During a typical 12-hour shift, Hector Hernandez can be found in just about any corner of Kaiser Sunset, tending to premature infants and the elderly, to patients with asthma and those with AIDS, to heart attack victims and survivors of car wrecks.
He connects patients to ventilators, evaluates lung capacity and blood gases and administers oxygen and aerosol medications. Clad in green scrubs and white running shoes, he is often the first to arrive on a “code blue” -- the term that is broadcast when a patient has stopped breathing.
Yet most of those he sees probably could not name his occupation. Hernandez, 49, is not a doctor or a nurse but a respiratory care practitioner.
“A lot of people don’t hear much about respiratory therapists,” he said. “We’re there. We help you. We’re gone.”
Many patients also probably don’t know that there are barely enough respiratory care therapists to go around.
Most people have heard about the nationwide nursing shortage. But the country is also experiencing a shortage of trained workers in the “allied health professions” -- respiratory care practitioners, medical transcriptionists, radiographers and about 200 other occupations that make up about 60% of healthcare workers.
“We call them the hidden healthcare workforce,” said Susan Chapman, director of allied health studies at the UC San Francisco Center for the Health Professions. “In the policy arena, there isn’t a lot of attention being paid to those folks.”
Yet the care they provide is vital.
“You can’t run a hospital without people to take the X-rays or do the lab tests,” Chapman said.
According to a recent study, California, with its burgeoning population, lags behind the rest of the nation in the number of allied health professionals per capita.
If he wanted to, Hernandez, who has worked at Kaiser Permanente Los Angeles Medical Center in Hollywood for 22 years, could moonlight at three hospitals a week.
And as baby boomers like Hernandez, who now make up much of the allied health workforce, begin to retire, demand is expected to outstrip supply in at least nine of 15 occupations surveyed. Those with the highest projected need include pharmacy technicians, dental hygienists and physical therapist assistants.
“The aging of the population is a double whammy,” said Michele Siqueiros, executive director of the nonprofit Campaign for College Opportunity. “It drives up demand [for health services] at the same time that people will be retiring from the very jobs that will be needed.”
The campaign, a coalition of California business, labor and community groups, joined with Kaiser Permanente and the California Wellness Foundation last fall to commission the study.
The allied health profession is a large and varied group. Some, like laboratory scientists (who analyze blood and other bodily fluids), need a bachelor’s degree. Pharmacists, licensed social workers and physical therapists need advanced degrees.
But most allied health jobs do not require four years of college. Training programs after high school can lead to state certification to be an emergency medical technician (who provides emergency care and transport) or a pharmacy technician (who counts pills, labels bottles and works the pharmacy counter). Community colleges offer two-year associate degrees for medical radiographers (who position patients for mammograms and other imaging machines) and for respiratory care practitioners like Hernandez.
And although some jobs are relatively low-paying -- the median wage for an EMT in 2005-06 was $12.19 an hour -- others pay two or three times that, according to the study. The median wage for dental hygienists was $36.83. The highest median wage was for pharmacists, at $53.03.
Yet despite the decent pay, to meet the need for clinical laboratory scientists -- median wage, $32.36 an hour -- the state would have to produce 559% more graduates in that field alone in the next six years, the study found.
“Laboratory sciences are just critical to our delivery of healthcare in an acute-care hospital,” said Roger E. Seaver, president and chief executive of Henry Mayo Newhall Memorial Hospital in Valencia.
“But they are out of sight, out of mind.”
The factors driving the shortages are similar to those behind the nursing shortage, experts say.
Allied health workers make more money in the clinic than in the classroom, leading to faculty shortages. Community colleges, underfunded and independently operated, do a poor job of letting students who are on a waiting list at one college know about available seats at another.
Attrition rates are high because many students are ill-prepared academically when they enter college and juggle classes with work and family obligations. Little is offered in the way of tutoring, counseling or financial aid.
Public-private partnerships to fix some of these problems in nursing education are already showing results, said Siqueiros, who is calling for similar steps -- and funding -- for the allied health fields.
Some hospitals, Kaiser among them, already work with community colleges to recruit and prepare students.
When Jerry Saldana became manager of respiratory care services at Kaiser Sunset, he knew that wages didn’t explain the problems he was having filling vacancies: The starting salary for respiratory care practitioners right out of school is $29 an hour plus full benefits. There just weren’t enough applicants to go around. So he set up partnerships with East Los Angeles College, Mt. San Antonio College in Walnut and Concorde Career Colleges to do the clinical training, which makes up the program’s second year, at Kaiser.
“We get to see the students here for a year, train them here,” he said. “I’ve hired quite a few right out of school.”
The worsening economy has sparked interest in the program among mid-career workers who have lost their jobs to downsizing or are seeking stable work. The field also attracts immigrants who worked in a health profession in their home countries.
“We’re making some ground on the awareness side,” said UC San Francisco’s Chapman. “But we still have a long way to go to have a serious, sustained commitment to this. Like in nursing, it’s not something that’s going to be resolved overnight.”