Following years of dead-end jobs in the fast-food industry, Hollee Brooks decided to trade her restaurant uniform for scrubs, and train to become a medical technician. If she makes it through nine months of training and gets state certification and some experience, she'll earn considerably higher wages and enjoy employment benefits that usually elude those who flip hamburgers for a living.
She is getting her training at the city campus of St Louis College of Health Careers, 909 South Taylor Avenue. It’s motto – “Come here, go anywhere” – is appealing to Brooks and many other people experiencing high unemployment and who yearn for careers that don’t require college degrees.
Brooks probably didn’t know it when she enrolled last fall, but her career path is a wise one. Locally and nationally, the health care industry remains an economic engine while much of the rest of the economy is struggling.
“Even in the worst part of what we call the Great Recession, we actually saw (employment) grow in the medical care sector,” says Tim McBride, a health policy analyst and health economist associated with the Brown School at Washington University in St. Louis.
McBride expects continued overall economic growth. That includes jobs in the health care sector,even for health workers at the lower end of the system. The growth, he says, is beginning to take off and will continue, spurred by provisions in the Affordable Care Act. McBride says the law will add millions of new patients to the health care system and require more workers and medical services to accommodate them.
A Brookings Report published in July finds the health care sector employs 14.5 million people and accounts for 10.3 percent of jobs nationally. Between 2003 and the first quarter of 2013, the industry added 2.6 million jobs nationwide, the report says.
“The industry’s 22.7 percent employment growth over that period significantly outstripped the 2.1 percent employment growth rate in all other industries,” the report says. In other words, health care sector employment grew 10 times faster than all other sectors of the economy.
The study says health care across 100 metro areas accounts for one in every 10 jobs. The share varies, with the numbers in Missouri ranging from 9.4 percent to 11.6 percent in the Kansas City area, and 11.7 percent to 14.2 percent in the St. Louis area.
Changing Lives
In practical terms, the data means people can earn enough in health care jobs to meet their household needs. That’s important to Brooks, 24, who grew up in a poor family, and is the mother of two, a four-year -old son, and two-year-old daughter.
“This position is going to open up doors and will change their lives as well as mine,” she says. “They will be able to have things that I didn’t have when I was a kid.”
In addition, she says her training will help her children in other ways. When one of her children becomes ill, she feels she’ll be in a better position to interpret the symptoms “because I’ve seen it before” during her training and work experience.
Another student at the health careers school is Marlee Wenski, 22, who moved here from Olethea, Kan., to live with her father. She had thought of a career in music after graduating from high school in 2010. She eventually decided to enter training as a medical assistant and aims to eventually to earn a nursing degree.
Wenski's situation says something about the health care industry as a magnet for drawing people to the region. She’s ambivalent about the St. Louis area, saying “there are things that keep me here and make me want to stay and things that make me want to go home. My heart really lies back home. I love Kansas more.”
On the other hand, she says meeting new people makes her want to stay. So do the employment opportunities. “There are a lot more jobs available here for medical assistants; there are a lot more hospitals and offices (that employ medical assistants) than where I was in Kansas.”
What Medical Assistants Do
The term medical assistant is a catch-all phrase covering workers who perform a variety of responsibilities in the health care industry. Their jobs range from phlebotomy to EKG work; from injections to checking a patient’s vital signs. A job posted last week for a medical assistant position at St. Anthony’s Medical Center provides a fairly typical description of a medical assistant's duties.
The hospital is looking for someone familiar with electronic medical records; knowledge of managed care and insurance billing; and state certification as a medical assistant. It also prefers three to five years of experience. Aside from salary, the perks included health, dental and vision insurance; a 401-k matching savings plan, tuition reimbursement, family medical leave, and on-site advanced education.
The salary for such jobs ranges from $11 and hour to $15 an hour, says Ed Carthew, chief human resources officer at St. Anthony's. He says the amount of experience required doesn't need to be an impediment.
