North Franklin Chicago, IL 60606

General Health Care Career Insights American Medical Association/Health Professions Career and Education Directory (www.ama-assn.org/ama/pub/category/2322.html) Healthcare Careers: Information for Students by Megan Malugani (healthcare.monster.com/articles/highschool) Medical Center of Central Georgia Health Careers Information (www.mccg.org/healthcareers/healthcareershome.asp)

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Y O U R R E F E R E N C E

Acupuncturist American Academy of Medical Acupuncture 4929 Wilshire Boulevard, Suite 428 Los Angeles, CA 90010 Phone: 323-937-5514 www.medicalacupuncture.org

F O R

Professional Associations by Occupation

American Association of Oriental Medicine 5530 Wisconsin Avenue, Suite 1210 Chevy Chase, MD 20815 Phone: 301-941-1064 or toll free 888-500-7999; e-mail: [email protected] www.aaom.org American College of Acupuncture & Oriental Medicine 9100 Park West Drive Houston, TX 77063 Phone: 800-729-4456 or 713-780-9777; e-mail: [email protected] www.acaom.edu Art Therapists American Art Therapy Association, Inc. (www.arttherapy.org) American Dance Therapy Association (www.www.adta.org) American Music Therapy Association (www.musictherapy.org) Dental Assistants American Dental Association 211 E. Chicago Avenue, Suite 1814 Chicago, IL 60611 Phone: 312-440-2390; e-mail: [email protected] www.ada.org Call or write for the brochure “Dental Assisting-Word of Mouth-Careers in the Dental Profession”; offers information on accredited dental assistant programs.

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R E F E R E N C E Y O U R F O R

The American Dental Assistants Association 203 North LaSalle Street, Suite 1320 Chicago, IL 60601 Phone: 312-541-1550 www.dentalassistant.org Offers information on continuing education for dental assistants. Dental Assisting National Board, Inc. 676 North Saint Clair, Suite 1880 Chicago, IL 60611 www.danb.org Offers information on becoming a certified dental assistant. The BLS Occupational Handbook (stats.bls.gov/oco/ocos163.htm) Offers additional stats and insight on dental assisting. Dental Hygienists American Dental Association 211 E. Chicago Avenue, Suite 1814 Chicago, IL 60611 Phone: 312-440-2390; e-mail [email protected] www.ada.org Offers the brochure “Dental Hygiene-Word of Mouth-Careers in the Dental Profession:” The American Dental Hygienists’ Association Phone: 312-440-8900 www.adha.org

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Dietitians American Dietetic Association 216 West Jackson Boulevard, Suite 800 Chicago, IL 60606-6995 Phone: 800-877-1600, ext. 5000; e-mail: [email protected] www.eatright.org Website provides additional information about careers in dietetics and listings of educational programs accredited or approved by the Commission on Accreditation for Dietetics Education of the American Dietetic Association.

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Y O U R R E F E R E N C E

Massage Therapists American Massage Therapy Association 820 Davis Street, Suite 100 Evanston, IL 60201-4444 Phone: 847-864-0123; e-mail: [email protected] www.amtamassage.org

F O R

Homeopaths American Institute of Homeopathy 801 N. Fairfax Street, Suite 306 Alexandria, VA 22314 www.homeopathyusa.org

National Certification Board for Therapeutic Massage and Bodywork 8201 Greensboro Drive, Suite 300 McLean, VA 22102 Phone: 800-296-0664 or 703-610-9015 Commission on Massage Therapy Accreditation 820 Davis Street, Suite 100 Evanston, IL 60201-4444 Phone: 847-869-5039 Medical Assistants American Association of Medical Assistants 20 North Wacker Drive, Suite 1575 Chicago, IL 60606 www.aama-ntl.org Offers information on accredited educational programs in medical assisting and the certified medical assistant exam. Registered Medical Assistants of American Medical Technologists 710 Higgins Road Park Ridge, IL 60068-5765 www.amt1.com Offers information on the registered medical assistant certification exam. Accrediting Bureau of Health Education Schools 803 West Broad Street, Suite 730 Falls Church, VA 22046 www.abhes.org Offers information on accredited medical assisting programs.

