Hospitals moved into the economic vacuum. Allegheny County, which includes Pittsburgh and many of its suburbs, now has the second-highest proportion of seniors of any county in the nation with a population over 1 million (after Florida’s Palm Beach). All those Medicare beneficiaries gave local hospitals a solid base of paying customers. A few smaller community hospitals closed, but many survived. UPMC, a nonprofit affiliated with the University of Pittsburgh, began expanding rapidly, buying up hospitals in the region and building up high-revenue specialties such as organ transplantation and oncology.
People in town like to credit the economic recovery to the combination of “eds and meds.” In addition to the big hospitals, Pittsburgh is home to two major university systems—Pitt and Carnegie Mellon University—with grant-winning research programs, along with more than a dozen other colleges. The University of Pittsburgh, with its medical school, has been a big breadwinner for the city. It hired a former top NIH official, and Pitt now ranks fifth in the country among universities collecting NIH grants—more than Yale, Duke, or Stanford.
Health care and social services represent about 10 percent of the Pittsburgh economy and 16 percent of its jobs, compared with averages under 8 percent and 13 percent nationally. It’s not the only business in town: Finance and high-tech jobs have grown, too. Google and other national corporations have chosen to open offices here. But it is health care that has grown steadily, in jobs and revenue, even when other industries have stagnated.
That’s why Tia Tomasic, 24, who grew up outside the city in North Huntingdon, always saw a job in health care as the safest way to a stable, rewarding middle-class career. In high school, she began volunteering in the nearby hospital. At first, she helped greet new patients and escort them to their rooms. Then she filed and circulated medical records, back when everything was paper. Tomasic began to realize how important the records were, and how much she could enable care even far from the bedside. So she sought out colleges with health information-management degrees. Many of her classmates also chose health careers, particularly nursing. “There are opportunities,” she says simply.
Hers is a good career. Tomasic earns between $40,000 and $50,000 per year and expects to do better and better as the field expands. As more hospitals and doctors switch from paper to electronic records, demand is rising for professionals who can manage them. Tomasic helps medical practices set up electronic systems and works out the kinks once they’re online. The job involves a range of skills—customer service, training, computer science. She works in a row of taupe cubicles in a new building on the banks of the Allegheny River, just a few blocks from the flagship hospital of the West Penn Allegheny Health System, which employs her, but she frequently travels around the region to help practices on site. “It’s never boring,” she says.
Her hospital chain is also helping to pay for her M.B.A., a degree that may open up other opportunities on the business side of hospital administration. That sort of professional development is not unusual in town. UPMC is so eager for trained nurses and technicians that it, too, offers substantial tuition assistance for employees who want to earn advanced degrees. Although the field has its share of low-wage jobs, health care offers an unusual range of opportunity for career growth and upward mobility.
At UPMC’s Shadyside School of Nursing a few miles away, 20 students are sitting around tables, taking in a lecture on intensive-care nursing. Shadyside offers a diploma in 22 months, and nearly every student in the classroom is enrolled in a loan-repayment program through the university. If they agree to work for the health system for two years, they won’t have to pay back their loans. “Basically, you’re guaranteed a job,” says Jacki Hammond, 19, the only student in the class to come straight from high school. Ann Harmon, 36 years old and beginning a second career, is a more typical student. She already works for Shadyside Hospital as a pharmacy technician; she returned to school after she felt she had “hit her ceiling” there. During a classroom Q&A about intravenous nutrition, Harmon knew all the answers: She’d spent years making the formulas in her pharmacy.
“Parenteral nutrition is prepared by who?” asks Amy Stoker, the teacher.
“Pharmacy technician,” Harmon answers immediately.
“If you’re worried about hyperglycemia, what can you add?”
“Insulin,” she says, then takes a small bow.
Stoker herself has ascended the career ladder. She started in intensive-care nursing at Shadyside Hospital after earning a bachelor’s degree. Then she used tuition assistance to get her master’s. Now 35 and a mother of two, she’s working on her doctorate. Her father, who built motors used in steel mills, managed to keep his job through the closings, but he knew he was lucky. Stoker, by contrast, knows she’ll never lack for job security. “There’s always a place for me at the bedside, in a nursing home, or in the community,” she says. “I could find a job really easily.”