Would you like EMS with that?

“Welcome to Ambulance Service, May I take your order?”

“Owwww…. Uggh… <gurgle>”

“Oh! I see that you’ve chosen the Multisystem Trauma with a side of Airway Compromise. Excellent choice Sir! That comes with complimentary splinting and bandage application along with spinal precautions. Would you like etomidate and succinylcholine with your airway management today?”

“Sir?”

“Sir? If you don’t answer me I will have to get a manager. There are other people in line too, ya know.”

Unless you’ve been living in a cave or haven’t checked Facebook lately, which is the contemporary version of the same thing, you’ve probably heard of the “national” fast food strike. You know the one, where fast food workers “across the nation!” are striking for better wages and better hours. Most of them, you see, are incensed about the legitimate difficulty of surviving on a minimum wage income and have come to demand a “living” wage of $15.00 per hour.

I’m not going to get into the nuts and bolts of the issue. I’m sure it’s exceedingly hard to survive on minimum wage and I’m absolutely certain that it would be terribly hard raising a “family of four” on minimum wage-level earnings. I’m certain that it’s much harder indeed doing so in an area with a higher cost of living or where amenities like public transportation are lacking or are not available. I’d be willing to say that it has to be a hard-knock life indeed for folks unfortunate enough to have to support themselves or their families solely on one minimum wage job as a burger flipper. My condolences to those who can aspire to no more than that for whatever valid reason, you’ve all got it pretty hard.

I’m also not going to weigh in on the side of the franchise owners, who despite the corporate image are mainly small business owners who don’t share in the overall profits of the corporations they represent and pay the exact dollar amount they need to in order to keep employees in their businesses slinging burgers at their customers. I’m sure they have it hard too. I’m sure their employee turnover is a nightmare and that they have severe problems even getting employees to show up for work, let alone work when they get there.

While any of my own opinions I put up on this issue will undoubtedly be lost amongst the bloviating of the political chorus, I will refrain from stating my opinions on the capitalistic system, supply and demand, and labor relations.  I will however link to my friend Cracked.com’s excellent (if a little salty) article on working in fast food joints for your reference and enjoyment: The Five Worst Things You See While Working in Fast Food

Are ya back? Great. Now consider this:

Percentile

10%

25%

50%
(Median)

75%

90%

Hourly Wage

$9.70

$11.81

$14.91

$19.56

$25.74

Annual Wage (2)

$20,180

$24,560

$31,020

$40,680

$53,550

Source: US Bureau of Labor Statistics May 2012 Occupational Employment and Wage Statistics for Emergency Medical Technicians and Paramedics – http://www.bls.gov/oes/current/oes292041.htm

That right there is the table showing the statistical wage estimates for all EMS Provider levels in the United States of America collected in May of 2012. The data is useful simply as a top-level view, but admittedly doesn’t take into account a lot of the aspects of the EMS profession as provided by different licensure levels in different areas of the country. Interestingly, when you look at the page data you find that the Chicago area in Illinois has the highest paid paramedics in the country which is weird… because that’s close to where I live and I’ve never made nearly that much but I digress.

We’ve been talking about paramedic and EMT wages on this blog for… a long time. Heck, here’s a post I wrote four years ago with statistics related to EMS pay with some salary comparisons for different job classifications. The numbers, I presume, have changed (I hope!) but it’s still valid data for the time: “Why Does Being a Paramedic Seem So Worthless Sometimes?” Since that data is old, I’m going to pick a random zip code close to where I am located as I write this and check three salaries from www.Salary.com:

Occupation

10%

25%

50%

75%

90%

Paramedic

$30,799

$34,785

$39,164

$44,595

$49,540

EMT-Basic (EMT)

$23,842

$27,383

$31,271

$36,074

$40,446

Fast Food Cook

$13,549

$15,987

$18,665

$22,143

$25,310

 

There’s a definite disparity there between what the 50th percentile fast food cook makes as compared with the EMT. However, when you take into account the fact that most fast food workers don’t quite put in 40 hours per week as opposed to the… probably more than 40 hours per week put in by darn near every EMT or paramedic and the wage seems to equalize. I’m not going to get into the differences in job responsibilities between the professions *ahem* I mean, “job titles” represented above, but I will say that the Federal Poverty Level for a family of four in the US in 2013 is this:

