Illustration 2005-01 Us New York Times

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Like Paperwork? Medical Workers Needed

Sunday, January 23, 2005

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Factories Rev Up (At Last) In the US By EDUARDO PORTER

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By THOMAS J. LUECK

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ITH the health care industry struggling to keep pace with the expanding requirements for paperwork under managed care, the New York region is confronting an acute shortage of physician assistants and clerical workers at the entry level in medicine, according to government labor statistics and industry executives. Although many see the demand as positive, they also see a downside. The situation may provide ample opportunity for jobs, some experts say, but medical assistant and recordkeeping work may lead to few, if any, chances for advancement because of rigorous training and licensing requirements. The demand for such workers is running high nationwide. A forecast released in February 2004 by the Bureau of Labor Statistics said the fastest growing occupation until 2012 will be medical assistants. Physician assistants ranked third on the bureau's list (behind data communications analysts), while medical records technicians ranked sixth and physical therapists' assistants ranked 10th. Demand for medical workers appears to be the most voracious among the huge concentration of hospitals, clinics, nursing homes and medical offices that make New York a magnet for health care. "I would bet that in New York, where health

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In the office, the No. 1 complaint is being too cold. By AMY ZIPKIN

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ERRY McCLOSKEY, director of research at a media company in Manhattan, describes her office as having "very strange temperature pockets." During the winter months, Ms. McCloskey keeps a red sweater handy and leaves a suit jacket in the office. Occasionally she wears a scarf. "It's hard to keep your thoughts from wandering with goose bumps on your arm," she said. She particularly dislikes the seventh-floor conference room, which she calls so cold that "when you open the door, you can almost see your breath." Her only recourse when she is cold is rn fall,a maiPUwwwcft.Paie'-.'Jiüiitaiify'-i

HREE years ago, Ace Clearwater Enterprises, a Torrance, Calif., maker of custom parts for everything from jet planes to power plants, offered its 175 workers the choice between a shortened workweek and job cuts. This year it is staffing up. "We've been in hiring mode for about a year now," said Gary Johnson, its vice president, who wants to bring his payroll up to 195. Manufacturing is back. Last year, producers of machinery increased employment by 22,000. Makers of computers and electronic products added 11,000 jobs. After six years of decline, manufacturing added 76,000 jobs in 2004. The increase hardly makes a dem in the 2.8 million manufacturing jobs lost from 2000 to 2003, when manufacturing took the steepest dive since the early 1980's. No economist expects manufacturing to return to its peak of the 1970's, when it accounted for 20 percent of the nation's jobs, compared with 11 percent today. Yet as producers of everything from power generators to surgical devices guardedly add to their payrolls, some economists are cautiously optimistic that the decline of the former great job engine, which supported the rise of the nation's middle class through the postwar era, might have finally come to an end. "We've probably hit bottom," said Josh Bivens, an economist at the Economic Policy Institute, who follows factory employment. "We should see some benefits from the fall in the dollar so far. If the fall ... SB^^CS ' ••' • - - ..••••••. • •'

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just the thermostat down the hall. Ms. McCloskey is not alone. A May 2003 survey by the International Facilities Management Association in Houston says being too cold was the No. 1 office complaint, followed by being too hot, poor janitorial service, not enough conference rooms and not enough storage and filing space in a workstation. The association conducted similar surveys in 1991 and 1997, and a spokesman, Donald Young, says the same complaints led both times, although once hot edged out cold. Winter took its time arriving this year in New York. Temperatures in the 50's during the second week in January were unusual. With oil prices ai or near record highs in the Northeast, and colder temperatures returning, companies are again keeping a watchful eye on the thermostat to minimize fuel costs. They take their cue from the federal government. While there are no national standards for energy conservation, the Department of Energy's Office of Energy Efficiency and Renewable Energy suggests that heating be set at 68 degrees in winter and cooling at 78 degrees in summer. That has been the rule of thumb since the 1973 oil embargo by the Organization of Petroleum Exporting Countries. And for every degree the heat is set lower than 68, utility bills are reduced by 1.5 percent, said Paul Hess, an energy information specialist for the Energy Information Administration. Now, though, Alan Hedge, director of the Cornell University Human Factors and Ergonomics Laboratory, says he believes corporate America has had it wrong for 30 years. Last winter, he conducted a study that he says shows that warmer office temperatures yield more productivity. And while some say his sample is too small to be statistically significant, it is drawing the attention of some businesses. Many commercial buildings adhere to guidelines set by the American Society of Heating, Refrigerating and Air-Conditionlng Engineers, a trade group in Atlanta. In 2004, the group suggested that thermostats be set between 68 to 7G degrees during the winter, when the humidity is low, and 72.5 to 80 degrees in the summer. "It's a comfort range," Mr.

