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It’s not often that the Roanoke Valley is a national harbinger. But when it comes to the job market, we’re already where experts say the country is headed, with 25,000 workers – 17 percent of the entire workforce – employed in medical-related jobs.
James Lesniak’s careening career path embodies the evolution of Roanoke’s economy: from a dinosaur of steely underpinnings to curative colossus of hospitals, clinics and emergency helicopters flying high above the worst of the recession’s woes.
The 43-year-old Lesniak, scheduled to graduate as a newly minted physician assistant from Jefferson College of Health Sciences in December 2011, has come a long way from his days working in a steel mill in Santa Barbara, Calif., in the 1980s.
“That was a pretty good job back then,” at $17 an hour, when Lesniak was seeking a liberal arts bachelors degree, he says.
During that same decade, Roanoke received a wake-up call about its future, when then-leading employer Norfolk Southern Railroad packed up its coveted headquarters and moved to its East Coast namesake city in 1982.
Now, Lesniak, the ex-steel worker, and Roanoke, the former railroad town where he moved in 1990, are partners in a new era. The largest employer hereabout today is the Carilion Clinic empire, which includes Jefferson College, and is among several hospitals and other facilities in the area that have physician assistant jobs available at pay that typically ranges from about $70,000 for new graduates to a mean income of more than $93,000. The jobs typically come with prescription-writing authority and the responsibility of interviewing patients and passing on the findings as essentially advisors to primary doctors.
Health-care jobs are the new employment frontier in Roanoke, where Carilion boasts 13,000 workers, more than twice the number at which Norfolk Southern peaked. In fact, the area’s second-largest medical payroll, HCA-owned LewisGale Regional Health System, has about 1,800 workers, slightly outnumbering Norfolk Southern’s roughly 1,700.
If economists and academic leaders are right, Lesniak is among the millions of Americans – thousands of them in the Roanoke area – who are right to pursue a career in health care as a path to job security and relatively good wages.
The Virginia Employment Commission predicts that five of the 25 job categories expected to grow fastest in the commonwealth by 2018 will be health related. They will include a wide range of education and training requirements – from a few weeks for nursing assistants to masters degrees for physical therapists and a decade to produce new MDs.
To be sure, pay scales vary greatly too, from below $10 an hour for hospital laundry workers and about twice that for home health aides who assist patients with eating, bathing and toileting, to doctors earning well into six figures annually. At the bottom of the pay pyramid, where no college is required, there’s little hope of advancement or significant pay increases.
What’s more, there’s some uncertainty about what impact President Barack Obama’s health reform law will have on medical jobs. But an estimated 32 million Americans are expected to acquire health insurance as a result of that legislation, so the federal program seems to mean that the market for care providers will keep growing, perhaps at a faster rate.
Meanwhile, the Roanoke area is already a microcosm of where experts say the national job market is headed. Health care is by far the largest segment of the labor market here, accounting for about 25,000 employees – or 17 percent of the entire workforce.
The abundance of health-care jobs has helped keep the Roanoke area’s unemployment rate at about 6.8 percent, far below the nation’s overall 9.1 percent. Still, despite those employment opportunities, Roanoke’s per-capita income languishes at $33,700, 15 percent below the U.S. average.
Roanoke’s employment base is nearing where Washington labor experts predict the entire country will be by 2018, when, they say, 22 percent of all workers may be in jobs related to health care.
What’s more, health care currently leads other Roanoke area economic segments in hiring needs. A recent list of job openings in Roanoke county by state employment officials found Carilion at No. 1 with 194 jobs. Others among the Top 20 employers with slots to fill, LewisGale with 62 and Emeritus Assisted Living at 21.
“Health care employees are highly skilled and extremely valued throughout the country, as well as the Roanoke Valley,” says R.J. Redstrom, vice president of human resources at LewisGale, which has hired about 200 new workers this year in the Roanoke Valley.
Those new jobs keep coming despite this area’s modest population growth. That’s because another demographic is in health-care opportunity’s favor.
“The aging baby boomers are becoming more prevalent as health-care consumers, and Southwest Virginia’s aging population is one of the fastest growing in the state,” says Redstrom.
The Department of Veterans Affairs Salem V.A. Medical Center has increased its employment by 198 since 2007 and now has 1,958 full-time employees. Shelby Benois, a spokeswoman for the facility, says management expects the need to recruit about 100 new workers in the fiscal year ending Sept. 30, 2012.
“We expect to continue to recruit for our hard-to-fill positions over the next few years,” says Benois, who adds that those jobs include physician assistants, registered nurses and licensed practical nurses.
Educators are rushing to keep up with demand. Virginia Western Community College is adding new space for classes in medical fields with the 68,000-square-foot Center for Science and Health Professionals, scheduled to open by the time this edition is published. The center will accommodate 1,400 students in such majors as dental hygiene and practical nursing, compared with a previous capacity of 900.
Margaret Andrews, head of Virginia Western’s practical nursing program, says that enrollment in her curriculm rose nearly 50 percent to 59 students last fall. Many of those new students are refugees from other segments of the economy, she says.
“Several have come from manufacturing places, including furniture. And we have a couple of people who were in banking.”
Andrews says the new health-care education building will underscore the direction of both the economy and her school. “There are jobs for practical nurses right now,” she says. They typically pay $19 to $21 an hour for graduates of the two-year associates degree program.
