EMS Pay Sucks! Let’s do something about it

Weíre gonna have ourselves a little Audience Participation Exercise.

This whole blogging thing is a pretty intimate relationship, isnít it? I mean, you all have your favorite bloggers that you regularly read and Iíd be quite honored if youíd count me among them. I write straight from the front of my ambulance and Iíve been repaid by all of you for it by your sheer act of coming to read what I have to say. I rarely hold anything back from your eyes, and this is no exception to that rule.

So please, dear reader, humor me for a bit here while I pull you in to a pretend scenario. Iím a rural Midwestern guy and like any of my peers I like my dive bars. Of course, Iím a family man and I try to be a good one so I donít frequent them very often anymore, but the one thing that Iíve always liked about them is the conversation that develops centered around the non-formal atmosphere that they hold. Itís pretty intense most times, usually brutally honest, and always entertaining as all get out. Everybodyís equal with a can oí PBR in their hand. (or, diet pepsi for the young folk as weíre a family establishment) (no swearing either) (well, not much).

So let me invite you to the ďLife Under the Lights Bar and GrilleĒ. Coming soon to this little blog of mine is the beginning of my crusade to kick the current EMS pay rates and system thereof squarely in the behind. Iím frankly, mad as heck and Iím not going to take it anymoreÖ well, at least as blogging is concerned as I still have to make a living, you know. Donít get dressed up, come as you are, and letís have a spirited conversation about why EMS people make such crappy money for doing what we do. Iíve got enough ideas on this topic to carry me through a few evenings of my wooden ďfree drinkĒ nickels and Iíd love to share some brutally honest conversation with the EMS folks in my audience that I think can make a difference in the quality of life for those who save lives. We need to, we have to, and we deserve to.

On duty personnel will be limited to a three-drink-maximum, as long as itís coffee or a soft drink of their choice. We are consummate professionals, you know.

Starting tomorrow Iím going to be writing a few good rants on this topic. Iím holding back tonight because well, coffee lends itself to more coherent writing than does late night camaraderie enhancement beverages. However, if you all would do me the honor of getting started by reading the following posts of mine:

Read this too if you want to get mad:

http://www.bls.gov/oes/current/oes292041.htm – The US Bureau of Labor Statistics Paramedic Salary page

————————

I’m turning this into a 5 or 6 part series, so here they are:

EMS Pay Sucks!! (part 2): Identifying the Problem

EMS Pay Sucks!! (part 3): Who or What is at Fault here?

  • http://twitter.com/theHappyMedic the Happy Medic

    When I didn't like the pay and system I was in we tries to change it and fight for better salaries but nothing worked. So I started looking around for what I did want. I found it, prepared, studied and ran morningand night to get in shape.
    Then we loaded up a half broken uhaul and drove 26 hours to our new start.
    I now make a more than fair salary in a world class City. The trade off? More often than not we're earning that salary, not just collecting it, but I love working for a living. I don't want handouts but many folks across the country in my particular international organization don't see the writing on the wall and demand higher salaries no matter what.
    I look forward to your thoughts and suggestions CK!

  • http://twitter.com/theHappyMedic the Happy Medic

    When I didn't like the pay and system I was in we tries to change it and fight for better salaries but nothing worked. So I started looking around for what I did want. I found it, prepared, studied and ran morningand night to get in shape.
    Then we loaded up a half broken uhaul and drove 26 hours to our new start.
    I now make a more than fair salary in a world class City. The trade off? More often than not we're earning that salary, not just collecting it, but I love working for a living. I don't want handouts but many folks across the country in my particular international organization don't see the writing on the wall and demand higher salaries no matter what.
    I look forward to your thoughts and suggestions CK!

  • http://www.firegeezer.com Mike "FossilMedic" Ward

    Happy:

    A typical functioning alcoholic response, a geographic change. :)

    I did the same thing in my second career, leaving a community college job I greatly enjoyed that paid LESS than the starting salary of a local firefighter/paramedic. My move was a 12 mile one-way commute change.