In New York, an acute shortage of health care office workers. care is such a dominant industry, the demand is going to be even greater in the rest of the country," said Michael L. Dolfman, the bureau's New York regional commissioner. A result is a large, growing entry point to the medical industry that is particularly suited to immigrants, who may lack extensive training or college degrees, but speak more than one language. Many of the clerical skills required can be mastered in associate degree programs or shorter course work. In a polyglot region where insurance forms, duplicate bills and other medical red tape can be frustrating for people with limited English, it has become essential for hospitals and medical offices to offer help in several languages. Moving up the career ladder, however, poses considerable challenges. Maritza Rodriguez of Manhattan, a 42-year-old divorced mother of two, had worked at clerical jobs in offices and in retail customer service before completing a 10-week course in medical billing and record keeping in October. She said she immediately found Jobs with two doctors, splitting her workweek between Brooklyn and Manhattan. "There is so much demand," said Ms. Rodriguez, who said she rarely logged more than 40 hours a week total and expected to make more than $50,000 this year, also receiving health care benefits. "I have always liked dealing with people, and it is especially nice to help Spanish speakers," she said. Over time, she added, "I would like to join up with some other people and maybe form a small medical billing company of our own." Experts say there is room for entrepreneurs in the field, as doctors, dentists, therapists and other professionals may turn more to outside companies to ease their record-keeping workload. For many of the new entry-level medical workers, it may require zeal to get ahead. "There are lots of opportunities, but they are limited," Mr. Dolfman said. "These are positions that fill boxes. I wouldn't say they are dead ends, but they are often specific jobs and not careers." Medical assistants, who take care

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M A K E M O N E Y AT H O M E ! An industry is born—loading ¡Pods for those without the time or patience. By Jennifer 8. Lee. Page 3.

Asia we could get more gains." Manufacturing workers have had a rough century so far. Employment at manufacturers fell from 17.2 million at the end of 2000 to 14.3 million at the end of last year, the lowest level since 1950. Much of the blame lies in a combination of lackluster spending by businesses since the recession of 2001,

Job Production Manufacturing employment is showing signs of recovery after several years of decline.

Manufacturing employment, monthly finally adjusted

0 90 92 94 96 '!'!! '00 02 04 Source: Department ol Labor The New York Times

which reduced demand for manufactured goods, and a burst of productivity growth as companies squeezed more out of their work force. Trade's role in this situation is in dispute. But as the nation's trade deficit has swollen, some American politicians have decided that imports — notably from China — displace American jobs. Currency manipulation by China, Japan, South Korea and Taiwan, the major Asian trading partners, has contributed significantly to the loss of United States factory jobs since July 2000, according to a bipartisan resolution introduced in 2003 by more than 50 House members. Last September, nine House Democrats introduced a bill that would require the administration to embark on negotiations with China to set limits on imports of Chinese textiles into the United States. Yet while foreign products can displace production by American workers, many economists argue that imContinued on Page 6

B E T T E R JOB T R A I N I N G Finding happiness in a barbecue restaurant, through a New York City program. By Nicholas Confessore. Page 4.

MARTHA AND HER CHOCOLATE FACTORY The owner of Li-Lac, a beloved New York candy shop, swings eight blocks north. By Louise Kramer. Page 4.

PAINT, POWDER, PROFIT Makeup artists, in demand, are turning into beautiful people themselves, By Linda Dyett. Page 6.

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