It takes more than years of clinical experience to move into management. Following a career track that leads to advancement and higher pay also requires that health care professionals keep an eye on the bottom line and stay focused on the latest management techniques.

"Salaries in health care become more competitive with other industries at the management and director levels," said Robin Singleton, senior vice president of DHR International, the world's fifth-largest retained search firm. Singleton specializes in health care executive searches nationwide.

"The top in-demand positions for directors of surgical services, outpatient surgery, ambulatory services and emergency departments can command annual salaries in the $100,000 range, depending on the size of the facility, the scope of the job, the practice area and the number of annual patient visits," she said.

A director of surgical services with at least five years of experience can earn as much as $140,000 a year in a large hospital. Many hospitals also offer incentives and bonuses to director-level employees, Singleton said.

"Georgia pays in the 90th percentile for people with this level of experience," she said. "Employers are finding that they must be competitive with the rest of the country to attract and retain the best people."

Working as an administrator requires a new outlook on managing staff and resources.

"The new business model in health care is metrics-driven, based on current state, desired state and bridging the gaps to move an organization," Singleton said. "Managers and directors must understand the management-information system at their institutions and literally manage shift-by-shift to maximize resources and staffing ratios. They have to be able to manage to the numbers and the day-to-day needs of patients and the hospital."

Singleton recommended that would-be managers seek ways to broaden their experience, including by aligning themselves with mentors who are vice presidents or directors; by pursuing a master's degree in business administration or health care administration; by attending professional management meetings; and by taking continuing education courses.

"Gone are the days when excellent clinical skills or tenure alone will bring a promotion and higher pay," she said. "You have to be focused on the bottom line, be willing to make the tough decisions, and keep up with the latest in management trends."