If you’re like many business majors, you chose this course of study because it promised the smoothest career transition after graduation. In today’s volatile job market, however, nothing is guaranteed. Even a business major has to approach the job search with creativity and competitive zeal in order to succeed.
One of the first hints that a health care career may prove agreeable to you as a new business graduate is the terminology currently of importance in this field: physician’s corporation, managed care, health maintenance I organization. Health care is big business, no question. More significant, however, is the fact that it is a business that is under heavy scrutiny to do a good job. The government watches health care, physicians have a vested interest, vendors and suppliers have every reason to pay careful attention, and the public, most of all, pays close attention to even the smallest change in health-care provisions.
Why? The reasons are largely economic in every instance. Health-care costs are steadily increasing, and as those costs increase, the employers and individuals who pay for health care complain. Here’s an example. We are all quite familiar with natural childbirth techniques. Natural childbirth is best defined as childbirth with prepared parents who have received education about the birthing process and who hope to experience the birth with a minimum of anesthetics or other drugs. (Having fewer drugs makes for a healthier baby and a faster recovery for the mother.)
Years ago, women stayed in the hospital for lengthy confinements. They delivered their babies under heavier anesthetics, which required more recuperation time. They also stayed in the hospital to learn about baby care from medical professionals. At that time, hospital costs were not as dramatic as they are now. But things have changed. Hospital stays began to shorten considerably. Parents became better educated about childcare, mothers were using very little medication, and we realize long hospital stays were increasingly costly and not a good use of medical staff. Others could teach parents about new-baby care more efficiently and more cheaply outside the hospital.
Business Sensitivity to Medical Issues
The controversy in the medical and popular press is that stays for childbirth have shortened too much. Hospital stays have now become as short as two or three days, and many women who have uncomplicated deliveries are being discharged after one nights stay or, in the most extreme cases, after as little as twelve hours! Insurance companies reward brief stays to encourage reduced costs. The U.S. Centers for Disease Control and Prevention reports that hospital stays for vaginal births have dropped from an average of 3.9 days in 1970 to 2.5 in 1999.
When length of stay dropped too low, legislators in Massachusetts, New Jersey, and Maryland actually passed laws regulating hospital stays for childbirth, and Congress later passed a federal law as well. What’s going on here?
What’s going on is health-care reform, a constant process that sometimes becomes a battle between health-care professionals and cost-containment interests—insurance companies, hospital administrators, employers who provide insurance, and government agencies including Medicaid and Medicare. Health-care professionals want to provide patients with the very best health care they can. Increasingly, the cost of providing that care has escalated as larger and larger monetary judgments are made against health-care providers for mistakes, omissions, or in some cases, malpractice. A significant increase in health-care costs is attributable to the threat of litigation.
Insurers and health-care cost-containment professionals want costs to stay as low as possible, and all have different reasons. Some want to make a profit on their policies; others want low costs to keep care affordable to as much of the public as possible.
This is obviously a situation that cries out for good business skills and management that is sensitive to the publics health-care and financial needs. Doctors and nurses provide quality health care, administrators manage paperwork, and insurers watch bills, but who is looking at the overall system? The important adjuncts of the treatment process are patient screening, long wait lines for services, presence or lack of amenities such as food services, shopping, and convenient parking at health-care providers. How successful can a doctor/patient interaction be if the patient wasn’t able to find parking space or feels the parking fee was too high, or has waited in line lor an hour only to be confronted with paperwork he or she cannot understand? Business concepts such as process redesign can help. There’s a place for business expertise alongside clinical care within today’s health-care delivery networks.
Definition of the Career Path
Health care is changing—fewer jobs are in traditional hospital settings, and more jobs are migrating to other places in the health network, such as outpatient treatment centers, medical office buildings, and skilled-care facilities. Because there are so many available job sites, each with its own unique conditions, let’s begin by looking at a number of health-care positions available to a recent graduate with a business degree. A good start might be with a position that emphasizes some of those skills and attributes we associate with the business degree. The following position is located within a major health maintenance organization (HMO) in the greater Boston area:
Assistant Home Care Contract Administrator: Responsibilities include negotiation and administration of contracts for home care services. Under direction of the Administrator, you will develop reimbursement agreements, ensure contract compliance, administer contracts, and perform cost and utilization analysis. Requirements include:
• B.A./B.S. in business or a health-care field
• Proficiency in Lotus I -2-3/Excel
• Willingness to participate in training/workshops to acquire clinical/ technical background in infusion therapy, DME, and respiratory services.