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R E F E R E N C E Y O U R F O R

Medical Lab Technicians National Accrediting Agency for Clinical Laboratory Sciences 8410 W. Bryn Mawr Avenue, Suite 670 Chicago, IL 60631 www.naacls.org Offers information on accredited and approved training programs for lab work. American Association of Bioanalysts 917 Locust Street, Suite 1100 St. Louis, MO 63101 www.aab.org Offers information on certification. American Medical Technologists 710 Higgins Road Park Ridge, IL 60068 www.amt1.com American Society for Clinical Pathology, Board of Registry 2100 West Harrison Street Chicago, IL 60612 www.ascp.org/bor National Credentialing Agency for Laboratory Personnel P.O. Box 15945-289 Lenexa, KS 66285-5935 www.nca-info.org American Society for Clinical Laboratory Science 7910 Woodmont Avenue, Suite 530 Bethesda, MD 20814 www.ascls.org

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Naturopaths The American Association of Naturopathic Physicians 8201 Greensboro Drive, Suite 300 McLean, VA 22102 Phone: 703-610-9037 or toll free 877-969-2267 e-mail: [email protected] www.naturopathic.org

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Y O U R R E F E R E N C E

Osteopathic Medical Assistants American Osteopathic Association (www.aoa-net.org)

F O R

Occupational Therapists American Occupational Therapy Association 4720 Montgomery Lane, P.O. Box 31220 Bethesda, MD 20824-1220 www.aota.org or www.otjoblink.org/links/link01.asp Offers a list of accredited programs in occupational therapy.

Pharmacy Aides and Technicians Pharmacy Technician Certification Board 2215 Constitution Avenue, NW Washington, DC 20037 www.ptcb.org Offers the National Pharmacy Technician Certification Examination Candidate Handbook. American Association of Colleges of Pharmacy (www.aacp.org) Physical Therapists American Physical Therapy Association 1111 North Fairfax Street Alexandria, VA 22314-1488 Phone: 703-706-3248 www.apta.org Offers information on accredited physical therapy programs and careers in physical therapy assisting. Podiatry Assistants American Podiatrist Medical Association (www.apma.org) Respiratory Therapists American Association for Respiratory Care 11030 Ables Lane Dallas, TX 75229-4593 www.aarc.org

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R E F E R E N C E Y O U R F O R

Committee on Accreditation for Respiratory Care 1248 Harwood Road Bedford, TX 76021-4244 www.coarc.com Offers a list of accredited educational programs for respiratory care practitioners. The National Board for Respiratory Care, Inc. 8310 Nieman Road Lenexa, KS 66214-1579 www.nbrc.org Offers information on credentials in respiratory care and state licensing agencies. Speech-Language Pathologists American Speech-Language-Hearing Association 10801 Rockville Pike Rockville, MD 20852 Phone: 800-498-2071 or 800-638-8255 www.asha.org Surgical Technologists Association of Surgical Technologists 7108-C South Alton Way Englewood, CO 80112 www.ast.org Offers information on becoming a certified surgical technologist. Liaison Council on Certification for the Surgical Technologist 7790 East Arapahoe Road, Suite 240 Englewood, CO 80112-1274 www.lcc-st.org Offers information on becoming a certified surgical technologist.

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Copyright 2002 WetFeet, Inc.™

Who We Are WetFeet is the trusted destination for job seekers to research companies and industries, and manage their careers. WetFeet Insider Guides provide you with inside information for a successful job search. At WetFeet, we do the work for you and present our results in an informative, credible, and entertaining way. Think of us as your own private research company whose primary mission is to assist you in making more informed career decisions. WetFeet was founded in 1994 by Stanford MBAs Gary Alpert and Steve Pollock. While exploring our next career moves, we needed products like WetFeet Insider Guides to help us through the research and interviewing game. But they didn’t exist. So we started writing. Today, WetFeet serves more than a million job candidates each month by helping them nail their interviews, avoid ill-fated career decisions, and add thousands of dollars to their compensation packages. The quality of our work and knowledge of the job-seeking world have also allowed us to develop an extensive corporate and university membership. In addition, WetFeet’s services include two award-winning websites (WetFeet.com and InternshipPrograms.com), Web-based recruiting technologies, consulting services, and our exclusive research studies, such as the annual WetFeet Student Recruitment Survey. Our team members, who come from diverse backgrounds, share a passion about the job-search process and a commitment to delivering the highest quality products and customer service. WetFeet is headquartered in San Francisco. You can visit us any time at www.wetfeet.com, by calling 1-800-926-4JOB (or 415-284-7900 from outside the U.S.), or by sending an e-mail to [email protected]. We would love to hear from you, whether you have a job success story, information about a company, new product ideas, or a suggestion for improvement. Thank you for your support!

About Our Name One of the most frequent questions we receive is, “So, what’s the story behind your name?” The short story is that the inspiration for our name comes from a popular business school case study about L.L. Bean, the successful mail-order company. Leon Leonwood Bean got his start because he quite simply, and very literally, had a case of wet feet. Every time he went hunting in the Maine woods, his shoes leaked, and he returned with soaked feet. So, one day, he decided to make a better hunting shoe. And he did. And he told his friends, and they lined up to buy their own pairs of Bean boots. And L.L. Bean, the company, was born . . . all because a man who had wet feet decided to make boots. The lesson we took from the Bean case? Lots of people get wet feet, but entrepreneurs make boots. And that’s exactly what we’re doing at WetFeet.

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