For-Profit Colleges Could Do More on Shortage of Health-Care Workers

January 20, 2011

For-profit colleges educate a growing share of the nation's health-care workers, but graduate relatively few students in the highest-need fields and may be producing too many medical assistants and massage therapists, according to a report released on Thursday by the Center for American Progress.

The report's release comes amid growing scrutiny of the expanding for-profit sector. For-profits have touted their role in training health-care workers in their fight against the Education Department's proposed "gainful employment" rule, warning that the proposal—which could shut down hundreds of high-cost programs—would worsen shortages of health-care workers. One advertisement opposing the rule, by the Association of Private Sector Colleges and Universities, features a nurse who returned to college after her husband became ill, and bears the message: "It's my education and my job—it should be my choice."

But the report, "Profiting From Health Care: The Role of For-Profit Schools in Training the Health-Care Workforce," says that for-profits conferred only 11,000 degrees in registered nursing, a field with one of the worst job shortages, in the 2008-9 academic year.

The report says for-profit colleges tend to focus on "support" occupations, like medical and dental assisting, rather than "practitioner" and "technician" fields, like registered nursing and diagnostic technology. Though support occupations are growing, the field is less than half the size of the practitioner and technician fields, and the jobs tend to be lower-paying.

In the 2008-9 academic year, for-profit colleges produced 247,480 degrees and certificates in the health professions, according to the report. Roughly a third, or 77,000, of them were in "medical/clinical" assistant programs and 25,000 others were in massage therapy.

By 2018 the nation is expected to need an additional one million nurses, but only 218,000 more medical assistants, according to the report. The Bureau of Labor Statistics projects that there will be only 39,500 job openings in massage therapy from 2008 to 2018. The report warns that some graduates of medical-assisting and massage-therapy programs may have trouble finding jobs in the future.

The report recommends that Congress create incentives for colleges to offer degrees in high-demand areas by expanding the Smart Grant program to cover more job titles and to work with colleges and the Department of Labor to help prospective students make better decisions. It also suggests that Congress require colleges to provide students with information about job placement, average salary, and graduation rates prior to enrollment, and direct accrediting agencies to develop standards around outcome measures.

The Association of Private Sector Colleges and Universities praised the report for its "fairness and balance" but issued a white paper "to clarify certain statements" in the report and "address points on which it disagrees."

Its response notes, for example, that for-profits award 32 percent of all health-care credentials and educate a growing share of nurses. From 2001 to 2009, the percentage of nursing degrees awarded by for-profits grew from 4 percent to 11 percent of the national total, while nursing awards from public colleges shrank from 78 to 70 percent, the association says.