    Like you, I am working harder at the university than I did at the community college. There are higher expectations and requirements.

    Your comment about your international association is a point in an article I am working on now.

    But, to get back to CK's point, how do we improve the pay if we cannot drive 26 hours (or 12 miles) to a better paying situation?

    Mike

  • Pingback: EMS pay sucks | Firegeezer

  • msparamedic

    *raises glass*

    I'm here with you, buddy. My ex works in a kitchen and makes $.50 less than me. What is that? I know that personally, I do not have a family that I'd have to move hours and hours away- but I'm still not in a position that I could do that. Don't we deserve more than a salary *just* over the poverty line? I think so. Sorry for my rant.

    MsP

  • http://twitter.com/firehat firehat

    EMS is caught in a no-man's land that prevents it from reaping the benefits of either the fire service or the professional healthcare fields.

    You either have to improve your education requirements and expectations (on par with RN's if you want that money) or pick up a heck of a lot more organization, depth of expertise (i.e., get on the 'all hazards' train), and more pride in the job.

    Not just in my own agency but pretty much everywhere I look I see a disturbingly high proportion of paramedics who are fat slobs with wrinkled uniforms untucked and running dirty trucks. These same people, as you've pointed out, have only a certificate from, at best, a community college. They wouldn't know the first thing about tech rescue, hazmat, terrorism, or any of the other things firefighters do.

    So what I see is a field that constantly complains about lacking the respect given to law enforcement and fire AND the respect given to nurses. Yet that same field doesn't do anything to mirror law enforcement and fire (ranks and paramilitary organization with discipline and an all-hazards approach) or nursing (academic degrees).

    I know some people who take EMS very seriously who are very professional about it but they're the exception.

  • joefirefighter

    Why does EMS pay suck?

    Because we are not seen as a professional service, there are dozens of people that will accept the low pay, there is a really low bar to enter this vocation, there are plenty of people and ambulance sevices that will provide the service at a lower fee/salary scale, one county in NJ had a job training program that trained EMTs using urban jobless people…

    I live in the great state of NJ where there are over 400 volunteer EMS units and dozens of small – 10 truck or less – transport companies. In one town the paid EMS is being killed in favor of a private company that is owned by a relative of a town politician.

    Why does EMS pay Suck?

    There are a lot of reasons.

  • Chief_RamblingChief

    I hear ya loud and clear. It is pretty sad that since EMS first started taking hold in the '70's and '80's, the pay for EMTs and paramedics has held steady…. really steady.

    When I used to work as an EMT in the 80s and early 90s, the EMT attendant was paid 25 cents above minimum wage, and the EMT driver was paid 75 cents above minimum wage.

    Pretty sad to see it is continuing. We've got your back.

  • http://twitter.com/firehat firehat

    EMS is caught in a no-man's land that prevents it from reaping the benefits of either the fire service or the professional healthcare fields.

    You either have to improve your education requirements and expectations (on par with RN's if you want that money) or pick up a heck of a lot more organization, depth of expertise (i.e., get on the 'all hazards' train), and more pride in the job.

    Not just in my own agency but pretty much everywhere I look I see a disturbingly high proportion of paramedics who are fat slobs with wrinkled uniforms untucked and running dirty trucks. These same people, as you've pointed out, have only a certificate from, at best, a community college. They wouldn't know the first thing about tech rescue, hazmat, terrorism, or any of the other things firefighters do.

    So what I see is a field that constantly complains about lacking the respect given to law enforcement and fire AND the respect given to nurses. Yet that same field doesn't do anything to mirror law enforcement and fire (ranks and paramilitary organization with discipline and an all-hazards approach) or nursing (academic degrees).

    I know some people who take EMS very seriously who are very professional about it but they're the exception.

  • joefirefighter

    Why does EMS pay suck?

