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• Significant Points
• Nature of the Work
• Working Conditions
• Employment
• Training, Qualifications, Adv.

• Job Outlook
• Earnings
• Related Occupations
• Sources of Additional Information

Significant Points

·            Earnings of medical and health services managers are high, but long work hours are common.

·            A master's degree is the standard credential for most positions, although a bachelor’s degree is adequate for some entry-level positions in smaller facilities.

·            Employment will grow fastest in residential care facilities and practitioners’ offices and clinics.

Nature of the Work

Healthcare is a business and, like every other business, it needs good management to keep it running smoothly. The term “medical and health services manager” encompasses all individuals who plan, direct, coordinate, and supervise the delivery of healthcare. Medical and health services managers include specialists and generalists. Specialists are in charge of specific clinical departments or services, while generalists manage or help to manage an entire facility or system.

The structure and financing of healthcare is changing rapidly. Future medical and health services managers must be prepared to deal with evolving integrated healthcare delivery systems, technological innovations, an increasingly complex regulatory environment, restructuring of work, and an increased focus on preventive care. They will be called upon to improve efficiency in healthcare facilities and the quality of the healthcare provided. Increasingly, medical and health services managers will work in organizations in which they must optimize efficiency of a variety of interrelated services, for example, those ranging from inpatient care to outpatient follow-up care.

Large facilities usually have several assistant administrators to aid the top administrator and to handle daily decisions. They may direct activities in clinical areas such as nursing, surgery, therapy, medical records, or health information.

In smaller facilities, top administrators handle more of the details of daily operations. For example, many nursing home administrators manage personnel, finance, facility operations, and admissions, and have a larger role in resident care.

Clinical managers have more specific responsibilities than generalists, and have training or experience in a specific clinical area. For example, directors of physical therapy are experienced physical therapists, and most health information and medical record administrators have a bachelor’s degree in health information or medical record administration. These managers establish and implement policies, objectives, and procedures for their departments; evaluate personnel and work; develop reports and budgets; and coordinate activities with other managers.

In group practices, managers work closely with physicians. Whereas an office manager may handle business affairs in small medical groups, leaving policy decisions to the physicians themselves, larger groups usually employ a full-time administrator to advise on business strategies and coordinate day-to-day business.

A small group of 10 or 15 physicians might employ one administrator to oversee personnel matters, billing and collection, budgeting, planning, equipment outlays, and patient flow. A large practice of 40 or 50 physicians may have a chief administrator and several assistants, each responsible for different areas.

Medical and health services managers in managed care settings perform functions similar to those in large group practices, except their staffs may be larger. In addition, they may do more work in the areas of community outreach and preventive care than managers of a group practice.

Some medical and health services managers oversee the activities of a number of facilities in health systems. Such systems may contain both inpatient and outpatient facilities and offer a wide range of patient services.

Working Conditions

Most medical and health services managers work long hours. Facilities such as nursing homes and hospitals operate around the clock, and administrators and managers may be called at all hours to deal with problems. They also may travel to attend meetings or inspect satellite facilities.

Some managers work in comfortable, private offices; others share space with other managers or staff. They may spend considerable time walking, to consult with coworkers.

Employment

Medical and health services managers held about 248,000 jobs in 2009. About 30 percent worked in private hospitals, and another 16 percent worked in offices of physicians or in nursing care facilities. The remainder worked mostly in home health care services, Federal Government health care facilities, ambulatory facilities run by State and local governments, outpatient care centers, insurance carriers, and community care facilities for the elderly.

Training, Qualifications, Adv.

Medical and health services managers must be familiar with management principles and practices. A master’s degree in health services administration, long-term care administration, health sciences, public health, public administration, or business administration is the standard credential for most generalist positions in this field. However, a bachelor’s degree is adequate for some entry-level positions in smaller facilities and at the departmental level within healthcare organizations. Physicians’ offices and some other facilities may substitute on-the-job experience for formal education.

For clinical department heads, a degree in the appropriate field and work experience may be sufficient for entry. However, a master’s degree in health services administration or a related field may be required to advance. For example, nursing service administrators usually are chosen from among supervisory registered nurses with administrative abilities and a graduate degree in nursing or health services administration.

Bachelor’s, master’s, and doctoral degree programs in health administration are offered by colleges, universities, and schools of public health, medicine, allied health, public administration, and business administration. In 2001, 67 schools had accredited programs leading to the master’s degree in health services administration, according to the Accrediting Commission on Education for Health Services Administration.

Some graduate programs seek students with undergraduate degrees in business or health administration; however, many graduate programs prefer students with a liberal arts or health profession background. Candidates with previous work experience in healthcare also may have an advantage. Competition for entry to these programs is keen, and applicants need above-average grades to gain admission. Graduate programs usually last between 2 and 3 years. They may include up to 1 year of supervised administrative experience, and course work in areas such as hospital organization and management, marketing, accounting and budgeting, human resources administration, strategic planning, health economics, and health information systems. Some programs allow students to specialize in one type of facility—hospitals, nursing homes, mental health facilities, or medical groups. Other programs encourage a generalist approach to health administration education.

