Why does being a Paramedic seem so worthless sometimes?

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?

  • The Happy Medic

    CK,

    Heavy stuff. I feel your anger. It comes through the way you struck the keys writing this post.

    To answer your rhetorical question at the end of this post, No we are not worthless, yet.

    Your amazing survival rates for cardiac arrest (out of hospital neuro intact?) are only a portion of our successes in the field. You are indeed correct that EMS 2.o can only be carried forward by professionals who view what we do as a profession, not a trade or skill. There is an art to monitoring 2 drips (my max, I can't imagine 4!) the intra aortic balloon pump and trying to figure out how to afford dinner on the way home. I've been there. Gas station burritos and Mr Pibb only go so far.

    EMS 2.0 is in good hands so far. Pass it along, Brother. Pass it along.

    Happy

  • Ckemtp

    Yea Happy, I'm kind of angry. Increasingly, I feel that my career is at a crossroads. I think that every medic, and probably everyone goes through it at some time.

    Unfortunately, most leave the profession.

    But I don't think I'm gonna.

    Is it idealistic to think that I can change it for the better?

  • Ckemtp

    and yes, they are out of hospital neuro intact.

  • http://twitter.com/DG_Medic Daniel Green

    Chris, I hope you will respond to a couple of my questions. First, let me say I agree with you, but also I completely understand that I am young, inexperienced, and not even a paramedic yet. I too live in the midwest(Kansas) and I believe you've been down here to Sedgwick County. Kansas requires an Associates in Applied Science to obtain your MICT(same as EMT-P).

    I think this question of pay is something we do to ourselves. Out of hospital care needs to happen, and we step up to do that. We work 80+ hours a week with knowledge we wont make very much, hell when I worked 911 in the north of my state we didn't even get paid for our mandatory 24 hour on-call shift, but we did it, because money isn't going to come out of my ass to feed my kids.

    Do you think the Fire-dept based model keep us from separating ourselves from the public safety realm and out of being recognized as healthcare professionals? Or do for-profit companies that pay their employees less and crappier benefits then a county or municipal service hurt retention and longevity in our field?

    You might find this interesting…. I had a discussion with a nurse at a local ER a couple of weeks ago. I was there as a paramedic student doing my 350 hours of clinical time, and in walked an EMT-B student from a local “technical Institute”. This was a new program, before this last fall semester, if you wanted to be an EMT-B you had to enroll at one of the community colleges, but now you can go do a 3 month class with NO EMS RIDE TIME. Their clinicals consisted of 2 8 hour ER shifts(at a heart hospital, not even a trauma center, which we have 2 of). This made me sad. I mean, we need to pushing more of our training into formalized education. That way people who want to do it and make a career out of it are taught to invest in their education. It seems like a step backwards to take a college level program like mine where my Paramedic instructor is not only a 22 year veteran of EMS but also has her Master's in Education, and start offering something that offers little more in the way of commitment and effort as a lifeguard class at the local YMCA.

    Perhaps, maybe this plays into a larger healthcare discussion, if we get paid more, our services will cost more to the people we serve, and while unfortunately(IMO) we don't live in a society that sees healthcare as a right, it would pain me to see more anguish caused to my patients because of financial distress from a larger ambulance bill. And Maybe Mark(@UKMedic999) can answer this, but do Paramedic make more in a universal system?

    Also, I believe you can get a Bachelors Degree in EMS from a handfull of schools… in fact doesn't The Happy Medic have a BS?Can you confirm there are some BS EMS degrees out there, because I'm not sure.

  • http://twitter.com/DG_Medic Daniel Green

    Chris, I hope you will respond to a couple of my questions. First, let me say I agree with you, but also I completely understand that I am young, inexperienced, and not even a paramedic yet. I too live in the midwest(Kansas) and I believe you've been down here to Sedgwick County. Kansas requires an Associates in Applied Science to obtain your MICT(same as EMT-P).