“It depends on the particular role and the office and specialty they are going into," Carthew says." Certainly we would prefer certification and experience, but that’s not always the case. It depends on the size of the office and the nature of the specialty.”
He says the medical center receives a good flow of applicants. They hire between 30 to 35 med assistants a year.
“The demand is strong,” he says. “The ACA is going to probably encourage folks to go to the physician proactively. The other piece, of course, is that the ACA provides for various wellness and training , all of which require follow up and scheduling.”
He sees jobs at the lower end of the health profession as a stepping stone for health careers.
"The industry in general provides folks who come in at entry level positions the opportunity to grow in their careers and professions. We see folks who come in at entry level positions take advantage of education and benefits to enhance their careers."
“The industry in general provides folks who come in at entry level positions the opportunity to grow in their careers and professions. We see folks who come in at entry level positions take advantage of education and benefits to enhance their careers," Carthew says.
Training Workers Can Be Challenging
Rush Robinson, president of the careers college, says the program poses many challenges for some students.
“Do we always succeed? No. I have looked at this 32 years. You can stand two people next to each other. One has terrible social problems at home, issues that would really impede a young person. Yet they hang in there. But a person with fewer problems somehow falls by the wayside,” Robinson says.
He says the difference between the two is grit. “Some people have the grit and hang in there.”
The college has ties to about 250 individuals and groups, called community partners. Those partners are able to help students overcome “terrible social problems.” Many of the students are single parents who “may have minimal support for child care and economic support.” But the program offers the advantage of moving students “into a short program that can get you into a job” and allows them to support a family.
He says he hears some student's life stories that “bring tears to your eyes.” He mentions a case of a woman who came to class with scars from “being beaten on a regular basis.” He says the woman finally grew to trust a faculty member who arranged one of the community partners to provide transitional housing and support for her and her children so she could continue the training.
“These are real key issues and some people overcome those despite massive impediments. And others don’t," Robinson says.
Robinson says the college aims for an 80 percent retention rate, but generally achieve rates in the high 60s and low 70s. The raw number of people landing jobs varies. Between July 1 and June 30 of last year, for example, 259 graduated from the city campus and 150 were placed in jobs. Some of those that didn't find a position chose to continue their education. At the county campus in Fenton, 181 graduated during the same period, and 132 found jobs.
Stress On The Job
Becoming a medical assistant requires medical training and soft skills for interacting with patients and families. Those skills are important, Robinson says, because the medical assistant is usually the person who has the most contact with patients. They greet patients when they walk into the door, give shots in the doctor’s office or clinic and hand out prescriptions at the pharmacy.
“When people are sick, they aren’t always the most charming," Robinson says. "Not only are then not the most charming, but neither are their significant others who brought them in. You have to be able to handle stress, your stress and the stress of people who come in.”
Tuition and Other Expenses
Tuition at the St. Louis campus exceeds $19,000. Robinson says the college is careful to prevent students from being overloaded with loan debt. The goal is to try to help them earn the equivalent of what they spend on their education in a relatively short time. He says students generally use about 7 percent of their income to repay loans, but financial aid officials propose that the repayment rate be based on 10 percent of income.
On the plus side, he says, becoming a medical assistant can be a stepping stone to a major health career. Due to the demand for health care services from doctors, hospitals and clinics, Robinson says the need for medical assistants will remain strong.
But McBride, from the Brown School, says the overall health system does face problems. He points to recent hospital layoffs in St. Louis and across Missouri as a weakness, stemming partly from structural changes in the health care industry. On the other hand, he agrees with Robinson that the demand for services will increase partly due to retirement of baby boomers who will need more medical care. In addition, he says Missouri would experience a net result of 24,000 jobs statewide if it decides to expand Medicaid.
“I don’t think people really understand what an economic engine this is,” McBride says.
Or what this growth means to uplifting St. Louis residents on the lower rungs of the economic ladder.
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