 Household Size

 100%

 133%

 150%

200% 

 300%

400% 

 1

$11,490

$15,282

$17,235

$22,980

$34,470

$45,960

 2

15,510

 20,628

23,265

  31,020

46,530

62,040

 3

19,530

 25,975

29,295

  39,060

58,590

78,120

 4

23,550

 31,322

35,325

  47,100

70,650

94,200

 5

27,570

 36,668

41,355

  55,140

82,710

110,280

 6

31,590

 42,015

47,385

  63,180

94,770

126,360

 7

35,610

 47,361

53,415

  71,220

106,830

142,440

 8

39,630

 52,708

59,445

  79,260

118,890

158,520

 For each additional person, add

$4,020

 $5,347

$6,030

  $8,040

$12,060

$16,080

Source:  http://www.familiesusa.org/resources/tools-for-advocates/guides/federal-poverty-guidelines.html

Interesting Fact: A single person qualifies for food stamps in Illinois (The SNAP) if they make less than $14,532 per year. A family of four qualifies if they make less than $29,976 per year (Source)

Heck, at two of my previous ambulance jobs (One was the very one I worked at when I wrote the article about paramedics being worthless) we dropped to minimum wage for the last 8 hours of our 24 hour shifts and only got paid our full wage if we went out on a call. I’m glad to say I don’t work for either of them now. They were good services, but they paid us terribly.

This “Nationwide Fast Food Strike,” which seems to have been brought on by a sample budget printed by McDonalds in order to show their employees how to live on their wages, has got me thinking. If fast food workers can get the attention of the national media focused on their wages and make it a political issue/distraction du jour for their benefit… why can’t EMS workers do the same? We probably all agree that EMS Pay Sucks, especially in smaller communities, but even though myself and many others have been writing, speaking, and doing our best to trumpet the issue we can’t seem to get anywhere near the attention that has been focused on your corner burger joint.

I’ve got an idea though.

I used to tell my partners that a patient needed a “Full Tune-Up and Lube Job” when they required the Advanced Life Support foundation treatments of an IV line, a cardiac monitor, a 12-lead EKG, and some oxygen. A trauma patient needing spinal immobilization would be “Put up on the rack” when we put them on a backboard. However, with the recent attention focused on the fast food employees I think I’ll change my vernacular to include “Would you like ALS with that?” to signify the same thing. CPR and Airway Management can become our Extra Value Meals and if we include medications and a shock or two we can call our care “Supersized.” Maybe we’ll never be able to shake off the things in our profession that keeps our wages so terribly low, like the chicken-or-the-egg battle that comes up when discussing how increased educational standards might increase our pay vs. increased pay being needed to make additional education worth something… but we might just be able to piggyback upon the success of our greasy brethren.

So… is anyone up for a burger? They might be on to something here

  • Dustin

    If fast food workers get $15.00 an hour I may quit EMS and get a job working behind the fast food counter. I wouldn’t have to worry about continue education hours. I would be able to sleep each night in my own bed without the fear of my pager waking me at 3 am to take care of someone who has been sick for the past week. I could screw up an order and no one loses their life over it. No lawsuits just offer them a hot apple pie for their food being late. I think the EMS associations should demand higher wages for EMS workers in the country. Not all EMS workers are union members most are private ambulance employees doing the same job as the firefighters who have to take their turn in the ambulance who are getting paid $60 grand a year because they have the IAFF backing them. Most private ambulance employees are making just slightly more than minimum wage and work at least 72 hours a week not to mention that most EMS workers have a part time job to make ends meet. We should not have to work 90 hours or more a week just to keep a roof over our heads. It is dangerous to work that many hours a week with a lack of sleep. Itnis dangerous to the worker and to the community which we serve.

  • DWallace

    One of the reasons, in my opinion the primary reason, EMS professionals do not make the money they should is because of the system design. Think about this, the only time most EMS services generate income is when they are transporting a paying patient. We need to find other ways to generate revenue for the services that employ us. How do we do that? This is usually legislative and will apply more to Paramedics than to EMTs. We need to expand the scope of Paramedic care to allow for revenue generation apart from transports only. Second, we are behind the ball right now with expanded levels of education and licensing. We need to push for Advanced Practice Paramedics that would be able to operate under a physician with the same scope as Nurse Practitioners. All of this will contribute to higher wages and more mobility within the profession.