    I think this question of pay is something we do to ourselves. Out of hospital care needs to happen, and we step up to do that. We work 80+ hours a week with knowledge we wont make very much, hell when I worked 911 in the north of my state we didn't even get paid for our mandatory 24 hour on-call shift, but we did it, because money isn't going to come out of my ass to feed my kids.

    Do you think the Fire-dept based model keep us from separating ourselves from the public safety realm and out of being recognized as healthcare professionals? Or do for-profit companies that pay their employees less and crappier benefits then a county or municipal service hurt retention and longevity in our field?

    You might find this interesting…. I had a discussion with a nurse at a local ER a couple of weeks ago. I was there as a paramedic student doing my 350 hours of clinical time, and in walked an EMT-B student from a local “technical Institute”. This was a new program, before this last fall semester, if you wanted to be an EMT-B you had to enroll at one of the community colleges, but now you can go do a 3 month class with NO EMS RIDE TIME. Their clinicals consisted of 2 8 hour ER shifts(at a heart hospital, not even a trauma center, which we have 2 of). This made me sad. I mean, we need to pushing more of our training into formalized education. That way people who want to do it and make a career out of it are taught to invest in their education. It seems like a step backwards to take a college level program like mine where my Paramedic instructor is not only a 22 year veteran of EMS but also has her Master's in Education, and start offering something that offers little more in the way of commitment and effort as a lifeguard class at the local YMCA.

    Perhaps, maybe this plays into a larger healthcare discussion, if we get paid more, our services will cost more to the people we serve, and while unfortunately(IMO) we don't live in a society that sees healthcare as a right, it would pain me to see more anguish caused to my patients because of financial distress from a larger ambulance bill. And Maybe Mark(@UKMedic999) can answer this, but do Paramedic make more in a universal system?

    Also, I believe you can get a Bachelors Degree in EMS from a handfull of schools… in fact doesn't The Happy Medic have a BS?Can you confirm there are some BS EMS degrees out there, because I'm not sure.

  • Robert

    It's a US thing in general. Over here in Ontario, Canada, police, fire, and ems all make around 70-80k per year.

    • Lm

      That’s only in parts of Ontario – the rest of Canada pays far less.

      • ckwarren

        I work in Saskatchewan and our provincial pay scale has EMT-P/ACP pulling in over $85k after only 5 years.

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  • Robert

    It's a US thing in general. Over here in Ontario, Canada, police, fire, and ems all make around 70-80k per year.

  • Prayingmedic

    Good article, thanks for doing the research on wages, etc. I worked in the Midwest as a paramedic for years. I made a little over minimum wage. Looking at bankruptcy, I bailed and moved to the pacific northwest. Wages here are much better. I work for a private company in Tacoma, Wa. (Rural Metro) and I make about $63,000 a year. I''m at the top of our pay scale. I never work overtime. I worked Fire – based EMS for a while but hated the politics. Private industry is way less stressful in my opinion. It does seem rather crazy how little EMS folks are paid in some parts of the country. FDNY is one example – low pay, and worked to death.

    Unfortunately, I don't see things getting better. The banking collapse created the housing collapse, which created a tax shortfall and now many municipalities are looking to cut costs everywhere they can. Including EMS jobs and wages. On the bright side, the proposed healthcare bill in congress should make insurance companies rich. Don't get me started….

    If money is important, consider re-locating to a place where the pay is respectable. There are a few places like this; not many, but a few.

    Finally – Some of us would do well to ask why we're doing this job in the first place.

    Is it money?

    Is it pursuit of knowledge?

    Is is a journey to find self-respect?

    Is it glory for ourselves?

    Or is it really to heal those who are sick and injured?

