SOUTHERN CALIFORNIA CAREERS : WHERE THE JOBS ARE : When Health Costs Are Squeezed, These Positions Tend to Flourish

Lisa Sorensen, a newly minted graduate of UC Davis’ nurse practitioner program, wasn’t even looking for a new job yet when the offers started coming in.

“I’ve gotten two calls from health maintenance organizations to come to work right away,” Sorensen said recently from her Sacramento home. “And they haven’t even seen me or interviewed me.”

Sorensen, 45, a veteran hospital nurse, chose wisely when she went back to school, studying for a career in one of the hottest fields in health care.

Nurse practitioners--registered nurses with advanced training that qualifies them to perform many traditional physician services, such as prescribing drugs and performing physical exams--are in strong demand in this era of medical cost-cutting.

HMOs, hospitals and even some corporate medical clinics are hiring nurse practitioners because they “provide quality health care at less cost,” explained Stephanie Chatoff, an emergency-room nurse who is president of the California Coalition of Nurse Practitioners.

The national drive to contain medical costs also is brightening prospects for other health care occupations. Among them: physician assistants (also known as “physician extenders,” who perform duties similar to those of nurse practitioners), home health care aides, respiratory and physical therapists and medical information systems specialists.

Other factors driving demand in the health care profession are the nation’s aging population and technology that prolongs lives and allows patients to receive more treatment, such as chemotherapy and intravenous infusion, at home.

Also spurring growth in health-care jobs are efforts by health insurers to limit the length of hospital stays and treat patients in less-expensive settings, such as long-term care facilities or patients’ homes.

The U.S. Department of Labor’s Bureau of Labor Statistics projects that health care will account for five of the 10 fastest-growing occupations through the year 2005. The hottest job in the nation will be that of a home health aide. The category is projected to grow from 347,000 jobs in 1992 to 827,000 by 2005--a 138% increase.

“Care is moving into the community rather than the hospital,” said Mari Cooper, a nurse recruiter at Huntington Memorial Hospital in Pasadena.

While forecasts of health care employment are largely based on current trends--such as continued enrollment growth in HMOs--not everyone agrees that these changes are inevitable.

“There is a lot of mythology about where the health care industry is going and what type of employment will be out there,” says Chuck Idelson, a spokesman for the California Nurses Assn., a labor union concerned about hospital layoffs of nurses. “Unfortunately, a lot of this is not based on the needs of the community but what is most profitable for people making the moves.”

If current trends hold, though, here is a brief look at a few jobs with bright prospects over the next few years.

* Nurse Practitioners/Physician Assistants: These similar professions have different educational programs and are governed by different state regulations. Both professions have a similar objective: to provide services comparable to a primary care physician at a lower cost, with equal outcomes and patient satisfaction.

Virginia Fowkes, director of the primary care associate program at Stanford Medical Center, said most who study for these professions have prior academic training and at least several years of work experience as registered nurses or emergency medical technicians, or in related fields. These programs--offered at medical schools, colleges and universities throughout the state--range from 15 months to two years in length.

One drawback: With state programs reporting five to six jobs available for each graduate, competition for getting admitted can be tough. The Stanford program, for example, attracted 700 applicants for 50 slots in its 1994 fall class, Fowkes said.

The good news, however, is that salaries range from $45,000 to $65,000. At community health clinics and in rural areas, where the need for these professions is great, salaries are on the low end of the scale.

* Physical Therapists/Therapist Aides: The Labor Department projects that demand for physical therapists and physical therapist aides will grow about 90% through the year 2005. Physical therapists, who help people alleviate pain and restore health, most often work in hospitals, nursing homes, rehabilitation centers, doctors’ offices or private clinics.

Physical therapists typically hold at least a bachelor’s degree and must complete a state licensing examination. Some have advanced training in particular clinical specialties, such as orthopedics, sports or geriatrics. Salaries range from about $36,000 to $56,000, but may be much higher for those who own a private practice.

* Home Health Aides: These workers receive training, often at community colleges, in a variety of medical procedures. They give baths, showers or shaves, check patients’ vital signs, provide back rubs or light exercise and may prepare a light meal or do minor housekeeping. They generally are not allowed to perform any invasive procedures such as giving injections.

Most are paid per visit, receiving $12 to $15 for a 45-minute to one-hour visit. A typical wage for an aide who works full time would be $375 to $425 per week.