Career Center

Health-care administration

For Robert J. Williams, PhD, being a health-care administrator means being able to touch many more lives than he did as a practicing psychologist.

"I see working with senior staff and mid-level managers to improve their ability to lead as a way to serve a lot more folks," says Williams, chief executive officer of Centerstone of Indiana, a community-based mental health center with 900 employees and a $116 million annual budget. "You can leverage individuals' capabilities well beyond working with just a handful of clients."

Like Williams, other psychologists are making it into the top tiers of health-care administration. They're drawing on their psychological expertise to act as their institutions' public face; serve as liaisons among governing boards, clinical professionals and support staff; and ensure efficient operations and high-quality care.

As the health-care industry expands in response to demographic pressures and other trends, opportunities are growing for well-prepared psychologists, experts say.

"There's no question health-care administration is going to be a growth career, because health care will be one of the industries expanding a lot in the next few years," says psychologist Leland R. Kaiser, PhD, a health-care consultant and associate professor emeritus of health administration at the University of Colorado at Denver.

Why it's hot

Between 2008 and 2018, medical and health services management will grow by 16 percent — faster than the national average for all industries, according to the Bureau of Labor Statistics. What's driving that growth? An aging population and health-care reform, says Kaiser, a former hospital administrator and coach to health-care CEOs. "Health-care reform is going to open the gates, so we'll be flooded with people who now have insurance," he predicts.

While the health-care industry's expansion and insurers' demands for greater efficiency will increase overall demand for managers, the bureau says, some administrative areas will see more growth than others.

The new emphasis on electronic medical records will increase demand for health information managers to oversee patient records and ensure their security, for example. As services that were once provided in hospitals shift to clinics and other outpatient settings, administrative opportunities in those venues will increase. And administrators with experience in large hospitals will also see more job opportunities as hospitals become larger and more complex, the bureau predicts.

What you can do

Health-care administrators work in a variety of settings, including hospitals, community health systems, county or state mental health divisions, clinics, small practices and even insurance companies.

But no matter what the venue, says Kaiser, the basic tasks are the same. "If you can manage Coca-Cola, you can manage U.S. Steel," he says. "And if you can manage U.S. Steel, you can manage a hospital."

As a top-tier administrator, you'll manage all the people it takes to make a complex institution run, working with vice presidents or other lower-level managers to oversee clinical operations, business decisions, fund raising and everything else. Working with the board, you'll make tough decisions about expansions, budgets and, sometimes, layoffs. You'll also serve as the institution's public face. "As CEO, you represent the institution," says Kaiser. When it comes to fund raising, for example, you'll assist your development staff by meeting with potential donors and hosting events. In general, you'll be the big picture person, says Anthony DeJoseph, PsyD, president of Associates in Behavioral Science in Berwyn, Ill.

"When I was administrator of a hospital, I viewed my role as developing the mission and then developing a team of executives who actually carried out the objectives," says DeJoseph, whose past roles include being the CEO of Genesis Health Systems and University Hospital in Chicago. "My job was to be a leader who developed the vision, conveyed that to my team and motivated them to fulfill it."

Earnings outlook

Although salaries vary by the size of the institution, level of responsibility, geographic location and other factors, health-care administrators are often well paid. "Your salary could easily be six figures," says Kaiser.

According to the Bureau of Labor Statistics, the median salary for medical and health services managers was $80,240 in 2008. Administrators at medical and surgical hospitals earned the most, with a median salary of $87,040. Median salaries were in the mid-$70,000s for administrators at outpatient care centers and physician offices, and in the low $70,000s for administrators of home health-care services and nursing care facilities.

How to get there

A doctorate in clinical or counseling psychology is an excellent foundation for future health-care administrators, says Kaiser.

"Management is really applied behavioral science," he says. "The most important skill is being able to understand and work with people."

Students should also get clinical experience, says Kaiser. "Any hospital administrator who has had direct patient experience of any kind is in a better position to understand how to be a good manager than one who has had no exposure to patients," he says. He credits his own clinical work for having given him a sense of "what doctors and nurses are up against every day."

Pay close attention to your courses on statistics and research design, says Williams, who often uses his training in psychometrics and data analysis to make smart decisions.

"I spend an awful lot of my time crunching data and drilling down to see what's working and what isn't and how we can be more efficient with the dollars we do have," says Williams. "You really have to be a bit of a data geek."

But a psychology degree usually isn't always enough, say Williams and other experts. While Williams says he has business "in my DNA," thanks to growing up in a family with a general store, others recommend formal training in business administration if your goal is the higher echelons of management.

"The entry degree for a hospital administrator is an MBA or its equivalent," such as a master's in health administration or public administration, says Kaiser.

As a psychology graduate student, consider taking classes on finance and administration, looking for mentors and reading business books, says DeJoseph, who received no formal business training, but made up for it with extracurricular reading — and lucked out by having a boss who was committed to fostering young leaders.

"I read as much as I could on business, especially publications on how to manage organizations," he says.

Classes in industrial/organizational psychology can also be helpful, he adds.

Pros and cons

The downside of an administrative career is occasional administrative burnout due to long hours, travel and potentially tedious tasks. Williams has put 120,000 miles on his 2008 Toyota, partly as a result of driving around the state meeting with the agencies Centerstone provides services for, state officials, consumer advocacy groups and other partners.

There can also be a disconnect between your daily work and your desire to help people, says Williams. "There are days — weeks — when it feels like life is one continuous budget meeting," he says. "There are times after a three- or four-hour meeting when I wish I were back with clients and not having to deal with stuff that seems so far removed from actual involvement with clients."

And while working with bright, well-educated people is an upside, he adds, getting them all to work together can sometimes feel "like hauling frogs in a wheelbarrow."

In addition, the high income often earned by health-care administrators can come at a price: a huge amount of responsibility. "If you're responsible for hundreds or thousands of employees, which is often the case, you're going to take a big load home on your shoulders every night," says Kaiser.

Despite these potential drawbacks, health-care administration is the perfect position for people who live to inspire others and have a talent for cutting though bureaucracy to get things done.

"There's an excitement to managing the dynamics of an organization," says DeJoseph. "It's a very stimulating and definitely an exciting kind of career to have."


Rebecca A. Clay is a writer in Washington, D.C.