Here’s a marvelous entry-level opportunity that will really groom you in the field of contract administration, specifically in the field of respiratory therapy. It will draw upon your computer skills, your economics classes, your business law course, and many others. This is the kind of exciting position that transforms a generalist business major into a skilled professional.
This next position is also for an HMO, another large and well-known entity with a reputation for excellent management. This position has a quantitative side, too, but with an emphasis on sales and promotion as well.
The following position is more suited to the graduate who enjoyed marketing courses or consumer behavior. This advertisement is for a position in a small to mid-sized hospital:
Account Manager: Oversee the day-to-day operational aspects of medical benefit plan administration for major existing accounts; providing ongoing guidance to major accounts with respect to projecting and planning for future medical benefit needs; working with underwriting, communications, and enrollment departments to initiate and complete annual renewals; and providing education regarding plan guidelines and benefits.
To be considered, you must have a bachelor’s degree in business or the equivalent and one to three years of related experience in a sales or service capacity. Strong communication and presentations skills are essential. Knowledge of self-funded and managed-care health benefits preferred. Extensive local travel will be involved.
Manager, Media Relations and Special Events: If you have excellent writing, interviewing, media relations, editing, and supervisory skills this might be the right position for you. Individual will be responsible for project management in media relations and special events as well as developing community outreach programs such as lecture series, public forums, etc. Position requires a bachelor’s degree in business, marketing, journalism, health care, or a related field.
Granted, the subject matter of your copywriting may be issues such as how to prevent osteoporosis or common skiing injuries and how to avoid them. The language and level of sophistication is for a general audience, and you will have professionals available to check the accuracy of the text. The craft and technique of media relations and special events remains the same. This is an exciting position on its own, and also one that could propel you to a larger medical facility or health maintenance organization, to magazines or other media specializing in health issues, or into the commercial world.
You may have noticed in the job listings is the requirement for a business degree –or- healthcare background. Health-care degrees are still in short supply, and many of those graduating from health-care programs are more interested in clinical (patient contact) positions, not administration or management.
The second reason for some equivocation in degree or experience requirements is that the industry itself is not sure which expertise is most critical, the management or the medical! Right now, in similar jobs all over the country, there are professionals from both backgrounds doing excellent work. At the top of the profession are physician executives educated in medicine and business, and paid accordingly, working as hospital system CEOs.
If you’re exploring the health-care field as a business graduate, part of that interest may stem from an interest in people and their well being, so you may want some contact with the patient population. You can have this! Let’s look at a couple of recently advertised positions that would offer some of that patient contact. Here’s a hospital-based position:
Executive Directors: Will be the senior manager in our adult day-care center and is responsible for all aspects of a center’s operation: meeting census and payer mix objectives; providing outcome-based care according to company standards; continuously improving center efficiency and achieving profitability targets. At least 50 percent of the ED’s time will be spent on marketing and sales. He or she must have the following qualifications:
• Some previous management experience
• B.A. degree
• Willingness and ability to sell service to community
• High energy, enthusiasm, warmth, and compassion
To do this job well, you’ll need to know your market. You’ll need to appreciate what motivates individuals to place parents or relatives in adult day care, and you’ll want to mix with the clients to learn their stories and their complaints and satisfactions with the care they’re receiving. Though the patient population here is, by and large, healthier, you will encounter clients with eating difficulties, hearing loss, poor vision, and perhaps symptoms of pre-senility, dementia, or early stages of Alzheimer’s disease.
