2006 Salary Survey Results

A touch of gray: Aging ICPs fuel jobs, salaries and worries

As veterans leave, field ponders new vision

The aging of the ICP work force is resulting in a gradual exodus of skilled health care epidemiologists, creating a plentiful job market and attractive salaries in the short-term but setting an ominous tone for the future of patient safety.

Consider the jarring juxtaposition of these trends. The Centers for Disease Control and Prevention estimates that some 2 million health care-associated infections (HAIs) result in 90,000 deaths and $4.5 billion in excess health care costs every single year. On the other hand, the primary profession dedicated exclusively to preventing these infections sees a touch of gray in the mirror. A full third of the infection control professionals responding to the annual Hospital Infection Control salary survey and career report were age 56 years or older. Thirteen percent of respondents were at least 61 years old. Moreover, a recent survey by the Association for Professionals in Infection Control and Epidemiology found that one out of five surveyed ICPs say they are going to retire within the next five years. Of those, about 25% expect to retire before 2008 and 20% before 2009.

"It is alarming for health care and patient safety in general that there are so many people planning to retire and there isn't a pipeline for these positions," says Kathy L. Warye, executive director of the Association for Professionals in Infection Control and Epidemiology (APIC). "That is one of the things that APIC has begun to work on. It's a massive problem that extends to the entire spectrum of nursing — not just infection control."

Job vacancies increasing

In the interim, however, the situation is creating no lack of job openings for an increasingly complex profession, which must fight the aforementioned HAI epidemic while preparing for emerging infections, bioterrorism, and an influenza pandemic. It's not for the faint of heart or, for that matter, the inexperienced.

"My impression is that we are trying to fill more jobs with the same number of people essentially," Warye says. "They want experienced people coming into those positions. They do not want to [recruit] people cold out off nursing and microbiology, although a fair amount of that does happen."

As a result, experienced ICPs can expect better compensation and job security remains a given. "I think that salaries are going to increase because we are seeing more job openings for a longer period of time from the incumbents' departure to filling that position," Warye says. "We don't have a lot of data around this but I do know from talking to people in [APIC] chapters that they are having increasing difficulty filling positions. The time gap — the vacancy period — is widening from what it was in the past. Candidates are demanding higher salaries. There is a supply-and-demand situation. If there is a scarce supply [of ICPs], theoretically the price will go up."

Median salary increases

Indeed, the median salary on the annual HIC salary survey and career report climbed to the $60,000 to $69,000 range, up a bracket from the $50,000 to $59,000 median reported in 2005. The 2006 survey of 272 ICPs found that the median age of respondents was in the 51 to 55 years old. In percentage breakdowns, 11% were making $40,000 to $49,999; 23% were paid $50,000 to $59,999; and 29% had salaries in the $60,000 to $69,999 range. On opposite ends of the spectrum, 3% were making $30,000 to $39,999; and 16% were in the $70,000 to $79,999 range. Seven percent drew a salary in the $80,000 to 89,999 range.

While shifting demographics may be driving wages, reported annual raises were generally not something to write home about. The survey found 54% of respondents drew wage hikes in the 1% to 3% range over the previous year. Overall, 23% of respondents drew raises of 4% to 6%, and 3% of respondents were given a raise in the 7% to 10% range. However, 17% reported no raises for the period — the same percentage of respondents who reported no wage growth in the 2005 HIC survey. Most survey respondents work in small to midsize hospitals, with the median response from facilities with 201-300 beds.

In a much larger survey conducted by APIC, the majority of ICPs reported a salary between $50,000 and $75,000. Only 7% of APIC members reported a salary of either less than $30,000 or greater than $100,000. Only about one-third of respondents in the APIC survey reported having a decision-making role in the development of their department budget. Indeed, one-fourth of survey respondents say they have no influence over their department's annual budget. One out of three APIC survey respondents consider the resources dedicated to their institution's infection prevention and control program to be either "excellent" or "very adequate." However, about 20% of respondents report resources are "barely adequate" at best, APIC reported.

"We would like to see that change over time as we see greater commitment to reducing HAIs, greater consumer awareness of this situation, and greater efforts on the part of state and federal legislatures to do something about this," Warye said. "I think over time we will see more resources going into infection prevention and control. I can't imagine in the grand scheme of things — with all of these things coming into play — that we are not going to see greater time, attention, and resources devoted to infection prevention and control."

Recruiting new ICP

The keys to enhancing infection control program funding in the future include recruitment of a new generation of ICPs and a much-needed perception shift of the field itself. "We have a commitment to broadening the pipeline and enhancing the profession," Warye says. "We are trying to encourage administrators and others to recognize that ICPs are not just nurses and microbiologists doing infection control. They bring a unique set of knowledge skills and competencies to the job. Once that recognition exists, I think you are going to see those positions treated differently and you will see people more inclined to move into them."

Career-building incentives

APIC is involved in awarding research grants to graduate students and conducting other career-building incentives to nurture the infection control field.

"We need to reach out to people in graduate schools and schools of public health," she says. "I think we need to spread the net wider in terms of people who might have the competencies to move into these positions."

As new surveillance technologies become more readily available the job may become more about primary intervention as opposed to data collection, she said. "That may be more attractive to a new generation of health care workers," Warye observes. "I think it is a shame that they spend so much of their time collecting and reviewing data and that their skills that really can be used to prevent infections are really not accessed or utilized."

Likewise, the old model of the ICP in the silo is giving away to a new vision of shared infection control responsibilities throughout health care networks. "We need to bring them into the epicenter of the institution so that infection control becomes everybody's job — not just the job of the ICP," she says.

To do so, APIC has been holding a series of future summits to try to imagine and empower the ICP of the future. "Infection control is an island [but] we're trying to influence the entire institution," APIC president Kathy Arias, MS, MT, SM, CIC, said at a recent press conference. "These professionals are not properly positioned within the institution to be able to do that. How can we fully integrate infection prevention and the professionals who have that knowledge into the institution and make adherence to things like hand hygiene integral in the DNA of every single employee in the institution? I think it's going to take a structural change as well as a behavioral change."

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