    Because we are not seen as a professional service, there are dozens of people that will accept the low pay, there is a really low bar to enter this vocation, there are plenty of people and ambulance sevices that will provide the service at a lower fee/salary scale, one county in NJ had a job training program that trained EMTs using urban jobless people…

    I live in the great state of NJ where there are over 400 volunteer EMS units and dozens of small – 10 truck or less – transport companies. In one town the paid EMS is being killed in favor of a private company that is owned by a relative of a town politician.

    Why does EMS pay Suck?

    There are a lot of reasons.

  • Chief_RamblingChief

    I hear ya loud and clear. It is pretty sad that since EMS first started taking hold in the '70's and '80's, the pay for EMTs and paramedics has held steady…. really steady.

    When I used to work as an EMT in the 80s and early 90s, the EMT attendant was paid 25 cents above minimum wage, and the EMT driver was paid 75 cents above minimum wage.

    Pretty sad to see it is continuing. We've got your back.

  • Enlightened

    Hmmm… Why does EMS pay suck? Well I guess that boils down to what you are being paid, and how you are required to perform. But if I had to put my two sense in. From 18 years of fire/ems service, I think we became a generation of ME!

    I have erased many paragraphs in this post. And the one point it boils down to is that:

    1. We no longer have each others backs; it is every person for themselves.
    2. We train to train.
    3. We have allowed organizations, and policies to dictate our pay, and competence.

    My dark side says the answer is a two day national sick out. But the lighter side of me says we kick out these idiots who have these pretend Bull Sh*t degrees.

    Bottom line is EMS pay sucks because we and management make us blue collar! Until we are recoginized as true professionals (Doctors, Lawyers, IT Professionals), no matter how much collar brass you have. You will always be considered a commodity!

  • Enlightened

    Hmmm… Why does EMS pay suck? Well I guess that boils down to what you are being paid, and how you are required to perform. But if I had to put my two sense in. From 18 years of fire/ems service, I think we became a generation of ME!

    I have erased many paragraphs in this post. And the one point it boils down to is that:

    1. We no longer have each others backs; it is every person for themselves.
    2. We train to train.
    3. We have allowed organizations, and policies to dictate our pay, and competence.

    My dark side says the answer is a two day national sick out. But the lighter side of me says we kick out these idiots who have these pretend Bull Sh*t degrees.

    Bottom line is EMS pay sucks because we and management make us blue collar! Until we are recoginized as true professionals (Doctors, Lawyers, IT Professionals), no matter how much collar brass you have. You will always be considered a commodity!

  • Pingback: EMS Pay Sucks!! Part 2 – Identifying the problem | Life Under the Lights

  • Gerald Woodruff

    There are many good comments about why EMS pay sucks. I agree. I know that this comment will not be popular but in essence the problem with EMS pay is that it is a microcosm for society and not of the police or fire fields.

    Police and fire have a deep structure honed over the years to develop whereas the EMS fields are relatively new comers. The fire and Police careers have a structure that at minimum normally has the rank and file and then the officer structure. The EMS field has rank and file divided between MFR, Basic, Specialist, Paramedic (at least in Michigan). They then may have supervisors, and a Director, and not much else. The Directors get a higher pay that could be between 50- 75,000 a year and the paramedic may get between 10-15 an hour.

    To make up the dirfference the rank and file work overtime, they may work between 48, 72, or 96 hours a week that gives them a comensurate salary but a dissproportionate hour worked. Mind you I can only speak of my area and am not speaking even State wide.

    I am on the board (unpaid) of two ambulance companies. I have tried over the years to limit the overtime by offering a higher wage at less hours. As a company, we cannot pay $25 dollars an hour for 72 hours a week pay. Medicare and Medicaid dictate what our compensation is on a call. An ambulance can cost up to $100,000 dollars and the equipment price, supplies, maintenance, mike fees, operational fees dictate that we must make money to
    remain viable as a company. About 5 years ago I proposed that we set up a schedule similar to the fire service with wages that would compete in our depleted economy. Basically they would work 9 days a month and receive $45,000 a year.

    Well, it failed. The rank and file refused this type of schedule because they could make more money if they worked 72 hours instead of 40 hours. They complained they would have to go out and get another job to make up the difference.