Andrews says she has heard of only one graduate from Virginia Western nursing class of May 2011 who hadn’t found a job within four months. “But it’s not because she couldn’t get hired, it’s because she didn’t like the job description”: working in a nursing home.
“Some of them don’t want to work in a nursing home. They want to be in a clinic or doctor’s office where they see a variety of patients,” Andrews explains.
The limit on job opportunities for practical nurses illustrate a reality in the health care employment market: Career prospects aren’t created equal and those who aspire to certain fields would do well to research them.
Job opportunities for registered nurses, who typically have four-year bachelors degrees, and whose median annual wage nationally is $63,000, are plentiful in Virginia. Barbara Brown, an RN and vice president of the Virginia Hospital & Healthcare Association, says, the commonwealth’s current demand for 3,600 new nurses annually may rise in 2014, when the Obama health plan becomes fully effective.
Is Virginia producing enough new graduates to offset a shortage? Brown says, “A recession brings folks back into the workforce and that has happened with the nursing supply overall in the last few years.” But many experienced nurses are nearing retirement age, and she wonders, “What happens in five to 10 years when the 50-year-old nurses who came back into the market decide to retire and permanently leave the workplace?”
Michael Geres, clinical manager of Eye Care & Surgery in Roanoke County: “There just aren’t enough qualified people to work in an office like this.” (Photo by Brett Winter Lemon.)
Some fields are relatively wide open for those who possess the right skills. Consider that Michael Geres, clinical manager of Eye Care & Surgery in Southwest Roanoke County, was recently planning to hire an ophthalmologist’s assistant even though the practice he runs didn’t have an opening.
The candidate, he says, “fits our mold and even though we don’t have an opening we’ll probably hire her because our practice is growing” and eye-care technicians are in short supply, Geres says. “The technical community is understaffed, meaning there just aren’t enough qualified people to work in an office like this.”
Eye-care technicians, who typically handle about 40 patients a day, check their eyes with a variety of equipment and ready them for further examination by optometrists and ophthalmologists. Such jobs pay in the range of $11 to $24 per hour to candidates whose training may vary from a one-year certificate program at a community college to a bachelors degree. There’s no education program of either sort in the Roanoke area, says Geres, who is in discussions with both Virginia Western and National College in Salem to help start one.
At the top of the medical jobs food chain, of course, are MDs, and the new Virginia Tech Carilion School of Medicine is attracting students such as Matt Joy, who came to Roanoke from California to start classes in August 2010.
Like Lesniak, the physician assistant student at Jefferson College, and similar to Roanoke’s economy in general over the last few generations, Joy is reinventing himself. In undergraduate school at the University of Southern California, he majored in, of all things, music – specializing in guitar.
“I was trying to do the music business thing in Los Angeles and it really wasn’t panning out to provide the lifestyle I wanted,” says Joy, now 29.
So in 2007 Joy returned to USC for a post-bachelor program that offered pre-med courses.
“I went right back to Biology 101 and that sort of thing,” he says. In 2009 Joy started researching and applying to medical schools. He noticed the fledgling VTC institution in Roanoke, paying special attention because his wife, now a teacher at Community High School, is from Winston-Salem, N.C. “We thought it would be nice to have family in the area,” he says.
The couple embodies the genre of young professionals that economic development officials around the country are wooing in the belief they’ll find job security and expand their spending by raising families. Sure enough, the Joys are expecting their first child.
Renting a home here while they try to sell a house in California, the couple has discovered that the Roanoke lifestyle appeals enough to consider staying in the Star City after four years of medical school.
“After years in Southern California, we were ready for a change of pace,” he says. “In terms of amenities, Roanoke is pretty nice. We’re happy with the arts, and some of the eateries have been pretty great. We’ve made friends and set in some preliminary roots here.”
Joy, who aspires to become a general surgeon, has even found a venue to play his guitar for a small audience. “I’ve gone to the open mike night a couple of times at the Village Grill in Grandin Village and brought some friends along,” he says.
Lifestyle is also important to Lesniak, whose wife is an administrator at Hollins University; the couple has a 13-year-old daughter. He had been trying to prepare for uncertain economic events even before focusing on the medical field. While working in a series of contract jobs for a variety of nonprofit community development groups and social service nonprofit agencies, he obtained a masters degree of arts and liberal studies from Hollins in 2003.
But by 2008, he had seen the pay level of his contracts gradually diminish. “I was at a point where the nonprofit market was becoming more difficult and finding funding” from grants and donations that have come under pressure during the recession “is getting harder,” Lesniak says.
So he applied for acceptance in Jefferson College’s physician assistant curriculum: “I’m looking for more pay and job security. I decided this was the right time, the beginning of a period of economic challenges for the country.”
He’s almost assured of landing a lucrative physcian assistant position in the Roanoke area early in 2012, after he graduates and passes the Virginia licensing exam for his profession.
Mark Lambert, spokesman for the Jefferson College of Health Sciences, says Carilion Clinic hires more than 90 percent of the school’s graduates.
The new job will probably solidify Lesniak’s family finances, but he isn’t expecting much of a change in spending habits. “I’m not going to buy a boat or start going on fancy vacations.”
Still, as with Roanoke’s economy in general, he expects health care will provide “more financial stability than I have ever had in my life.”
For one thing, he hopes his new employer will almost certainly provide a benefit he hasn’t enjoyed while working in his last few temporary jobs in the nonprofit sector.
“We’ve always had to rely on my wife’s health insurance. Now, I think I can have my own.”