Health care industry overview and structure

Health Care

The Staffing Policies Matrix

Hospitals are in the clubs quadrant of the staffing policies matrix. Hospitals are in this sector because careers are slow-moving. This means that the focus is not on constant promotion. Instead, individuals work based on their specialist area, whether it be nursing, rehabilitation, or various medical specialties. On a day-to-day basis the focus is on being reliable and consistent.

Sonnenfield and Pieperl (1988) note that organizations in the clubs sector have a fixed hierarchy with an emphasis on status. This is true of hospitals with overall status based on the hierarchy of professions. This hierarchy has support staff at the lower levels, nurses at the middle levels, medical professionals at the higher levels, and specialist medical staff such as surgeons at the highest level. Within the levels, seniority determines status. Seniority is also the basis on which promotion is generally given. This is a slow-moving process, where individuals will eventually gain a senior status and a subsequent promotion.

Another important point is that individuals work based on their specialty area, while all employees contribute to the overall service being supplied. The overall service is the provision of health care, with individual specialty areas needing to combine to provide the service. This makes hospitals group-based, which places them in the clubs sector of the staffing policies matrix.

Sonnenfield and Peiperl (1988) also noted that organizations in the clubs quadrant tend to have a public interest mission. This is true of hospitals, since they operate to provide a public service.

2. Employment Growth in Health Care

Given the figures for health care employment in 1998 and the projections for employment in 2008, the percentage growth can be calculated for each health care occupation. This shows the following growth levels, arranged from lowest growth to highest growth:

Occupation

Percentage Growth

Dentists

Optometrists

Clinical lab technologists and technicians

Licensed practical and licensed vocational nurses

Physicians

Registered nurses

Physical therapists

Speech-Language pathologists and audiologists

Dental hygienists

Respiratory therapists

Physician's assistants

The highest growth area is in support positions. For example, physician's assistants and dental hygienists have increased, while dentists, physicians, and registered nurses have decreased. This change reflects the strategic actions of health care organizations, specifically their focus on cost-cutting. The occupations that are growing are less specialist and allow health care organizations to reduce costs. For example, an organization pays less to a physician assistant than a registered nurse. Therefore, by replacing registered nurses with physician's assistant, the service is provided at a lower cost. The same applies to replacing dentists with dental hygienists.

It also seems that even physicians are being replaced by physician's assistants. This is part of the strategy to limit access to specialists, with patients now seeing lower level medical staff, with higher level staff only involved when the case warrants it.

The relatively low increase in physicians, dentists, and optometrists is also linked to the way that health care organizations are requiring copayments so that patients are more sensitive to the costs of health care. This strategy makes it more likely that patients will ignore minor complaints instead of choosing to get medical attention. This includes that they may forgo checkups. This partially explains why dentists, optometrists, and physicians are all expected to increase more slowly than other professions.

The emphasis on prevention is also reflected in the changes in growth rates. This is seen especially in the comparison between dentists and dental hygienists. A dental hygienist's job is specifically based on preventing dental problems. The growth in dental hygienists shows the increasing focus on prevention. This also explains the slow growth rate in dentists, since preventing dental problems effectively reduced the demand for dentists.

The market demand for medical care is expected to increase. Overall, this should improve employment in the health care sector. The demand for each occupation will be inline with growth in that occupation. This means that there will be limited demand for dentists, optometrists, and lab technicians. There will be a medium level of demand for vocational nurses, physicians, and registered nurses. Finally, there will be a high level of demand for physical therapists, speech-language pathologists and audiologist, dental hygienists, respiratory therapists, and physician's assistants.

3. Future Employment Needs

While there is uncertainty in the demand for health care workers, employment needs are expected to increase as the demand for health care increases. One thing that organizations can do to meet their future needs is to focus on retaining good staff. Since employment is not expected to decrease, health care organizations can reasonably assume that they will not need to reduce staff numbers. This means that there is little risk in a strategy based on retaining staff, while keeping current staff members reduces the need to recruit new employees. At the same time, retaining staff means that the organization will have a higher number of long-term employees with experience within the organization. This can help the organization to introduce new staff members effectively, while also limiting the problems associated with introducing new staff.

Another key issue is that a particular health care organizations ability to recruit staff depends not only on the employment market overall, but also on the individual organization. This means that even if the employment market is suffering from a lack of qualified staff overall, a particular organization may not suffer if it is a desirable place to work. Health care organizations can prepare for the possibility of needing to recruit from a relatively small pool of employees by ensuring that the organization is desirable to potential employees. If this is managed effectively, the desirable organization will gain suitable staff, while less desirable organizations will suffer. This can become a potential source of advantage for health care organizations.