    Most of the rank and file that hire into our service demand 72 hours a week or they hire into our competitors. I continually see the negative consequences of this schedule in the burnout of these employees. It appears that we are giving our rank and file a shelf life. A question that arises that has not been addressed is; “Why are classes constantly putting out paramedics and EMT's and companies are begging for more.” It is the constant turnover of employees. Look at the companies in our area that are constantly hiring, training using, and then starting the process all over again.

    In our area we are in competion with the other agencies in our area, We do not get millage money from the county, like the police, fire do. We are solely supported by the monies earned from runs. Yes, we as a company make if you will a profit, that profit is plowed back into the company for its expenses and capital improvement that is necessary for the viability of our company. Our agency is about 40 years old, if we want to see 50 we have to run as a business. The wages we pay are low, it is a shame. In our area, with the economy and the overtime our rank and file are on top of the food chain when you factor in that they basically are working two jobs a week. The per hour wage is low but the overtime makes the difference. Consider this, if I lower the hours I have to increase the manpower, If I raise the hours, I have to decrease the manpower. I do not see this changing at present and any changes that will be made will take time and a different way of thinking about the service. If we are not a company then those that are making this money do not get it.

    Over the past several years there has been talk of consololdation of the different services. This will increase the manpower but will drive down the wages. Operational costs are pretty much a constant but wages are the ripe pickings in today's society.

    I can only speak of the area that I work in in and do not say that I can speak for all. I may be way off base when you consider fire based EMS or big city EMS as I am in a more or less smaller setting. If change will come, more education and training or certification will not be the factor that changes the wage settings, it is going to be a lifestyle change. There was a comment that if we were trained to the level of an RN then we would get RN wages is not true in my opinion. If my well holds 5 gallons of water for 5 people then I will get a gallon of water. If my well holds 1000s of gallons of water with 100 people then I can get ten gallons of water. The people that use our services are being hit and hit hard, Retirees who have earned pensions for service are now finding themselves trying to stretch every dollar. There are elderly that instead of taking meds once a day are taking them every other day or not at all as the price increases.

    The voice of EMS is getting lost in society. Having said that I personnally feel the all EMS workers are underpaid. The work, the danger, and the long hours should be better compensated. On the other hand when a paramedic runs maybe 7 calls in a 24 hour shift (see I told you we were smaller), I also have found it difficult to get them to clean up after themselves, restock their rigs, and generally to do anything other than take the calls that they are assigned.

    From a supervisor's stand point, a call may last one and a half hours. This means that they are actually working ten and a half hours a day and not doing anything for thirteen hours a day. Should I be concerned when the rig is dirty, unstocked and the base is a mess, the shoot times are askew and then have some of those same people say, “I need to have more pay and improved working conditions.” Yes, you do need more pay but unless the circumstances change in funding the well is dry. Both sides have merit and there are many dedicated, hard working EMS people out there that do not get what they deserve. Change I fear will be slow and will occur over the resistance of all concerned. Now my turn for a cup of coffee.

  • http://twitter.com/firehat firehat

    Are you arguing against higher education in EMS and then, in the next paragraph, complaining about being characterized as blue collar?

  • Gerald Woodruff

    There are many good comments about why EMS pay sucks. I agree. I know that this comment will not be popular but in essence the problem with EMS pay is that it is a microcosm for society and not of the police or fire fields.

    Police and fire have a deep structure honed over the years to develop whereas the EMS fields are relatively new comers. The fire and Police careers have a structure that at minimum normally has the rank and file and then the officer structure. The EMS field has rank and file divided between MFR, Basic, Specialist, Paramedic (at least in Michigan). They then may have supervisors, and a Director, and not much else. The Directors get a higher pay that could be between 50- 75,000 a year and the paramedic may get between 10-15 an hour.

    To make up the dirfference the rank and file work overtime, they may work between 48, 72, or 96 hours a week that gives them a comensurate salary but a dissproportionate hour worked. Mind you I can only speak of my area and am not speaking even State wide.

