Thursday, September 29, 2011

Are all medical jobs created equally?

Guest blogger: Elizabeth O’Malley

Elizabeth graduated with a degree in Public Health Administration before relocating with her family to Seattle. She is currently writing, and her favorite topics include health care, work-life balance, and travel. Thank you Elizabeth.

In prestigious medical careers that require years of education and experience to climb the ladder of success, people of lower socioeconomic (SES) backgrounds, often ethnic minorities and women, may face disadvantages in their pursuit of a career in medicine. I am a firm believer that most people can achieve their dreams if they work hard. However, countless studies have shown that persons from low SES backgrounds have more difficulties in their paths to educational and professional success than persons who come from more affluent families.

Medical professionals are some of the highest earners in America, especially the professionals at the top of the medical earnings scale, including anesthesiologists, surgeons, and other medical doctors. Becoming a successful medical professional costs more than even most from upper-middle-class backgrounds can afford without taking out loans. People from a low socioeconomic background may not have the resources or time to consider going to college or medical school because of the expense and other factors such as family responsibility. The psychological consequences of socioeconomic status may prevent people from considering a high paying career as a viable option.

Instead, the lowest paying jobs in medicine are often the options most available. If someone has a GED or high school diploma, for example, they can become a certified nursing assistant or registered nurse assistant. Usually this requires a certification program that takes much less time than a degree. However, in a hospital setting CNA’s and RNA’s often work long hours of overtime and often do the most menial and labor-intensive tasks on their floor, such as cleaning bedpans and changing soiled linens. Nursing assistants generally have to spend much more time with patients than RN’s or MD’s. At times this can be enjoyable if they are able to develop relationships with their patients, but it can also put them at more risk of violence in some circumstances. Working as a nurse assistant also offers little opportunity for upward mobility.  

Is it really fair that those who do so much labor are also the lowest paid? Inequality in opportunity to achieve success extends beyond the medical profession. It rests on the class bias and wealth stratification of our country’s social structure in general. But more people are taking notice of the stratification of work that exists within the medical profession itself, and between medical career paths.

The bigger question remains: how do we solve these inequalities? The issue of work distribution inequality deserves more attention from health care professionals and researchers. Professionals such as Paul Fischer have recently suggested that within the medical profession itself should advocate for a more level playing field. Perhaps it is time to encourage more people to join the medical profession for the work itself, as opposed to the money. This solution might involve lowering the already exorbitant pay of some health care workers to discourage those who have no interest in helping others from going into medical professions, and considering whether a medical career might not be the right choice for them. Distributing information about medical careers to schoolchildren in low income areas so that they are encouraged to consider the medical profession a viable option and increasing the cultural competency of medical education might also help lower these barriers to equal opportunity over time.

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