Reading these advertisements, you may be interested in the jobs but concerned that you don’t understand all the medical jargon and terminology. Actually, even medical professionals struggle with the lingo outside their areas of expertise. You’ve encountered a number of terms in these ads: respiratory therapy, continuous quality improvement, census, payer mix, DME, rehabilitation, and so on. Don’t be dismayed. Every field of work has its own vocabulary. The terminology of the stock market is equally confusing to the uninitiated. What do you do? Consult a dictionary! Black’s Medical Dictionary, Stedman’s Medical Dictionary, or the Merriam Webster Medical Dictionary (all listed in Additional Resources and generally available in larger reference libraries) is a few examples of the many resources available to you. Certainly, you’ll want to investigate and understand any terminology in the job ad itself and, once on the job, begin a regular self-tutorial to learn the vocabulary of your new environment. If necessary, you can also pursue education—advanced degrees in health administration or public health or a certificate in one of the allied health professions.
How patients enter, are processed, and discharged from a facility is not just a cost issue, but a patient care issue. Repeat business in situations where clients can select their provider may be in large part influenced by how smoothly they felt the administrative process was managed. On the patient care side, an agitated, anxious patient who has been waiting too long, is overly confused by paperwork, or whose admission records are missing is harder to treat and takes longer to respond to treatment. The individual whose job is to facilitate the administrative process can have a positive and direct effect on a patient’s well being.
Working Conditions
We’ve looked at a variety of job types and environments. Despite the variety, however, there are still some generalizations we can make about working conditions that can guide you in your job search.
Behind the Scenes
The administrative, quantitative, computer-oriented, and analysis jobs are going to be located, in most cases, in the offices and administrative suites that lie behind the scenes of patient care. While some of these kinds of offices may be located in a section of a health-care facility, many are not; they are situated in office buildings indistinguishable from neighboring buildings. Billing services for a radiological corporation of physicians may not even be located in the same town as the medical office. So even though you are in health care, yoii are not necessarily at a work site where health care is being delivered. That may or may not be your preference.
On the Front Lines
There are, however, numerous jobs sited at hospitals, adult day-care facilities, nursing homes, rehabilitation centers, health maintenance clinics, and other locations that receive a constant flow of patients and their families. In some of the jobs we have listed, some contact with the patients is important it) do the best job possible. If you’re a patient care administrator, not only will you do a better job by getting out and talking to patients about their treatment, but you’ll also recognize errors sooner.
Know Your Environment
In the health-care field, the better you know the clientele—the patients and their families—the better you can do your job. One of the major complaints about nonmedical personnel in the health-care field is that they don’t have a sense of appreciation for the individual patient and focus overly much on the paperwork, forgetting the human element. Let that criticism be a warning of how you might be perceived with a business degree and no health background. You’ll need to be concerned about patient welfare and let people know that you are. Take action steps to keep yourself informed of these issues by reading professional journals and newspapers and watching the local news for coverage of health-care issues.
Because health care is undergoing dramatic changes, both in new scientific developments and in its corporate structure, you’re going to experience a lot of change in your job. New employees will arrive at your organization to fill new jobs, new forms will appear to meet new needs, and you will encounter new ways of doing things, new products, new techniques, and a constant flow of information. If change is difficult for you on the job, you may find a career in health care a challenge to your peace of mind.
On the other hand, the workday is relatively structured, and most administrative staff have very regular hours. Office spaces are generally attractive. Because you’re in health care, where the well-being of the individual is paramount, its recognized that workplace aesthetics and working conditions make a major contribution to an employee’s sense of well-being. Of course, as a salaried worker, you’ll probably find there are many times when your day doesn’t begin or end with any regularity.
Workplace Risk Issues
There is a myth among the uninitiated that if you work in health care and work in a hospital, you’re going to get sick, catch some disease, or generally be more susceptible to infection. Absolutely not! There is no documented evidence that working in a health-care facility in any way increases ones average rate of illness or infection.
Training and Qualifications
As an undergraduate business major, you probably don’t have any medical background, other than your own experience as a patient in the medical community (which may be valuable!). You might have had some college or high school courses in physiology or chemistry, but nothing medical or health related. That’s OK. Your entry into the world of health care will not depend upon that. You’re being hired essentially for your business degree.
