Ben Houck is a graduate of the UNC-Chapel Hill Department of City and Regional Planning and a CCP intern working in Lenoir County.
Career maps available here: Lenoir County Health Care Career Maps
In North Carolina, employment growth in the health care sector has helped to buffer losses in manufacturing employment. This same trend occurred in Lenoir County, and it’s hard not to notice. While driving around Kinston earlier this week, I found it nearly impossible to drive a city mile without passing a clinic, home care provider, or assisted living facility. While private practices and specialty providers concentrate around the hospital, other facilities are dispersed into peripheral communities such as Pink Hill and La Grange.
Beyond their geographic distribution, providers take on various physical forms. Some family care homes blend into the community resembling just another residence along tree-lined streets. Home care offices settle as tenants within commercial lots while at least one home care provider is found in Kinston’s small business incubator along Queen Street.
As certainly as these facilities are found throughout Lenoir County and operate in their many physical forms, they are the face of an industry offering an abundance of employment opportunities. Direct Support Professionals, including Home Health Aides, Nursing Assistants, and Personal Care Aides, comprise over 1,000 jobs in Lenoir County. Licensed Practical and Vocational Nurses add another 200, and Registered Nurses, 600. Therapeutic occupations also offer opportunities within patient-care settings, including respiratory, physical, and occupational therapy. In some instances, licensed practitioners employ assistants which are often attainable through associate degree programs. Certification at this assistant level – sometimes voluntary and, in other cases, required by law – allows for greater career mobility and higher pay.
While employment may be good, and a goal in itself, health employers benefit when their workers turn their employment into careers. And in thinking of careers, it is natural to think of career advancement. Career maps are a simple way to display these careers and the necessary steps in order to reach one’s goal. Breaking the sector down into smaller pieces, several health care fields offer a structure amenable to career advancement and career ladder programs.
Advancement within the nursing field is a well-established practice. Nursing Assistant certificate programs are offered by more than half of the 58 community colleges across the state. Research from the North Carolina Board of Nursing indicates an increase in the total number of qualified applicants to practical nursing and entry-level RN programs in recent years. Once in the nursing workforce, professionals have opportunities to extend their education in order to practice a particular specialty. The Board finds that approximately 17% of entry-level RNs extend their levels of education by at least 1 degree during the first 10 years of their career and that this frequency increased in recent decades.
Beyond nursing, other pathways exist within allied health careers. One promising field is that of health information and communication. This includes entry-level positions such as medical records coding assistants and medical secretaries; mid-level occupations such as certified medical records coders, patient representatives, and medical transcriptionists; and supervisory positions such as health information administrators and unit supervisors. In 2002, 4,390 health information technicians were employed in North Carolina. And these professionals are finding employment in more diverse settings. The Sheps Center reports that while in 1998 nearly 3 out of 4 health information professionals worked in hospitals, only about half of this workforce worked in hospitals by the year 2000. Despite this trend, one of the limiting factors to career laddering in health information management is the tendency towards cross-practicing among these levels, as administrators working for smaller employers take on coding responsibilities while in other cases coders work without the supervision of a credentialed administrator. In Lenoir County, health information occupations are found in a variety of settings and their presence will remain vital as communication among providers, insurance companies, and regulatory agencies transforms in coming years.
Another target for career ladder intervention is in the field of clinical laboratory science. This includes entry-level positions such as Medical Lab Technician and Phlebotomist and mid-level positions such as Medical Lab Technologist and Cytotechnologist. Finally, occupations in radiologic sciences offer various points of entry. This includes certificate-level Portable Equipment Technicians and associates-level occupations such as Radiation Therapist, Radiology Technician, Cardiovascular Technician, and Nuclear Medicine Technician.
To sum up, health care has transformed over decades to reach its current state. Health care occupations have changed as well and will continue to change in response to consumer demand and federal reform. An era of managed care introduced the occupation of Hospitalist to act as a communicator between office-based physicians and patients admitted to hospitals. Anesthesiologist Assistant is another young profession – one found in Lenoir County – and legislation regarding its credentials and licensing was only passed by state legislature in 2007. As occupations adapt to changing models of health care provision, career ladder interventions may be found a potent tool in workforce development. The career maps and research to be presented to Lenoir County health care employers in coming weeks may represent a further step towards local career ladder interventions.