US Hospitals - Staffing
At hospitals in the U.S., approximately 55% of employees are directly responsible for patient care or for technical occupations related to patient care. Another approximately 13% are engaged in office support functions and a further 3.5% are employed in management. Of the individual jobs, nurses make up the largest share of hospital employees, representing nearly 30% of all hospital staffs. Doctors, meanwhile, are underrepresented in most data related to hospital employment, since most physicians that work at hospitals are not directly employed by the hospitals themselves. However, an analysis of the statistics, as described below, suggests that doctors represent approximately 7% of the people working on hospital grounds.
Major Categories Of Hospital Employment
According to U.S. Department of Labor data from 2016, the most recent year for which statistics are available, here is the breakdown of employees at hospitals in the country by major category: Healthcare Practitioners and Technical Occupations - 55.10% Office and Administrative Support Occupations - 12.60% Management Occupations - 3.55% Building and Grounds Cleaning and Maintenance Occupations - 3.19% Community and Social Service Occupations - 2.60% Healthcare Support Occupations - 2.46% Food Preparation and Serving Related Occupations - 2.34% Business and Financial Operations Occupations - 2.14% Computer and Mathematical Occupations - 1.32% There are also some miscellaneous categories, collectively representing less than 5% of hospital staffs. Each of the individual category in this miscellaneous group is a negligible portion of the overall employment at the hospital and includes things like legal, media, construction and sales.
Also, as explained in greater detail below, physicians are underrepresented by the Department of Labor data on hospitals and should be considered in a separate category. For the purposes of the categories listed above, physicians would be included in the "Healthcare Practitioners and Technical Occupations" category.
However, due to the way the data are compiled, they make up a nearly negligible proportion of this group and for the purposes of this report, they have been broken out into a separate category.
Of the individual professions, nurses make up the largest part of hospital staffs by a significant margin. Registered nurses (RNs) represent 29.6% of hospital employees. The next largest group is nurses assistants, which make up about 6.6% of hospital staffs.
No other individual profession represents more than 3% of hospital staffs on average.
Here is a breakdown of all the individual professions that make up at least a 2% share of hospital staffs, according to the Department of Labor data (again, as of 2016):
Medical Secretaries 2.52% Medical and Health Services Managers 2.09% Radiologic Technologists 2.02%
Physicians Working At Hospitals
Because of the structure of the relationship between hospitals and most doctors, very few physicians are employed directly by a hospital. Most of the doctors who practice at the hospital are credentialed to work there but are not officially employed by the hospital. For instance, in the Department of Labor statistics, physicians and surgeons make up a total of 1.8% of the workforce at hospitals. That total of doctors would imply a ratio of nurses to physicians of 16:1 in U.S. hospitals, using the DOL stat on the number of nurses employed at hospitals. However, a separate set of statistics compiled by Statista suggest a ratio of closer to 4.2 to 1. (Specifically, the ratios implied by the Statista data are between 4.14:1 and 4.22:1, depending on the type of hospital.) This ratio is generally supported by overall data on the number of nurses and physicians in the overall population. According to stats compiled by the Kaiser Family Foundation, there are approximately 4.15 million nurses in the U.S. (as of October 2017) and about 951,000 doctors. This would imply a ratio of nurses to physicians of 4.36 to 1, in line with the totals suggested by the Statista data.
If a ratio of 4.2 to 1 is applied to the Department of Labor data on hospitals, that would suggest that doctors make up about 7.1% of the people working on hospital grounds, even if they are not directly employed by the hospital.
This stat is derived by taking the proportion of nurses in the DOL data (29.6%) and applying the 4.2-to-1 ratio. This leads to proportion of doctors of just below 7.1%.
Variance Among Hospitals
It should also be noted that ratios of the different hospital workers varies between hospital type and likely among individual hospitals. For instance, the Statista data source indicated that the ratio of employees to occupied patient beds was substantantially lower at hospitals that were part of a multi-hospital system (MHS) ownership structure than at non-MHS hospitals. Meanwhile, some of the individual ratios were slightly different. For example, the data indicate that the nurses made up a lower percentage of overall staff at non-MHS hospitals than at MHS hospitals. The stats show a ratio of non-therepeutic employees to registered nurses at MHS hospitals was approximately 2:1. At non-MHS hospitals, this ratio was closer to 2.5:1, indicating that nurses made up a smaller percentage of the overall employee base. This stands to reason since one of the advantages of a MHS hospital is that the office and other support staffs (like human resources, etc.) can be shared across multiple hospitals. This efficiency would lead to a higher percentage of hospital staff dedicated to direct patient care.
Organizational Structure And General Employment
The Department of Labor data suggest that 5.9 million people are employed at hospitals in the U.S. As noted above, this under-reports the number of physicians working at the hospital but technically employed by a private practice or other organization. A separate Department of Labor report, derived from a separate data set, suggest that the total population employed at hospitals (as opposed to employed by hospitals) would be just over 7 million.
In terms of organizational structure, the data suggest that approximately 45% of employees are engaged in support functions, with about 13% part of the office staff and another 3.5% part of management. The majority of employees, as well as the physicians working at the hospital, are engaged in direct patient care.
A majority of employees at hospitals are engaged in direct patient care, with nurses making up about 30% of the total. Doctors are underrepresented in the data due to the organizational structure. However, an analysis suggests they make up about 7% of the staff on hand at a hospital, though a majority are not directly employed by the hospital itself.