New graduates with master’s degrees in health services administration may start as department managers or as staff employees. The level of the starting position varies with the experience of the applicant and size of the organization. Hospitals and other health facilities offer postgraduate residencies and fellowships, which usually are staff positions. Graduates from master’s degree programs also take jobs in large group medical practices, clinics, mental health facilities, multifacility nursing home corporations, and consulting firms.

Graduates with bachelor’s degrees in health administration usually begin as administrative assistants or assistant department heads in larger hospitals. They also may begin as department heads or assistant administrators in small hospitals or nursing homes.

All States and the District of Columbia require nursing home administrators to have a bachelor’s degree, pass a licensing examination, complete a State-approved training program, and pursue continuing education. A license is not required in other areas of medical and health services management.

Medical and health services managers often are responsible for millions of dollars of facilities and equipment and hundreds of employees. To make effective decisions, they need to be open to different opinions and good at analyzing contradictory information. They must understand finance and information systems, and be able to interpret data. Motivating others to implement their decisions requires strong leadership abilities. Tact, diplomacy, flexibility, and communication skills are essential because medical and health services managers spend most of their time interacting with others.

Medical and health services managers advance by moving into more responsible and higher paying positions, such as assistant or associate administrator, or by moving to larger facilities.

Job Outlook

Employment of medical and health services managers is expected to grow faster than the average for all occupations through 2010 as the health services industry continues to expand and diversify. Opportunities for managers will be closely related to growth in the industry in which they are employed. Opportunities will be especially good in home healthcare, long-term care, and nontraditional health organizations, such as managed care operations and consulting firms. Managers with work experience in the healthcare field and strong business and management skills should have the best opportunities.

Hospitals will continue to employ the most managers, although the number of jobs will grow slowly compared with other areas. As hospitals continue to consolidate, centralize, and diversify functions, competition will increase at all job levels. Medical and health services managers with experience in large facilities will enjoy the best job opportunities as hospitals become larger and more complex.

Employment will grow the fastest in residential care facilities and practitioners’ offices and clinics. Many services previously provided in hospitals will continue to shift to these sectors, especially as medical technologies improve. Demand in medical group practice management will grow as medical group practices become larger and more complex. Medical and health services managers will need to deal with the pressures of cost containment and financial accountability, as well as with the increased focus on preventive care. They also will become more involved in trying to improve the health of their communities. Managers with specialized experience in a particular field, such as reimbursement, should have good opportunities.

Medical and health services managers also will be employed by healthcare management companies who provide management services to hospitals and other organizations, as well as specific departments such as emergency, information management systems, managed care contract negotiations, and physician recruiting.

Earnings

Earnings of medical and health services managers vary by type and size of the facility, as well as by level of responsibility. For example, the Medical Group Management Association reported that, in 2009, median salaries for administrators were $72,875 in practices with 6 or fewer physicians, $95,766 in practices with 7 to 25 physicians, and $132,955 in practices with 26 or more physicians.

According to a survey by Modern Healthcare magazine, median annual compensation in 2009 for hospital administrators of selected clinical departments was $76,800 in respiratory care, $81,100 in physical therapy, $87,700 in home health care, $88,800 in laboratory services, $90,200 in long-term care, $93,500 in medical imaging/diagnostic radiology, $94,400 in rehabilitation services, $95,200 in cancer treatment facilities, $96,200 in cardiology, $102,800 in nursing services, and $113,200 in pharmacies. Salaries also varied according to size of facility and geographic region.

According to a survey by the Professional Association of Health Care Office Management, total 2009 median compensation for office managers in specialty physicians' practices was $72,047 in gastroenterology, $66,946 in dermatology, $66,207 in cardiology, $64,543 in ophthalmology, $63,801 in obstetrics and gynecology, $62,545 in orthopedics, $58,595 in pediatrics, $52,211 in internal medicine, $50,924 in psychiatry, and $50,049 in family practice.

Related Occupations

Medical and health services managers have training or experience in both health and management. Workers in other occupations requiring knowledge of both fields are insurance underwriters and social and community service managers.

Sources of Additional Information

Information about undergraduate and graduate academic programs in this field is available from:

• Association of University Programs in Health Administration, 2000 North 14th St., Suite 780, Arlington, VA 22201. Internet: http://www.aupha.org

For a list of accredited graduate programs in medical and health services administration, contact:

• Commission on Accreditation of Healthcare Management Education, 2000 North 14th St., Suite 780, Arlington, VA 22201. Internet: http://www.cahmeweb.org

For information about career opportunities in health care management, contact:

• American College of Healthcare Executives, One N. Franklin St., Suite 1700, Chicago, IL 60606-4425. Internet: http://www.healthmanagementcareers.org

For information about career opportunities in long-term care administration, contact:

• American College of Health Care Administrators, 300 N. Lee St., Suite 301, Alexandria, VA 22314. Internet: http://www.achca.org

For information about career opportunities in medical group practices and ambulatory care management, contact:

• Medical Group Management Association, 104 Inverness Terrace East, Englewood, CO 80112-5306. Internet: http://www.mgma.org

For information about medical and health care office managers, contact:

• Professional Association of Health Care Office Management, 461 East Ten Mile Rd., Pensacola, FL 32534-9712.

For information about career opportunities in health information management, contact:

• American Health Information Management Association, 233 N. Michigan Ave., Suite 2150, Chicago, IL 60601-5800. Internet: http://www.ahima.org