Remember what you’ve read about the volatility of the health-care field. One of the major ingredients in the constant redefinition of health-care delivery is the increasing pressure that exists between the field of medicine and the realm of medical cost containment. Professionals hired on the business side of the equation are well advised to know their stuff! Whether you’re looking at sales, finance, systems management, accounting, administration, or facilities management, be prepared to demonstrate, display, and talk about your business education. The prize (a great job) will go to the candidate who knows what he or she’s talking about.
Begin a Health-Care Study Program
Your initial attractiveness to the health-care employer will be your potential to cut costs and improve the delivery of patient care. Your competition will be those earning health-care degrees or even those with master’s degrees in public health or hospital administration. If you can demonstrate good management skills, a strong goal orientation, and an appreciation of the dynamics of the health-care industry, you’ll find the focused generalist (you!) is still a competitive bidder for many entry-level jobs.
While your entry into the field will not depend upon your grasp of the health-care industry, your successful career progress will. Your health-care career will be a sophisticated and complex combination of patient awareness, medical expertise, and economics. You will be learning about each as you progress. More than any other path described in this book, the health-care career path demands that you constantly educate yourself, both on and off the job. On the job, avail yourself of the expertise of those individuals who are more experienced than you are and have them teach you all they can about the profession. Ask for and take advantage of every professional development opportunity your employer makes available to you. Outside of your working hours, keep up with television and press coverage of health-care issues, and read professional journals and magazines to increase your store of information on every aspect of your profession, from disease entities to patient service provisions.
Once you’ve secured your position and begun your own training program, both formally and informally, your ability to hold your job and to advance in your field will be directly related to your grasp of those larger issues you’ve been reading about. Eventually in all management jobs, you’ll be called upon to concentrate on the more conceptual aspects of your job; e.g., planning and implementing new systems and procedures. This means letting others have responsibility for many of the technical skills and procedures you may have enjoyed and done well. You won’t be ready for that change if you haven’t taken time to educate yourself along the way in the bigger issues of your industry.
Earnings
You can reasonably expect that in an industry growing as fast as health care the earning power of skilled workers will be correspondingly high and growing. While managerial types in health care (those with business backgrounds) are currently very highly paid, the volatile nature of the industry and the increasing rate of takeovers, mergers, and consolidations of services make earnings very difficult to predict.
While the demographics discussed below would indicate that as the number of people needing health care rises, the value placed on that care and the people who provide it should rise, the correspondingly great pressure from government and private industry to reduce costs may have a dampening effect. There are already situations in state-run health-care facilities where skilled workers are paid less than bus drivers. These discrepancies are being increasingly challenged in the courts under the doctrine of job comparability, which has thus far not received any legal sanction but remains an arguing point in contract negotiations.
Some of the best information about starting salaries in health care is available from the Collegiate Employment Research Institute at Michigan State University. Here are some entry-level salaries for people with undergraduate business degrees pursuing careers in health care that correspond to some of the job postings reviewed earlier:
Human resource management $28,000
Advertising $34,333
Marketing $34,000
Financial administration $42,850
Source: Collegiate Employment .Research Institute, Michigan State University.
Career Outlook
Even with the many challenges the industry presents as it seeks to contain costs and provide good care, the career outlook for jobs in the health-care industry is superb. The U.S. Bureau of Labor Statistics predicts that the health services industry will add 2.8 million jobs by 2010—13 percent of total employment growth!
There may only be a small segment of job types among those jobs that you are interested in, but even a small percentage would mean thousands of jobs. Labor Department figures indicate positions for administrators in health care will increase by about 30 percent by the year 2010. Moreover, nine out of twenty of the fastest-growing occupations the Bureau projects are professional and technical health-care jobs. Almost every occupation in health care will have higher-than-average growth through the next decade, including the highly paid managerial positions. Among these occupations, in addition to those that would be attractive to someone with an undergraduate degree in business, there are some that do not require college degrees (home health aides, secretaries, etc.) and some requiring advanced degrees (psychologists, psychometrists, and others).
