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So far this year, the number of jobs in ambulatory care – including dentistry, outpatient care, imaging and diagnostic work – continues to increase. Another 12,000 new employees began working in August, for a total of 101,000 jobs created within the last six months, according to the Bureau of Labor Statistics 2013 second quarter report.  

Overall, ambulatory service jobs account for 84 percent of all jobs added to the healthcare industry this year. As hiring shifts from hospitals to out-patient facilities, a greater ratio of low-wage nursing aides to doctors are being employed.

“It’s like the physician is the commander, and they have an army of soldiers to win the war,” said Fred Hagigi, a professor of healthcare management and finance at the UCLA Anderson School of Business.

Nursing aides, orderlies and attendees often perform daily administrative and routine tasks – such as blood pressure screenings – without doctor supervision, according to Hagigi, who spent nearly two decades managing several health care facilities before deciding to teach full-time.

The trend of fewer doctors and more assistants is expected to grow, especially once the Affordable Care Act goes into effect and increases the number of doctor visits. With the increase in visits, however, health care providers are supposed to focus on preventative services such as screenings for diseases and stress tests – tasks easily done by nurses or nursing aides.

In the last six months, ambulatory services had an average monthly increase of 16,000 jobs per month, while hospitals trailed with an average gain of 1,000 jobs per month, according to a federal jobs report.

While sequestration and cuts to Medicaid programs have been blamed for stagnant job growth at hospitals, competition from freestanding ambulatory care centers have also taken a chunk out of hospital profit margins as hospitals have been forced to cut staff to stay afloat.

In May 2013, hospitals had the worst single month of overall hiring since 2004 - losing 6,000 jobs. The same time period, however, saw growth in all other health care sectors according to the labor department.

As the job market shifts more towards nurses and ambulatory care workers than doctors, students interested in the medical profession may need to reconsider their career goals. 

You can reach staff reporter Denise Guerra here. Find her on Twitter here.