    I am on the board (unpaid) of two ambulance companies. I have tried over the years to limit the overtime by offering a higher wage at less hours. As a company, we cannot pay $25 dollars an hour for 72 hours a week pay. Medicare and Medicaid dictate what our compensation is on a call. An ambulance can cost up to $100,000 dollars and the equipment price, supplies, maintenance, mike fees, operational fees dictate that we must make money to
    remain viable as a company. About 5 years ago I proposed that we set up a schedule similar to the fire service with wages that would compete in our depleted economy. Basically they would work 9 days a month and receive $45,000 a year.

    Well, it failed. The rank and file refused this type of schedule because they could make more money if they worked 72 hours instead of 40 hours. They complained they would have to go out and get another job to make up the difference.

    Most of the rank and file that hire into our service demand 72 hours a week or they hire into our competitors. I continually see the negative consequences of this schedule in the burnout of these employees. It appears that we are giving our rank and file a shelf life. A question that arises that has not been addressed is; “Why are classes constantly putting out paramedics and EMT's and companies are begging for more.” It is the constant turnover of employees. Look at the companies in our area that are constantly hiring, training using, and then starting the process all over again.

    In our area we are in competion with the other agencies in our area, We do not get millage money from the county, like the police, fire do. We are solely supported by the monies earned from runs. Yes, we as a company make if you will a profit, that profit is plowed back into the company for its expenses and capital improvement that is necessary for the viability of our company. Our agency is about 40 years old, if we want to see 50 we have to run as a business. The wages we pay are low, it is a shame. In our area, with the economy and the overtime our rank and file are on top of the food chain when you factor in that they basically are working two jobs a week. The per hour wage is low but the overtime makes the difference. Consider this, if I lower the hours I have to increase the manpower, If I raise the hours, I have to decrease the manpower. I do not see this changing at present and any changes that will be made will take time and a different way of thinking about the service. If we are not a company then those that are making this money do not get it.

    Over the past several years there has been talk of consololdation of the different services. This will increase the manpower but will drive down the wages. Operational costs are pretty much a constant but wages are the ripe pickings in today's society.

    I can only speak of the area that I work in in and do not say that I can speak for all. I may be way off base when you consider fire based EMS or big city EMS as I am in a more or less smaller setting. If change will come, more education and training or certification will not be the factor that changes the wage settings, it is going to be a lifestyle change. There was a comment that if we were trained to the level of an RN then we would get RN wages is not true in my opinion. If my well holds 5 gallons of water for 5 people then I will get a gallon of water. If my well holds 1000s of gallons of water with 100 people then I can get ten gallons of water. The people that use our services are being hit and hit hard, Retirees who have earned pensions for service are now finding themselves trying to stretch every dollar. There are elderly that instead of taking meds once a day are taking them every other day or not at all as the price increases.

    The voice of EMS is getting lost in society. Having said that I personnally feel the all EMS workers are underpaid. The work, the danger, and the long hours should be better compensated. On the other hand when a paramedic runs maybe 7 calls in a 24 hour shift (see I told you we were smaller), I also have found it difficult to get them to clean up after themselves, restock their rigs, and generally to do anything other than take the calls that they are assigned.

    From a supervisor's stand point, a call may last one and a half hours. This means that they are actually working ten and a half hours a day and not doing anything for thirteen hours a day. Should I be concerned when the rig is dirty, unstocked and the base is a mess, the shoot times are askew and then have some of those same people say, “I need to have more pay and improved working conditions.” Yes, you do need more pay but unless the circumstances change in funding the well is dry. Both sides have merit and there are many dedicated, hard working EMS people out there that do not get what they deserve. Change I fear will be slow and will occur over the resistance of all concerned. Now my turn for a cup of coffee.

  • http://twitter.com/firehat firehat

    Are you arguing against higher education in EMS and then, in the next paragraph, complaining about being characterized as blue collar?

  • http://www.firegeezer.com Mike "FossilMedic" Ward

    Gerald:

    I great and amazing post. Thanks!