What has fueled that growth? A number of specific trends, including demographics, technology, changing finances, and home health care.
Changing demographics are a major factor in health-care industry growth. An aging population is aging with better health and more activity than ever before and more income to spend on health maintenance. Those over seventy-five years old, requiring the most medical assistance, will increase by 35 percent over the next two decades. In 1980, the United States achieved the distinction for the first time in history of having slightly more than half its citizenry past the age of thirty. Birth rates and fertility rates remain rather low, but median age continues to climb and remains the single most impactive demographic component of the health-care revolution. A continuously aging society will cause many changes in our future, but the one that concerns us here is the expanded workforce in the health-care field.
The emergence of new technology also affects the health-care industry. Examples of procedures using new technology include reading x-rays long distance, lengthening shortened limbs with external fixation devices, and providing patient-administered analgesics at bedside. As technology proliferates, more services are created and more care opportunities evolve.
Changing finances are another important influence in health care. Talk to people you know who are on a medical coverage plan, and they will tell you they have experienced changes: changes in providers, changes in administration, and especially, changes in cost and who bears that cost. With hospitals forced to deal with cuts in government support, and with the new types of health-care organizations (HMOs and PPOs) growing across the country, management and accounting skills are more highly valued than ever before. We can expect continuing changes in the mix of public and private financing of our health-care system.
Home health care is on the rise, affecting the health-care sector that provides related services. As hospital stays decrease, technology increases, and a patients confidence in his or her ability to self-manage care continues, the possibilities for what can be done in the patient’s home grow.
Strategy for Finding the Jobs
Because your business program has probably not exposed you to the health-care field in any significant way, much of your job search will involve discovering an entire new sector of our economy. If you are like others who have sought employment in the health-care field, you’ll find the field very fertile ground for the newly minted business degree student.
I recommend you obtain a good guide to health-care employers, such as Peterson’s Job Opportunities in Health & Science 2000. This book is readily available to borrow from many college libraries, college career centers, and larger city libraries. It is also available at a modest cost in larger bookstores.
It’s a solid resource for two reasons. First, it lists thousands of health-care employers (indexed geographically and alphabetically), and tells you what they do, how many people work for them, and what expertise they may be looking for in new hires. It should expand your horizons about what is possible. For example, perhaps you have some experience in information systems. You probably already realize you can apply at hospitals, larger nursing homes, HMOs, and the traditional sites. Reading through this type of guide, you will begin to recognize other employment opportunities, such as eye-care firms, hospital equipment manufacturers, and pharmaceutical manufacturers.
Expanding your list of possible job sites should be very helpful to you. Each type of employer has its own work environment, its own “climate.” Some may suit you more than others. Also, as an entry-level employee with a general business background, you need the flexibility of lots of places to look for entry-level positions in a specialist world such as health care.
You should begin to sort potential employers by hiring needs. Of course, that will help you to locate employers based upon your own talents and career objectives. But it helps in other ways as well. If you are interested in finance, you’ll find a long list of employers who generally seek those skills. But, if your job search is localized to a specific geographic area, you can still get some excellent ideas from books like this about the kinds of health-care employers that seek finance skills. Use that information to customize your search to your own geographic area.
Don’t overlook state Health and Human Services departments. You might never have thought of those agencies in your own search. While many listings are for federal positions, it’s a good bet that your state agency has similar needs. Call the agency and make an appointment to go in and talk to a representative of its human resource department about the agency’s expectations for college graduates with interests in finance.
Don’t overlook any area of the market:
Assisted living services
Biomedical firms
Dental companies
Health maintenance organizations
Mental health agencies
Hospitals
Instrumentation manufacturers
Insurance companies
Laboratories
Life sciences companies
Medical management firms
Medical records management firms
Medical software firms
Medical systems
Pharmaceutical manufacturers
Physician services
Rehabilitation centers
Senior citizens’ homes
Therapy associates
In examining various sectors of the market, look for job opportunities that fit your expertise. Health care is no different than other areas of employment; it maintains all the essential functions of any business including marketing, sales, administration, finance, accounting, public relations, and all the other traditional business functions.