    If you picked the last one, check out my blog. This post might be a place to start looking for answers:
    http://mobileintensiveprayerunit.blogspot.com/s

    thanks,
    Dave

  • Prayingmedic

    Good article, thanks for doing the research on wages, etc. I worked in the Midwest as a paramedic for years. I made a little over minimum wage. Looking at bankruptcy, I bailed and moved to the pacific northwest. Wages here are much better. I work for a private company in Tacoma, Wa. (Rural Metro) and I make about $63,000 a year. I''m at the top of our pay scale. I never work overtime. I worked Fire – based EMS for a while but hated the politics. Private industry is way less stressful in my opinion. It does seem rather crazy how little EMS folks are paid in some parts of the country. FDNY is one example – low pay, and worked to death.

    Unfortunately, I don't see things getting better. The banking collapse created the housing collapse, which created a tax shortfall and now many municipalities are looking to cut costs everywhere they can. Including EMS jobs and wages. On the bright side, the proposed healthcare bill in congress should make insurance companies rich. Don't get me started….

    If money is important, consider re-locating to a place where the pay is respectable. There are a few places like this; not many, but a few.

    Finally – Some of us would do well to ask why we're doing this job in the first place.

    Is it money?

    Is it pursuit of knowledge?

    Is is a journey to find self-respect?

    Is it glory for ourselves?

    Or is it really to heal those who are sick and injured?

    If you picked the last one, check out my blog. This post might be a place to start looking for answers:
    http://mobileintensiveprayerunit.blogspot.com/s

    thanks,
    Dave

  • Prayingmedic

    Good article, thanks for doing the research on wages, etc. I worked in the Midwest as a paramedic for years. I made a little over minimum wage. Looking at bankruptcy, I bailed and moved to the pacific northwest. Wages here are much better. I work for a private company in Tacoma, Wa. (Rural Metro) and I make about $63,000 a year. I''m at the top of our pay scale. I never work overtime. I worked Fire – based EMS for a while but hated the politics. Private industry is way less stressful in my opinion. It does seem rather crazy how little EMS folks are paid in some parts of the country. FDNY is one example – low pay, and worked to death.

    Unfortunately, I don't see things getting better. The banking collapse created the housing collapse, which created a tax shortfall and now many municipalities are looking to cut costs everywhere they can. Including EMS jobs and wages. On the bright side, the proposed healthcare bill in congress should make insurance companies rich. Don't get me started….

    If money is important, consider re-locating to a place where the pay is respectable. There are a few places like this; not many, but a few.

    Finally – Some of us would do well to ask why we're doing this job in the first place.

    Is it money?

    Is it pursuit of knowledge?

    Is is a journey to find self-respect?

    Is it glory for ourselves?

    Or is it really to heal those who are sick and injured?

    If you picked the last one, check out my blog. This post might be a place to start looking for answers:
    http://mobileintensiveprayerunit.blogspot.com/s

    thanks,
    Dave

  • Prayingmedic

    Good article, thanks for doing the research on wages, etc. I worked in the Midwest as a paramedic for years. I made a little over minimum wage. Looking at bankruptcy, I bailed and moved to the pacific northwest. Wages here are much better. I work for a private company in Tacoma, Wa. (Rural Metro) and I make about $63,000 a year. I''m at the top of our pay scale. I never work overtime. I worked Fire – based EMS for a while but hated the politics. Private industry is way less stressful in my opinion. It does seem rather crazy how little EMS folks are paid in some parts of the country. FDNY is one example – low pay, and worked to death.

    Unfortunately, I don't see things getting better. The banking collapse created the housing collapse, which created a tax shortfall and now many municipalities are looking to cut costs everywhere they can. Including EMS jobs and wages. On the bright side, the proposed healthcare bill in congress should make insurance companies rich. Don't get me started….

    If money is important, consider re-locating to a place where the pay is respectable. There are a few places like this; not many, but a few.

    Finally – Some of us would do well to ask why we're doing this job in the first place.

    Is it money?

    Is it pursuit of knowledge?

    Is is a journey to find self-respect?

    Is it glory for ourselves?

    Or is it really to heal those who are sick and injured?

