EXPOSED
This is a residual bucket — orthotic and prosthetic fitters, hearing instrument specialists, patient navigators, sleep and neurodiagnostic techs, transplant coordinators, cardiovascular device specialists — so the modal worker is a patient-facing technical specialist with a certification rather than a full license. The hands-on parts (fitting devices, placing electrodes, positioning patients, adjusting hardware on a real body) are robot-proof for the foreseeable future, but the documentation, insurance authorization, patient education scripting, and preliminary tracing/result interpretation that fill much of the day are exactly what AI now drafts and pre-reads. Credentialing is typically state-optional or board-voluntary, which leaves this group with a thinner regulatory wall than nurses or radiologic technologists.
Most of this decline happened after 2021 — it is not the pandemic dip.
This line is counted by the Bureau of Labor Statistics — the one figure on this page that isn't a judgement of ours. Headcount moves on demand, offshoring, demographics and the business cycle, and automation is one term among several, often not the loudest.
So a falling line is not evidence that AI did it, and a rising one is not evidence that it won't. Both happen in this register: some occupations resist automation and shrink anyway, others are highly automatable and keep growing.
BLS projection, 2024–2034
+3.6%
Percentage only. The projection counts a different population from the 35,010 above — it includes self-employed workers, which for this occupation is most of them, so the two headcounts are not comparable.
Growing, and only partly exposed
The BLS expects +3.6% more of these jobs by 2034, and at 57/100 the work is only partly exposed — some tasks are automatable, the core of the job is not. Nothing here is in tension.
Different clocks. The score is what current AI could do to this work today. The projection is how many of these jobs will exist in 2034. Everything between the two — how fast employers actually adopt, whether demand grows in the meantime — is why they can point opposite ways without either being wrong.
~2,600 openings a year on average, including replacing people who leave.
DoulaBirth DoulaLay MidwifeKinesiologistDrug CoordinatorPostpartum DoulaCertified MidwifeHomebirth MidwifeMedical ConsultantPheresis SpecialistBirth Center MidwifeDirect-Entry MidwifePodiatric TechnicianLicensed Midwife (LM)Child Health AssociateTransplant CoordinatorCentral Supply TechnicianExtracorporeal TechnicianHealth Service CoordinatorLicensed Direct Entry MidwifeTraditional Chinese HerbalistCertified Direct-Entry MidwifeLicensed and Certified MidwifeUtilization Review Coordinator
The BLS uses Healthcare Practitioners and Technical Workers, All Other for work that doesn't fit any named occupation, so it covers roles that have little in common with each other. Two consequences worth knowing before you read anything below:
Holding it up: embodiment . Weakest point: liability shield .
Mixed — a routine tier and a judgment tier Placing a 21-lead polysomnography montage on a squirming patient, casting a residual limb for a socket, or programming a hearing aid to a real-time loudness discomfort response cannot be done from a screen, but the shift's other half — scoring sleep epochs, drafting the fitting note, chasing prior authorization, building the patient education handout — is already machine-drafted, which is what holds this at 13 rather than the 16+ a pure hands-on trade would earn.
Hands-on in uncontrolled environments The work happens on a live body in a room you don't control: kneeling to align a prosthetic knee while the patient walks a corridor, taking an ear impression with cure-time on the clock, positioning a bariatric patient for an overnight study, or driving to a home or nursing facility for a device check — 14 rather than 18 because it's mostly clinical or lab space rather than roadsides and rooftops.
Certification preferred, not legally required Most of this bucket runs on voluntary board credentials — ABC or BOC for O&P, RPSGT for sleep, NBC-HIS for hearing instruments — and only about half the states license hearing aid dispensers or O&P practitioners at all; the ordering physician or audiologist signs off on the plan, so an 8 reflects a certification that gatekeeps hiring but rarely puts your own name on the legal hook.
Meaningful discretion You decide when a tracing is artifact versus a genuine arrhythmia worth waking someone over, when a socket fit is failing versus a patient still desensitizing, when to stop a study for a safety concern — real calls, but they run inside AASM scoring rules, manufacturer fitting protocols, and physician-written orders, and the definitive interpretation and treatment decision belong to someone else, which is a 10 rather than a 15.
The verdict above describes this occupation as a whole. Almost nobody does the typical version of a job — tick what's actually in your week and see how your own mix sits.
Your task mix speaks to task resistance (13/20 here) — how much of the day's work current AI already does. That is the dimension the boxes above are about.
