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A Day in the Life of a Health Care Administrator

The health care industry has become a behemoth, employing hundreds of thousands of physicians, nurses, health specialists, and other non-health workers, and wielding considerable clout on Wall Street. Health care administrators run this behemoth, coordinating and organizing the financing and delivery of care and assisting in the management of health facilities. Executive-level administrators are highly educated individuals responsible for overall policy directions. They assess the need for services, equipment and personnel and also make recommendations regarding the expansion or curtailment of services, and the establishment of new or auxiliary facilities. They also oversee compliance with government agencies and regulations. Their duties tend to vary with the size and operations of the health facility where they are employed; generally, smaller facilities have less staff support so administrators are left with larger work loads. In larger facilities, administrators can delegate duties and devote more time to policy directives. Assistants to administrators at large facilities typically provide support in the execution of top-level decisions. Depending on their expertise and experience, some assistants oversee the activities of clinical departments such as nursing or surgery, or they may direct the operations of non-health areas such as personnel, finance and public relations. At nursing homes, home health agencies, and other smaller facilities, the duties and responsibilities of administrators are vast and varied. Administrators wear multiple hats in departments such as human resources, finance and operations, and admissions. Clinical managers are health specialists who supervise specific clinical services in the health care industry. They have job-specific training and are involved with implementing policies and procedures for their departments, while coordinating their activities with other managers. Policy decisions do not fall within the purview of managers for small group practices, but larger groups usually retain the services of a full-time administrator who not only coordinates activities on a day-to-day basis but also develops and implements business strategies.

Paying Your Dues

To land a plum job in the health care industry, it is sensible to first complete graduate studies. A bachelor’s degree will only open doors at the entry level, and only a lucky few will be able to work up to a top-level position in a small operation or a middle-management position at a larger facility. A Master’s degree in hospital or nursing administration, public health, public or business administration, and other related fields is usually a requirement for executive office. Courses in accounting and budgeting, management principles, hospital organization and management, health economics, and health information systems provide the student with a solid foundation. Applicants to the field must be willing to work their way up the corporate health ladder, as even new graduates with master’s degrees often start out as assistant administrators or managers of non-health departments. As in all management positions, strong leadership qualities, effective communication and analytical skills, and the ability to motivate others will greatly enhance employment opportunities. Specialized expertise in one type of health facility-HMOs, mental health hospitals, nursing homes, general hospitals or outpatient care services-can significantly expand the possibility of easy placement in the industry.

Present and Future

The rise of both private indemnity insurance and government-sponsored health entitlements earlier in this century have spawned a complex medical bureaucracy. As health services continue to expand and diversify, so will job opportunities, though the trend toward “managed care” and “economies of scale” in large health management organizations (HMOs) will result in restructuring. As HMOs and other health care providers expand operations, competition for executive-level positions within these organizations will be keen, and overlapping administrators will be squeezed out of merging companies. A rapidly aging population, especially a growing 75-years-and-older segment who will require the continued services of health care professionals, assures employment opportunities in nursing homes and related industries in the coming decade.

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Quality of Life

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