    If you picked the last one, check out my blog. This post might be a place to start looking for answers:
    http://mobileintensiveprayerunit.blogspot.com/s

    thanks,
    Dave

  • sclark

    i have had over a yr of college and have been in the medical field for 8 yrs. but decided to get my emt-b. i am now making $8.00 an hr! i love this job, but don’t know if i want to continue on with my medic or finally get certified in surgery. it is hard enough being a single mom of 3 and you can do what you love because you can’t pay your bills!! and  it’s so aggravating when fast food workers make more than you!

  • http://www.joomla-web-developer.com joomla developers

    This is a great article. I am pretty much impressed with your good work.You put really very helpful information. Keep it up.

  • cJackson

    I’ve worked several different types of jobs growing up. I’m 23 now and never, I repeat never thought I would finish medic school and be making 12 bucks an hour. For one, jobs that required you to use your professional impression to make your own judgement call paid more by far. For EMS, this is not the case what so ever. I shouldn’t have to explain any further. lol… But I love the job and hope one day I can volunteer for a natural disaster or something. Dedicate my time to help else where, as long as I can get a plate of food and a warm bed to sleep in, maybe a cig before I go to bed.

  • cJackson

    Its hard to find on the web… But there’s a group of ppl trying to push for a NEW medic! Advanced paramedic. More schooling of course… But with more schooling comes more pay.. cough cough RN

  • http://firefighterparamedicstories.blogspot.com/ FireMedic

    I remember working on the private side of EMS and feeling this way. Thankfully, I’m in no position to gripe about it any more. Here in the western US we seem to be paying a little more but it’s still way below what it should be for what we do.

  • http://www.paramedictrainingspot.com/ Alex

    This is such a serious and sensitive topic.  As much work goes into paramedic training–clinical, field internships, let alone the didactic instruction–you would think that paramedic salary would be higher.

    Granted, school is not as lengthy (or expensive) as becoming a doctor.  But, the responsibilities (in a overarching sense) are the same: You’re often responsible for saving someone’s life–or at least, keeping them sustained while you transport them to a nurse at the hospital.

    I don’t want to get into a long diatribe about Hollywood actors getting paid millions, or ball players having obnoxious contracts.  I’ll just say that there’s absolutely no reason why a profession as honorable and sorely needed as that of a paramedic doesn’t get the financial compensation that other jobs do.  That’s not to say that other people in other professions don’t work hard.  Surely they do.

    But the world, quite literally, needs EMS professionals.  As much as we love sports, we don’t need guys who can shoot a basketball in the NBA or drive a car at high speeds around a track in NASCAR.

    Anyway, great article.

  • PCP.ON

    Not only in Ontario… In Alberta and Sask. they pay very well for ‘medic. Ontario has higher taxes too…and a higher burn out rate. In Toronto they’re 200 paramedics short of reaching goal-projected call volume to be met, but they need another 200 or so to fully achieve good status. Corrupt city it is. They cut social programs and the councillors increase their salaries while they cut jobs.

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Chris Kaiser aka "Ckemtp"

I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.

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  • Comments
    mr618
    Welcome to the Club
    Well said, Chris. We can't save everybody, but the ones we don't save tend to stick around a lot longer than the ones we do save.
    2014-10-18 14:40:00
    Steel City Medic
    Welcome to the Club
    Particularly appropriate for me this week. Thanks.
    2014-09-23 21:46:00
    DiverMedic
    Welcome to the Club
    Very well done, Chris.
    2014-09-17 22:15:00
    DiverMedic
    My Blogroll
    One of these days you'll figure out where my blog is... :)
    2014-09-17 22:11:00
    emtterri123
    Six Tricks You Can Use Today to Improve Your EMS Narrative Report
    The first and best way to get people reading you to think that you are an idiot is to pepper your writing with spelling and grammatical errors. It makes you look dumb. - Me thinks this should have been restructured as it does not flow and caused me to reread it several times. lol :)
    2014-09-17 08:27:00

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