By John Bethune
Lack of respect. Budget cuts. Red tape. Healthcare reform uncertainties. Limited opportunities for advancement. Heavy workloads. Insufficient training. Tensions with the IT department. Outsourcing. Low pay.
The list of drawbacks to a career in healthcare technology management (HTM) is long, and seemingly growing by the year. Few biomedical technicians see any near-term hope for improvement.
Yet when you ask them whether they would recommend their line of work to young people entering the workforce, nearly 9 out of every 10 professionals say they would. Despite their ability to name a multitude of reasons to dislike their jobs, biomeds remain dedicated to their work and deeply passionate in their commitment to healthcare.
For this year’s respondents to 24×7 magazine’s annual salary survey of the HTM community, the compensation they receive is to be measured in more than dollars and cents. As one biomed we surveyed put it, “I see miracles in the work I provide; we make a difference.”
To gauge the typical salary and benefits of HTM professionals in the United States and to assess their level of satisfaction with their jobs and employers, 24×7 conducted an online survey from September 28 to October 10, 2013, using SurveyMonkey.com. It consisted of 30 questions about the respondent and about his or her job, employer, education and training, workload, job satisfaction, and compensation and benefits. Of the 946 magazine subscribers who responded to the survey, 866 provided usable survey results. Only responses from full-time biomedical technicians or clinical engineers working in the United States were used in this analysis.
This year, in an effort to produce more statistically reliable geographic figures, salaries have been analyzed in terms of four regions—West, Midwest, South, and Northeast—rather than last year’s smaller sample sizes from nine regions.
As always with surveys that rely on self-reported data, the information presented here should be viewed as a rough guide to HTM compensation and job satisfaction, rather than an authoritative report.
The healthcare technology management field remains heavily dominated, at least in numerical terms, by men. In this year’s survey, as in 2012, just 8% of respondents were female. Given such a small sample size, no reliable conclusions about gender equity in the workplace can be made. While most women respondents did not raise the issue, one commented that “compensation is certainly not equal” between men and women, adding that, “if you are a male, options are open and unending; if you are a female, you must be bullheaded and willing to stand your ground.” Despite this assessment, the respondent asserted that “this is a great profession to be in” and that she would recommend it to other women.
To judge from our survey results, the HTM profession is demographically unbalanced in another key respect: age. Our pool of respondents was heavily represented by those with long careers; nearly 60% reported having more than 15 years of experience in the field, while more than half identified their job levels as either senior (BMET 3) or mid-level (BMET 2). As will be discussed in greater detail later in this article, many respondents described the aging of the HTM workforce as one of the greatest challenges faced by the profession.
Geographically, the bulk of the respondents came from either the Midwest (35%) or the South (33%), with the Northeast and West each accounting for 16%. Most work as biomedical specialists for hospitals or medical centers with 200 or more beds. Nearly 2 in 10 describe their roles as managerial.
|Percentage of respondents by employer type. Other includes home-based care, military, nonprofit, depot services, and education. (Click to enlarge)||The percentage of hospital employees who responded, per the number of staffed beds. (Click to enlarge.)|
Nationwide, average annual salaries by job title range from $43,857 for respondents at the BMET 1 level to $110,930 for department directors or executives. Ranked from lowest to highest annual salary, job titles go in order from BMETs 1, 2, and 3 to clinical engineer, radiology equipment specialist, manager, and director or executive. This ranking mostly holds true for regional breakouts as well.
|Average base salaries per job title nationwide. (Click to enlarge)|
Regional disparities in pay within job titles are most pronounced in the West, where the average salary for a BMET 3, for instance, is more than $10,000 higher than in the three other regions. For the same job title in those other regions, by contrast, the difference in pay is less than $1500.
In general, survey respondents reported having a generous array of benefits. Perhaps not surprisingly for employees of healthcare providers, more than 90% of respondents said they have employer-provided health insurance. Between 80% and 90% also said they receive dental, vision, and life insurance, as well as retirement benefits. Slightly more than half also receive some amount of tuition reimbursement. Only 1% reported receiving no benefits.
More than half of the respondents say they are either satisfied or very satisfied with their salaries. The 35% who say they are not satisfied are generally on the lower end of the pay scale, between $38,000 and $41,000 on average. The breakdowns are similar when asked if their salaries are fair in relation to their levels of experience or education. In both cases, more than half of respondents feel their pay is fair.
|Satisfaction with pay.||Satisfaction levels by salary.|
|Satisfaction with pay in relation to education level.||Satisfaction with pay in relation to years of job experience.|
There is a clear relationship in the survey data between education levels and salary levels. Each step up from an Associate degree to a Master-level degree is worth $10,000 or more in annual salary. Even so, working toward a higher degree is not a choice most respondents have chosen to make. Just 20% say they are currently pursuing further formal education.
|Average salaries of respondents by educational degree. Sample size for PhD recipients was insufficient to report results.||Pursuing further education? Percentage of respondents who are currently working towards a higher degree.|
For most HTM professionals, a heavy workload is a given. More than two thirds of respondents describe their workloads as heavy or excessive. Not surprisingly, perhaps, more than half report earning overtime or on-call pay, and nearly a third receive bonus pay.
|How respondents characterize their workload, by percentage. (Click to enlarge)||Percentage of respondents who earn bonus, overtime, or on-call pay in addition to their base salary. (Click to enlarge)|
When the 16% of respondents who describe their workload as excessive are asked what accounts for the excess, many point to an increasing amount of red tape and paperwork combined with reduced manpower. As one respondent succinctly put it: “Too few people, too many PMs.”
Biomeds have plenty to say about both the pluses and minuses of their jobs. A commonly cited negative is the perceived lack of respect from upper management. As one respondent said, what he dislikes most about his job is “having to continually justify the position, value, and contribution of Healthcare Technology to the C-Suite.” Or as another put it, “I’m not sure whether we are considered one step below or one step above maintenance.”