It cannot move the other three. Liability shield (8/20) is whether the law requires a licensed human to sign. Trust premium (12/20) is whether buyers specifically pay for a person. Judgment and accountability (10/20) is whether the role exists to own consequential calls. Those are facts about the occupation's standing, not about which tasks are in your week — a paralegal who does only trial exhibits still holds no licence. Together they are 30 of this occupation's 57 points (53%).
Embodiment (14/20) is also a property of the work rather than the worker, but we don't tag individual tasks as physical or not, so the picker can't tell you anything about it. That's a limit of this tool, not a claim.
Did we get the list right? Tell us what's missing — the tasks are written from the outside, and you're reading this from the inside.
The moves above are yours to make. This is the other half: what would have to change in the world for the occupation itself to score higher. None of it is in any one person's gift, but it is where the floor actually comes from. Scores here are not a one-way ratchet. Only two of the five dimensions — task resistance and embodiment — track what machines can do. The other three track law, what buyers will pay for, and who is answerable, and those move in both directions, often in response to the same pressure AI creates. If every lever below landed, this occupation would score around 74/100 — SAFE.
CMS or accreditor rules requiring a credentialed human tech to attest to raw data quality on AI-scored studies — e.g. AASM accreditation standards requiring an RPSGT to review and sign each auto-scored sleep study epoch set, or the same for ABRET-registered techs on autoscored EEG before physician read. AASM already requires human review of automatic scoring; formalizing personal attestation raises this.
Genuine two-tier occupation: if AI absorbs prior authorization drafting, education scripting, and preliminary tracing pre-reads, the residual day is device fitting on atypical anatomy, electrode placement on uncooperative or pediatric patients, and troubleshooting artifact — tasks where failure is tactile and patient-specific. Task-mix shift alone, no rule change needed.
State-level mandatory licensure (not voluntary board certification) for the sub-occupations currently exempt — e.g. states adopting licensure for orthotic/prosthetic fitters on the model of the ~20 states that already license O&P practitioners under ABC/BOC standards, or expanding hearing instrument specialist licensure to require a named licensee to sign the fitting record and hearing aid purchase agreement. Watch state legislature O&P/hearing-aid licensure bills and Medicare's requirement that custom orthotics/prosthetics be furnished by a qualified (state-licensed or ABC-certified) supplier for payment.
Transplant coordinator and cardiac device roles absorbing organ-acceptance and remote-monitoring triage decisions as OPTN/UNOS allocation changes push more time-critical accept/decline judgment onto coordinators; similarly if device clinic protocols name the specialist as the person who decides which remote alerts escalate. Documented as a delegated protocol with named accountability rather than physician-only.
Narrow route only: hearing aid and prosthetic markets where OTC/direct-to-consumer competition (FDA OTC hearing aid rule, 2022) has made professional fitting a paid differentiator — clinics marketing real-ear measurement and in-person gait tuning against mail-order fitting. Applies to a minority of this bucket; patient navigators and inpatient techs have no such route.
The limit. Because this is a residual SOC bucket, no single lever moves the whole code — licensure gains would land on O&P fitters and hearing specialists while patient navigators and neurodiagnostic techs stay exposed. Realistic combined ceiling is roughly the low 70s, and only if state licensure spreads; without it the embodiment floor is the main protection.
| New Orleans-Metairie, LA | 1,910 | $63,240 -4% |
| Los Angeles-Long Beach-Anaheim, CA | 1,430 | $78,940 +20% |
| New York-Newark-Jersey City, NY-NJ | 1,340 | $101,870 +55% |
| Baltimore-Columbia-Towson, MD | 1,080 | $75,000 +14% |
| Philadelphia-Camden-Wilmington, PA-NJ-DE-MD | 1,070 | $49,260 -25% |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 1,030 | $107,650 +64% |
| Atlanta-Sandy Springs-Roswell, GA | 850 | $78,190 +19% |
| Chicago-Naperville-Elgin, IL-IN | 830 | $72,750 +11% |
| San Jose-Sunnyvale-Santa Clara, CA | 260 | $121,850 +85% |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 1,030 | $107,650 +64% |
| Louisville/Jefferson County, KY-IN | 60 | $105,370 +60% |
We have no reported case of a named organisation automating this occupation. Not one deployment, not one announcement.
That is worth saying out loud next to a score of 57. The verdict above is about what the work exposes — what current AI could do to these tasks. It is not a claim that anyone has done it. For this occupation those two things have come apart completely: the capability argument is on this page, and the evidence column is empty.
Has AI actually changed your work? One tap, anonymous, and the running tally is public. Nothing else is asked of you.
Rather than check back: get the digest and we'll tell you what changed — or watch a single occupation from its own page.