Much has changed in the health care sector in the Tri-Cities region over the past 20 years. Specialty or tertiary care is now common. One can now find specialists here who simply weren’t present then. Residents do not need to travel as much to Spokane or Seattle.

As of last year, health care and social assistance amounted to the second largest sector in Benton and Franklin counties, by head count. A sector is the highest grouping of industries in economic typology.

A growing sector

This sector claimed slightly more than 13% of all workers here. Consider its position in 2003, when the sector accounted for slightly more than 8% of all workers. This is seen in the accompanying Trends graph modified to show only this sector.

Note, too, the comparison to the Washington state average over the years. In 2003, the relative size of health care and social assistance here lay well below its size in the state. Fast forward to 2023, the ranking is reversed: the health care and social assistance sector here is now relatively larger (13.3%) than in the state (12.8%).

A word about the social assistance component: This includes a variety of social services for various ages and target populations. But the largest industries consist of services for the elderly, followed by child care. This component is much smaller than the traditional industries of health care delivery, such as ambulatory care, hospitals and nursing homes. But it is not insignificant. In 2023, the component made up 23% of the headcount in Benton County and 45% in Franklin County.

As the population in the greater Tri-Cities has rapidly grown and become older, as can be seen in Trends data, it stands to reason that the demand for this sector’s services has increased.

Just because health care and social assistance payrolls have grown disproportionately over the past two decades does not mean its workforce is adequate to the population. Another Trends indicator tracks the number of physicians and their rate per 1,000 residents. It shows that the number of physicians in the two counties has recently plateaued in the 850 to 900 range and so has the rate-per-residents. As of 2023, it stood at 2.8 physicians per 1,000 residents. This is far below the state rate of 4.4 physicians per 1,000 residents.

Two-county differences

And within the two counties, there are considerable differences. Physicians practicing in Benton County show a ratio in 2023 of 3.5 per 1,000 residents, but the ratio for Franklin County is 1.2.

Within the broad spectrum of specialties of physicians, some differences stand out. Orthopedic surgeons are well represented in Benton County, that is, at a rate higher than the state average. Franklin County shows 10 or fewer.

Radiologists and general surgeons in Benton County also are present at higher rates than the Washington average, although not in Franklin County.

Yet, for the all-important disciplines of primary care, the rates are below the state average for both counties. This applies to family practice, internal medicine, OB/GYN and psychiatry specialties.

Data from the same source, the Washington Office of Financial Management, or OFM, paints a slightly different picture for two other provider types: nurse practitioners and physicians assistants. For ARNPs, Benton County most recently (2021) shows a much higher concentration than the state; Franklin, however, lies below the average. The bulk of the ARNPs here are specialists.

The same is largely true for physician assistants. Benton County shows a rate slightly higher than Washington’s, yet Franklin County’s rate is about half of Benton’s.

High-demand jobs

OFM does not provide data on nursing counts by county. But the Washington Department of Employment Security, source of the state’s labor market data, publishes an insightful monthly report of occupations in highest demand for each county in the state.  

For Benton County, the registered nurses category nearly always sits atop of the list, by a wide margin.  The same occupation usually lands among the top three for Franklin County, albeit at a much lower level. Clearly, demand for nurses in the greater Tri-Cities is outstripping supply.

With a robust population forecast on the horizon and one that is aging, the Tri-Cities will continue to see strong demand for the services of the various industries of the health and social assistance sector. The challenge of the local health care workforce to respond adequately looms large. If it cannot, the relative size of this vital sector might not be as large in five years as it is today.

D. Patrick Jones is the executive director for Eastern Washington University’s Institute for Public Policy & Economic Analysis. Benton-Franklin Trends, the institute’s project, uses local, state and federal data to measure the local economic, educational and civic life of Benton and Franklin counties.