Because health care is growing so rapidly, you’ll encounter many new and smaller firms that are growing rapidly. These firms have leaner staffs and make more use of cross training. Staff members need to be very flexible and may change jobs frequently as the organization grows. You might want to consider a strategy of affiliating with a smaller, rapidly growing health-care firm. Work hard, learn all you can, and you could find you’re riding along with that growth in your own professional advancement.
Here’s an eight-step checklist of items to consider in seeking out the best job for you:
1. Check Out Prospective Employers
Everyone in the career field is always suggesting you research the company you are considering. How do you do that? Do you have time to learn to be an employment researcher? Probably not. Start by asking a good reference librarian what you might be able to find out about a company. He or she will suggest everything from stock ratings and Better Business Bureau complaint histories to articles in periodicals. If you can visit the office, park your car outside and observe who comes and goes. What’s the building like? Is it attractive and well maintained? How do employees act and dress? Try to arrange an informational interview through the human resources department or the department that is your area of interest. On the day of your appointment, stroll into the lobby (don’t worry, nobody will remember you!), look around, ask the receptionist about the firm, and pick up any promotional literature you might find displayed. An on-site visit can be very revealing. If you like what you find, follow up later to track job openings.
2. Display Your Communication Skills
Your resume, cover letter, thank-you note after an interview, and your manner on the telephone and during an interview are all examples of how you communicate and how you’ll do as a communicator for an employer. You’ll be judged on that as much as anything. Ensure your written communications are perfect and practice your interviewing skills. Get on the telephone with a friend who will act as the employer in a phone conversation to critique your telemarketing skills. You’ll be glad you did.
3. Do You Know a Foreign Language?
It may be too late now to begin a college program, but speaking ability in Spanish would be a real plus in many health-care organizations. Certainly, foreign travel and a sensitivity to other cultures is a valuable experience and one you’ll want to talk about, if you can.
4. Prove You Are Results-Oriented
Health care is under the gun and everyone is working hard to produce good results that are economically viable and sensitive to patient and physician needs. In your resume and during your interview, you want to communicate to the best of your ability that you are a results-oriented person.
5. Add to Your Experience
Going into a field such as health care with a language all its own and a different focus than the kinds of business entities you’ve studied in college will put some heavy demands on you to grow and add to your experience— quickly. Before that happens, take advantage of your own rich college experience and sample some of the wonderful guest speakers, seminars, and conferences that occur on your campus. Raising your general information level makes you a more valuable employee. You are aware of more issues and can relate more easily to other people through shared ideas and an enhanced appreciation for differing viewpoints. Each learning opportunity of this kind adds to your value to an employer.
6. Network
You may need to brush up on the mechanics of networking. In the health-care field particularly, there are many shared relationships. Professionals in the field share many of the same concerns as health care both grows and changes. You’ll meet many fine people during your job search. Regardless of the outcome of those meetings, maintain those relationships and stay interested in those individuals, for they may prove helpful in furthering your job search or in performing your job once you land one.
7. Set Your Job Goals
Health care is a busy field. The business section of a major Boston, Massachusetts, daily recently featured health-care-industry business maneuvers in four of the five front-page stories. With newsworthy changes occurring daily, health care is not an industry where employees will have free time to help you figure out what you want in a job or career. Learn about the industry, learn about the jobs these workers do, and make your own decisions about where you might best fit in. Change your mind as much as you want and as circumstances and information alter your ideas about career paths—but have a plan.
8. Raise Your Level of General Information
Health care is its own field, with its own concerns and issues. You can’t change that, but you can change. You can adapt and grow and develop new skills, new talents, and new ways to use your education. By far the best technique to improve your chances of getting hired is to stay abreast of the issues facing health care in this country today. Learning about issues such as length of hospital stay, litigation, medical malpractice, and misdosing of prescriptions, new advances in radiology, pain, and genetics, and countless other issues will tune you in to the concerns, vocabulary, and players in the health-care game. You’ll be guaranteed to draw on this information again and again. Make reading the daily paper a habit!