For others, the main drawbacks to their jobs are an excess of paperwork, tight budgets, and growing workloads. As one respondent put it, there are simply “not enough hours in the day.”
When it comes to the positives about the work that HTM professionals do, the respondents are effusive. For many, the greatest joy in their jobs comes from their interactions with technology, particularly problem-solving. One respondent pointed to “being able to figure out what is wrong with equipment and repair it, and come up with solutions,” while another spoke of “the feeling of accomplishment when you’ve repaired something on a complex imaging system.”
For others, the rewards of working with technology are increased by the variety of equipment they deal with, “doing different things,” and “learning something new every day.” As one put it, “There’s always new and challenging technology being implemented in the hospital. It’s exciting, yet challenging, to integrate those systems into the facility.”
Though change is often a source of stress, it can also be a path to fulfillment. For one biomed, the greatest thing about the job is “change, change, and more change.” No other industry, he wrote, “has so many different influences as ours. Balancing between financial, regulatory, technology, patients, nurses, physicians, manufacturers, and other needs, you are always challenged in finding solutions that impact so many.”
But biomeds are not simply technology nerds focused solely on the workbench. Many speak of the rewards of working with people throughout their facilities. One cited the rewards of “building relationships with the floors and caregivers” and “interacting with employees at all levels.” As another biomed puts it, “Meeting and working with people from all walks of life helps me keep a strong perspective on how important my job is.”
Ultimately, the people who matter most to biomeds are those who ultimately benefit from their work: the patients. The greatest reward of the job, one biomed said, is “knowing that my attention to detail on equipment will ensure the highest quality of care, diagnosis, and treatment for patients.”
Key Challenges for the Profession
Asked to identify the most important issue facing the HTM profession today, the survey respondents focused on a handful of key challenges. The top challenge, cited by 19% of the 564 people who answered the question, was the integration of the biomedical discipline with information technology. Next in line was uncertain impact of the Affordable Care Act, or Obamacare, cited by 13% of respondents, followed by budgetary pressures (12%), the need for better training (11%), the lack of respect for HTM professionals (9%), keeping up with rapidly changing technology (8%), staffing problems (7%), and the aging of the HTM workforce (5%). Other challenges cited included pay, relationships with OEMs, increasing red tape, outsourcing of CE services, growing regulations, and certifications.
Integration with IT. Of those respondents who cited IT issues as the most important for the HTM profession, some worried about “becoming lost under the IT umbrella” or “being taken over” by IT. “I realize that a lot of biomed work crosses into the IT realm with monitoring and the like,” one said. “But IT’s attitude in this facility is that Biomed does not do anything, so they can just be used to pull cable and replace keyboards and mice. No joke!”
Other respondents believe that CE departments need to take more initiative on IT integration: “Do we want to be left behind, relegated to menial physical maintenance tasks, or do we want to work on cutting-edge software and network equipment? We need to bring the profession up to speed, and to prepare for the future, we need to embrace IT.”
A few see clear benefits to the integration with IT. As one said, “Biomed roles are going to become morphed into IT roles one way or another, and having both clinical and technical expertise should make CEs much more valuable!”
Healthcare reform and budgetary pressures. For many of the biomeds we polled, the greatest challenge to their profession can be summed up in one word—often enhanced with all caps and exclamation marks: Obamacare.
Those who felt the need to say more generally emphasized the budget cuts they anticipate: “The uncertainty of the ongoing ‘reform’ of healthcare and Medicare/Medicaid reimbursement can cause facilities to run such a tight budget,” one respondent said, “that we are pressed to stretch the expected life of equipment with less money and personnel while still keeping patients safe.”
Not everyone who cited Obamacare saw it as entirely negative for biomeds. “Obamacare will be here in one shape or another,” one said. Biomeds, he continued, are “primed to position themselves as a steward of healthcare technology. By doing so, we have great opportunities to help manage a more cost-effective solution for healthcare.”
Even without formal healthcare reform, hospitals would be facing intense pressure to cut costs. Many respondents see “having to do more with less” as an inevitable reality in the future, whatever comes of Obamacare.
Training, technology, staffing, and the aging workforce. This cluster of related issues concerned a large number of respondents. As one put it, “The constant changing of our field is a pressing issue. We need to stay current on certifications, college education, and just general BMET knowledge of our field, which can make it difficult to stay current and educated.”
The pressure to keep up with technology without formal training can place enormous stress on biomeds. “We are expected to be experts on all equipment in all of our facilities,” one respondent lamented. “We have hundreds of different devices and manufacturers and simply can’t be experts on all of the different equipment. Recently we have been taking care of all of the electronic health records, which is also making us be experts in information systems without any formal training. Most of our training is all on-the-job self-training.”
Compounding these problems is the aging of the biomed workforce and the perception that younger people are not drawn to the field. For one respondent, his biggest challenge is the “lack of new, young biomeds. In my shop we are all pushing 50 or above. We have tried to get younger associates in new positions and failed. What will happen when we all retire?”
Despite the many challenges the profession faces, biomeds overwhelmingly remain committed believers in their occupation. Nearly 90% say they would recommend it to others.
Many biomeds would no doubt agree with one respondent who recommended the profession for the stability and nature of the job, but not for the pay. They might also agree with another of their peers for whom pay was not the ultimate goal of a career: “I know of no better job where one can stay on the cutting edge of technology, engage in the care of patients, help control escalating healthcare costs, support clinical teams, and leave work each day knowing you played a role in helping the healthy and the sick. That’s job satisfaction at its best.” 24×7
John Bethune is editorial director of 24×7. He can be reached at firstname.lastname@example.org.