一方面，乔治城大学教育与工作中心（Center on Education and the Workforce at Georgetown University）最近公布的一份研究发现，持有学士学位的人比仅有高中文凭的人，平均收入高84%。与1999年的75%相比，增长幅度非常显著。
过去30年里，沙特金一直在研究就业市场，他尤其关注不断变化的经济对技能需求的影响。他曾参与出版了《一百个无需大学学历职业排名》（Top 100 Careers Without a Four-Year Degree）一书。近期，该书出版了第10版。书中包含大量的宝贵信息，列举了预计未来七年中招聘岗位增长率将超过平均水平的诸多领域，它们涉及从广告销售到焊接工作的众多行业。而且，这些领域中的职位空缺数量将超过合格求职者的人数。
本书涵盖的100大最有前途职业中，有11个来自医疗保健行业。其中有一个工种被称为“病例与医疗信息技术员”，听起来恰好符合你女儿的想法。美国劳工统计局（Bureau of Labor Statistics）报告称，医疗保健服务提供商计划在2018年之前增加招聘具有计算机化病例记录专业知识的技术员，新增比例将达到20%。
在未来三年中，对这一工种的需求将尤为迫切。因为美国联邦法律要求，所有医院要在2014年之前将电子病例记录系统投入使用，而许多医院远未做好准备。除了专科学历外，医疗信息技术员一般需要参加由美国健康信息管理协会（American Health Information Management Association）举办的考试，并获得注册医疗信息技术员（Registered Health Information Technician）认证。
而医疗编码认证无疑也将成为抢手货，比如由医疗专用编码与合规委员会（Board of Medical Specialty Coding & Compliance）提供的认证。美国联邦法律规定，截至2013年10月，医院应开始使用全新的编码系统，其中的编码数量将超过155,000种。
Dear Annie:I had hoped my oldest daughter would be heading back to college right about now, but after doing all right academically in her freshman and sophomore years, she decided she'd rather look into other opportunities instead. I'm trying very hard not to think of this move as "dropping out," but I can't help worrying about her future if she doesn't finish school. One of the careers she's considering has something to do with computerized medical record-keeping. (She's very good with computers.) Do you know anything about that? Could she make a decent living at it? — Concerned Dad
Dear CD: Your worry is certainly understandable, but consider your daughter could be on to something. Exactly what a four-year college degree is worth, in dollars-and-cents terms over the whole course of someone's career, is a complex question.
On the one hand, according to a new study from the Center on Education and the Workforce at Georgetown University, bachelor's degree holders earn, on average, 84% more than people who have only a high school diploma. That's a marked increase from 75% more in 1999.
But at the same time, those averages can be deceptive. The Georgetown researchers note, "People with lower educational attainment can often make more than those with higher attainment as a result of occupational differences."
For instance, their analysis found that more than a quarter (28%) of people with a two-year associate's degree make more than the median average pay of workers with bachelor's degrees, and 40% of bachelor's degree holders out-earn the median income for people with master's degrees.
As the study puts it, "these figures reflect a critical aspect of the education and earnings game: The actual job that someone does -- the work they perform -- has a significant effect on earnings."
One thing is certain: With or without a four-year degree, "rapid changes in technology now require people to continue learning throughout their work life," says career expert Laurence Shatkin. "Jobs are constantly upgraded, and many of today's jobs can't be done by people who have only the knowledge and skills that were adequate a few years ago."
Shatkin has been studying the labor market for the past 30 years, with particular attention to how the ever-evolving economy affects which skills are in demand. He is co-author of the recently published 10th edition of Top 100 Careers Without a Four-Year Degree, which is a gold mine of information on fields -- from ad sales to welding -- where the rate of job growth is projected to exceed the average for all fields (and where job openings will outnumber qualified applicants) over the next seven years.
Of the 100 promising careers the book covers, 11 are in health care. One of them, a category called medical records and health information technicians, sounds like what your daughter has in mind. Health care providers plan to hire 20% more technicians with the know-how to computerize medical records by 2018, the Bureau of Labor Statistics reports.
Demand for these workers will be especially strong over the next three years: Federal law requires all hospitals to put electronic record-keeping systems in operation by 2014, and many are nowhere near ready. In addition to an associate's degree, records technicians typically take an exam, administered by the American Health Information Management Association to earn the Registered Health Information Technician (RHIT) certification.
Certifications for medical coding, such as the one offered by the Board of Medical Specialty Coding & Compliance, are also a hot commodity right now, and no wonder. Federal regulations dictate that hospitals start using an entirely new coding system, with more than 155,000 codes, by October 2013.
In other words, although a bachelor's degree is a great thing to have, your daughter could do a lot worse than to get trained in this field. And look at the bright side: With the economy still shaky and unemployment stubbornly high, her decision to pursue a specific marketable skill may turn out to be smarter than you think.
Talkback: Has a four-year degree paid off for you? If you don't have a bachelor's degree, has the lack of one been an obstacle in your career? What skills have served you well instead? Leave a comment below.