Health care is big business is Spokane - accounting for about one in six jobs in the Lilac City - and it's going to get bigger.

The recent purchase of Empire Health Systems, which operates Deaconess and Valley medical centers, will result in a $100 million injection of capital spending over the next five years, notes the Spokane Journal of Business. At the same time, the Providence-owned Sacred Heart and Holy Family hospitals are working on 10-year expansion plans.

All the hospitals report increases in key metrics - everything from ER visits to volumes in the maternity wards - and expect that Spokane's growing population will continue to drive demand for health care.

And with more doctors coming to town, that's driving demand for more medical office space, the JoB says, noting that there have been five clinic projects of varying size underway in Spokane this fall.

The only potential hang-up to this is - you guessed it - a looming labor shortage. There's a shortage of medical professionals and support staff in the state - even a shortage of professors to train them. To address the need, the University of Washington Medical School has opened a Spokane branch to train 20 doctors, while Washington State's Spokane-based nursing program has launched a PhD program to train people to teach the next generation of nurses.

Elsewhere in Spokane, there seems to be immunity from worries about a housing slow-down. Developers are going forward with a long-planned subdivision that will bring 454 more houses south of the city limits.

OF COURSE, WENATCHEE continues to be the last of the red-hot real estate markets. Realtor Geordie Romor took a look at the reasons why at the Seattle P-I's real estate blog. Among them: solid local job growth, and a surge in retirees looking to snap up relative bargains. Wenatchee - which in some reports includes Lake Chelan - had lagged behind the urban west as the real estate bubble expanded. Now it's experiencing the valuation run-up that we saw in home markets on The Coast the past couple years.

We got an indicator that the job market should stay somewhat stable this week when Alcoa signed a 17-year power agreement with the Chelan County PUD. Alcoa employs 390 people at its Wenatchee smelter, and with the power contract in place, it's expected to expand the operation, adding another 60 workers.

That will offset 59 jobs that will be lost when Tree Top closes its Cashmere juice plant after the first of the year.