    Mike

  • http://www.firegeezer.com Mike "FossilMedic" Ward

    Gerald:

    I great and amazing post. Thanks!

    Mike

  • http://twitter.com/firehat firehat

    Maybe part of the problem is the prevalence of “for-profit” service delivery systems. I put that in quotes because I know the profit is often negligible. Police and fire services are not efficient and SHOULD NOT be operated at maximum efficiency. Emergency services are supposed to be targeted for optimal performance in a contingency. That makes them inherently inefficient when run right. When local governments want to run a fire department “more like a business” they usually just mean cutting services to a level that is dangerous 1% of the time. EMS systems regularly attempt to run “like a business” and therefore overwork and underpay their operators.

  • http://twitter.com/firehat firehat

    Maybe part of the problem is the prevalence of “for-profit” service delivery systems. I put that in quotes because I know the profit is often negligible. Police and fire services are not efficient and SHOULD NOT be operated at maximum efficiency. Emergency services are supposed to be targeted for optimal performance in a contingency. That makes them inherently inefficient when run right. When local governments want to run a fire department “more like a business” they usually just mean cutting services to a level that is dangerous 1% of the time. EMS systems regularly attempt to run “like a business” and therefore overwork and underpay their operators.

  • Pingback: EMS Pay Sucks!! (part 3) – Who or What is at fault here!? | Life Under the Lights

  • Enlightened

    No. What I was pointing out; obviously poorly. Is that these people using these degree mills, and “on-line” educations are now in charge. They are poor managers with fake alphabets after their names. Who ever heard of a four week mini-mester for a physics course? That doesn't even cover the first chapter in physics.

    I am for higher education. But it seems like everyone and there mothers have created “Universities” for fire and EMS professionals, just look in any EMS/Fire magazine. And the funny thing is allot of people fall hook line and sincker for it.

    The end result is that we are watering down what it means to have a B.S., M.S., Ph. D.

  • Enlightened

    No. What I was pointing out; obviously poorly. Is that these people using these degree mills, and “on-line” educations are now in charge. They are poor managers with fake alphabets after their names. Who ever heard of a four week mini-mester for a physics course? That doesn't even cover the first chapter in physics.

    I am for higher education. But it seems like everyone and there mothers have created “Universities” for fire and EMS professionals, just look in any EMS/Fire magazine. And the funny thing is allot of people fall hook line and sincker for it.

    The end result is that we are watering down what it means to have a B.S., M.S., Ph. D.

  • Enlightened

    No. What I was pointing out; obviously poorly. Is that these people using these degree mills, and “on-line” educations are now in charge. They are poor managers with fake alphabets after their names. Who ever heard of a four week mini-mester for a physics course? That doesn't even cover the first chapter in physics.

    I am for higher education. But it seems like everyone and there mothers have created “Universities” for fire and EMS professionals, just look in any EMS/Fire magazine. And the funny thing is allot of people fall hook line and sincker for it.

    The end result is that we are watering down what it means to have a B.S., M.S., Ph. D.

  • Enlightened

    No. What I was pointing out; obviously poorly. Is that these people using these degree mills, and “on-line” educations are now in charge. They are poor managers with fake alphabets after their names. Who ever heard of a four week mini-mester for a physics course? That doesn't even cover the first chapter in physics.

    I am for higher education. But it seems like everyone and there mothers have created “Universities” for fire and EMS professionals, just look in any EMS/Fire magazine. And the funny thing is allot of people fall hook line and sincker for it.

    The end result is that we are watering down what it means to have a B.S., M.S., Ph. D.

  • Pingback: Behind the Seams: The History of EMS, Happy Blogiversaries and More | Tactical Pants Blog

  • http://fatloss4idiots-diet.net fat loss 4 idiots diet

    See where you are interest-wise and then let the other pieces fall into place accordingly. … working as a paramedic!

  • Zzess

    It’s hard to go on strike to demand better pay if by doing so, you are seen as sub-human for not being active†while people are dying…

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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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