    • Aflac-Medic

      The only difficulty with “other revenue streams” is that it’ll never work. Our pay is determined by the insurance companies, all of whom use Medicare as their guide. Medicare defines EMS as a transportation service, and therefore sees the only “billable” portion of our jobs as the actual transport. No ride, no cash. That person I pushed D50 on who signed the waiver? Not a penny will leave Blue Cross’s bank account and into mine. That “chronic cough” patient the Advanced Practice Paramedic wrote an inhaler prescription for? I bet that they’ll fall under the same curse. Before we can change how EMTs and medics are paid, we need to change how insurance companies and patients pay us.

      • Medic mike

        I’ve been saying this for yrs. we need lobby folks to work on the insurance companies.

        • Phil

          Should you be paid to sit around? I’m a critical care paramedic that is paid on call. Why? I’m also a master auto tech that makes $60K a year. As a mechanic I am paid by the job and bonuses for doing the job efficiently. While working as a mechanic my efficiency is constantly charted. For the last 5 weeks, my average has been 123%. I am paid accordingly.

          As a paramedic I am paid hourly. If you take into account the hours I work and the time I actually spend on a call, I am at 14% efficiency. Why should the system pay any more than they do for a job that is so inefficient?

          As an Assistant Chief, I can say that if you want to be paid what you think is right, you better be putting out some work. Working on a Fall prevention program, giving flu shots, working as a Community provider or something. I’m certainly not going to be paying a person $20 an hour to play Wii.

          • Josef P Melech

            I’m glad you are able to work as a master mechanic in your down time. Unfortunately the agency I worked at when i first finished my BS in Emergency Medical Technology, expressly prohibited moonlighting. If we were caught in an outside job, even in our off hours, their reasoning we were on call when not on duty, we would be automatically terminated.

            I have talked with other EMT/P’s and they tell me the same thing, 90 hr work weeks, no sleeping on down time, and no moonlighting.

            With these facts present, there would be no way we could make 60k a year where we are paid on efficiency. Instead, we get paid whatever the service wants, with no opportunity for working other jobs.

            As a note, the agency i worked at fired a guy because they considered his volunteering as a disaster responder with the American Red Cross as moonlighting.

            You have it lucky, most of us don’t.

          • Jdmedic

            I agree whole heatedly. I have advocated for years that we need to do more in our communities. We bitch when we show up at the senior citizens complex and there is no med list and/or nobody can give an accurate PMH. How much time and effort would it take to make a regular visit and help the people put together this information? From a selfish standpoint that would make our jobs easier. From a compassionate view it’s simply the right thing to do. Just one example. Anyone else have ideas?

          • Matthew Daniel Watkins

            If the only thing your company has to do for work is playing Wii then I want my full pay, how is that my problem and not the companies? If I am on company time, waiting for a pager to go off, on time and dressed professionally, as well as away from my family and giving my freedom away for money….I want my pay. If a company doesn’t have anything for me to do, that’s there problem besides the point that I am doing something by being there dressed and ready for action. That’s why you pay me.

      • DWallace

        You bring up a good point but one I have considered. It is actually a combo-type deal. It is not unlike what nursing has and since it is not a new concept it will be easier for insurance to migrate over. I am running for the House of Representatives in Arkansas next year. If elected, this will be one of my primary issues and feel it will pass the Legislature easily. I already have a lot of support for it with those who already hold office. It may still take a few years to iron out all the details for APP but expanded scope of care should be done quickly.

  • emtp82

    We are currently experiencing a dramatic turnover at one of the agencies I work. 35% in a month. The response from the owner? Are shifts/vacancies filled? good business as usual and at a lower payroll.

  • Jana

    I’m a RN. Went through many years of education and training to do what I do. I will admit that nurses make more money than an EMT. But, EMT’s do a lot more life saving than the average nurse. We get to take care of them once the EMT saves their lives. Nurses don’t have to be ACLS certified to work but a paramedic does. It sucks that EMT’s and Paramedics are the first to respond in a life saving situation and don’t make that much money. I say if the burger flipper wants more money go to school and earn it. If an EMT/ Paramedic charges tips to each sorry, ungrateful person they save from death then maybe they will get the respect they deserve

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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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