This isn’t a happy post.
I love EMS and love being a paramedic. I love the job, love taking care of the patients, and love the challenge, excitement, and challenge. I’ve always said that EMS is an abusive, co-dependent relationship for me. I need it and really, I’ve always thought that it kind of needs me too… But as I’ve hinted at here on the blog before, it’s hard to pay the bills on the salary that a Midwestern paramedic makes in a small community. We can work well over a hundred hours per week, can hone our skills as much as we’d like, and can save lives and alleviate as much suffering as one person can handle, but it isn’t enough to put a full tank of gas in our car every time we need to fill up and also to afford cable television. Heaven forbid that we don’t take our lunches to work or want to take our wives out to a nice dinner.
The service that I work for has a cardiac arrest survival rate of between 40-60% (yes! www.callandpump.org) We have advanced protocols, work with a lot of autonomy in the field, effortlessly switch between 911 response and critical care transports, and maintain a 3-5 minute response time anywhere in our community. I carry a critical care reference in my pocket, have to study to keep up with the new changes in our protocols (Coming soon: Field-initiated Therapeutic Hypothermia), and regularly work with physicians to determine the best course of treatment during long-distance critical care transport. Ever maintained a vent, conscious sedation, and 4 drips for an hour-long transport? I do, a lot, and I barely make enough to cover lunch for my trouble.
What other healthcare profession would put up with this? Seriously… I mean, are paramedics worthless?
According to Salary.com here are some job titles and pay ranges for comparable healthcare positions in my town:
Job Title – (percentage of income levels on the right) |
10th % |
25th % |
75th % |
90th % |
Paramedic (EMT-P) |
$29,659 |
$34,112 |
$44,181 |
$48,896 |
EMT (EMT-B) |
$22,285 |
$25,396 |
$32,810 |
$36,449 |
Registered Nurse (Staff RN) |
$49,911 |
$55,582 |
$67,474 |
$72,629 |
Resp. Therapist (RRT) |
$48,129 |
$51,740 |
$60,200 |
$64,292 |
Radiology Tech. (X-ray Tech) |
$39,030 |
$42,743 |
$51,168 |
$55,125 |
Police Officer |
$33,661 |
$41,185 |
$58,338 |
$66,432 |
High School Teacher |
$31,479 |
$41,345 |
$61,293 |
$69,588 |
HVAC Mechanic |
$28,971 |
$34,026 |
$46,467 |
$52,739 |
Fast Food Cook |
$13,013 |
$15,352 |
$21,257 |
$24,294 |
Security Guard (unarmed) |
$21,809 |
$25,479 |
$33,272 |
$36,698 |
The Median household income in the Zip Code queried is $43,408
So, there are four job titles that make less than paramedics up there, one of them is the EMT-Basic (and that’s a given), the others are the “fast food cook”, “HVAC Mechanic”, and the “Security Guard”. The RN and the RRT (almost) start higher on the bottom scale than the Paramedic’s top income level. A Police Officer, who by definition works for a governmental agency is lower on the above scale than the RN, RRT, and X-Ray Tech, but tops out higher than everyone but the teacher, RN and the RRT. In addition, the Police Officer has a career advancement ladder and benefits including retirement, healthcare, and other benefits. I just got a high-deductable healthcare policy after I found out that I have no sick time. In addition, I’m close to 10% on the above scale.
I thought about writing this post after a good friend of mine who is a HVAC (Heating, Ventilation, and Air Conditioning) Tech told me that he was pretty tired after working last week. He said that he had put in 62 hours and got a WEEKLY paycheck that is more than my biweekly paycheck for working OVER 100 HOURS PER WEEK. He’s a great guy, and he works hard and deserves his money. I’m not saying that he isn’t worth everything he gets. However, last week I saved two lives (Had two “Snatch life from the jaws of death calls”) and took some complicated medical issues in the back of my truck. I taught new EMTs and EMT-Ps and took care of everyone I had contact with to the very best of my ability. I’ve also had some years of college and carry a medical license. Look at the job titles up there. There’s a few of them that can kill people if they have a bad day, however it’s debatable if any of them have more responsibility than a paramedic.
There’s some other information that we can draw from the above scale. There are ten job titles up there. Broken down further:
Minimum Entry-Level Educational level |
Certificate |
Assoc. Deg. |
Bachelors Deg. |
Higher |
Paramedic (EMT-P) |
X |
|||
EMT (EMT-B) |
X |
|||
Registered Nurse (Staff RN) |
X |
|||
Resp. Therapist (RRT) |
X |
|||
Radiology Tech. (X-ray Tech) |
X |
|||
Police Officer |
X |
|||
High School Teacher |
X |
|||
HVAC Mechanic |
X |
|||
Fast Food Cook |
X |
|||
Security Guard (unarmed) |
X |
Mid-Career Educational level |
Certificate |
Assoc. Deg. |
Bachelors Deg. |
Higher |
Paramedic (EMT-P) |
X |
|||
EMT (EMT-B) |
X |
|||
Registered Nurse (Staff RN) |
X |
|||
Resp. Therapist (RRT) |
X |
|||
Radiology Tech. (X-ray Tech) |
X |
|||
Police Officer |
X |
|||
High School Teacher |
X |
|||
HVAC Mechanic |
X |
|||
Fast Food Cook |
X |
|||
Security Guard (unarmed) |
X |
High-End Educational level |
Certificate |
Assoc. Deg. |
Bachelors Deg. |
Higher |
Paramedic (EMT-P) |
X |
|||
EMT (EMT-B) |
X |
|||
Registered Nurse (Staff RN) |
X |
|||
Resp. Therapist (RRT) |
X |
|||
Radiology Tech. (X-ray Tech) |
X |
|||
Police Officer |
X |
|||
High School Teacher |
X |
|||
HVAC Mechanic |
X |
|||
Fast Food Cook |
X |
|||
Security Guard (unarmed) |
X |
The above standards aren’t based upon statistics, and I can’t find where to get accurate, verifiable information on that. However, from my personal knowledge of the above career types through friends and acquaintances that are in the above professions, this is as close as I can get. I could infer that every EMT-B advances to the paramedic level when wanting to advance their career however some communities only have an EMT-B response and there is no reason for some EMS people to attain the paramedic certification. (Really, why would they when they can make more as any other profession with like educational standards) It is interesting that there are progressive career levels for higher educational levels in the other career paths, but not for EMS people.
Are paramedics worthless? Or are we keeping ourselves down? Is there a reason that our salaries are so low?
I think that it is because the public doesn’t know what we do, nor have they been made to care. In my community, the taxpayers pay a minuscule amount to the ambulance service compared to the Fire Department, Police Department, Street Department, Sanitation Department, and pretty much everything else. Is it because the public doesn’t care?
I don’t think so. I think that as a profession, we accept the offensive compensation because we love the job so much. We accept it, and then work for the services that pay us this because there are no viable market alternatives. Unions have made inroads in improving our pay… but at what cost to the true calling of the profession?
EMS 2.0 needs new revenue sources to provide value to our profession. EMS 2.0 needs market valuation for paramedical skills commensurate with our true worth. EMS 2.0 needs people who are willing to become true professionals and hold ourselves to stringent professional standards. EMS 2.0 needs paramedics and EMTs willing to rise to the challenge, and unwilling to accept where we’ve found ourselves.
Are we worthless?
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