# IFT vs 911 Pay



## Acetone (Dec 18, 2010)

Hey everyone,

I am in the middle of an emt course and the topic of ift vs 911 pay discrepancies have come up many times.  I am located in LA county, and the word out of my instructors is that IFT pays much better than 911.  From what I'm gathering from the instructors, they say that 911 = excitement, crappy hours, crappy pay.  IFT = flexible hours (especially for part time), good pay, kind of boring.  Is this accurate?  Does IFT pay like 1.5 times what 911 would?

-Tones


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## Sasha (Dec 18, 2010)

> kind of boring.



Don't know about pay in your area, but it's only "Kind of boring" if you're too interested in the flashly lights and loud sirens to take a minute and learn from the patients you're transporting. A lot of them have fascinating stories (Like my psych who killed his wife, or the lady who'se accelerator stuck and she had a choice of running into a group of people, or into a brick wall with no airbags... Personally I'd have chosen the people.) and they're even more interesting on a medical level. You're exposed to treatments, tests, procedures and illnesses you'd never even think about on 911. 

It gives you the chance to see what happens to the people 911 brings in, long term. It gives you a chance to be exposed to diseases in all different stages. Like early dementia vs. ES alzheimers. 

911 certainly has it's merits, and I believe everyone should get experience in both, but I certainly wouldn't call IFT boring.


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## MusicMedic (Dec 18, 2010)

in La County IFT Companies generally pay more depending on the company
911's usually pay around Minimum Wage.. IFT's pay anywhere from 9.50 to 12.00/hr

IFT's are a good place to get patient exposure in a slower(for the most part)  paced enviorment.. you get good practice taking vitals/patient assesments... 
as well as learn about disease processes
They also tend to work with your schedule more often than not
IFT's can get pretty monotonous.. especially when majority of the calls consist of dialysis/hospital discharges 

i do agree with sasha though Psych calls are really fun and tend to be unpredictable.. ive picked up a few crazy patients from Jails/Private Residences/Pysch Facilities... they all have their own stories..(there are some that will spill their guts, some that wont talk to you, and some that'll wrestle/fight with you!!)  

Beware of IFT companies in LA County/LA City as there are a MILLION of them and alot of them tend to be sheisty.. so research their reputation before applying

Try to get on with a company that does both IFT's and 911 such as CARE, Gerber, AMR or Bowers(they do mainly IFT's, but have a contract or two for 911) 

hope that helps, feel free to reply here or PM more for more questions


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## terrible one (Dec 19, 2010)

Sasha said:


> 911 certainly has it's merits, and I believe everyone should get experience in both, but I certainly wouldn't call IFT boring.




Have to disagree, IFT is crazy boring! Sure you can learn a lot from the transfers you mentioned, however, IFTs in LA are mainly dialysis and SNF discharges, a lot of pts that could have done with out an ED to begin with. You can only learn so much from Mr. Smith with ESRD who you see every M, W, F. 
While I recommend doing IFTs to begin just to get basic gurney ops, driving, and hospital roles down eventually I'd move on.
As fas as pay I make $22/hr as an IFT medic. Job isn't fun but I have learned a lot and it's nice to take a break while I'm in school and have other things going on. But come end of next semester I'll take less pay to play with lights and sirens


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## Journey (Dec 19, 2010)

terrible one said:


> Have to disagree, IFT is crazy boring! Sure you can learn a lot from the transfers you mentioned, however, IFTs in LA are mainly dialysis and SNF discharges, a lot of pts that could have done with out an ED to begin with. You can only learn so much from Mr. Smith with ESRD who you see every M, W, F.



Dialysis patients are not boring in any way. In fact these patients amaze me each time one comes into the ED or hospital.  ESRD is the end diagnosis and there is a long list of initial and inbetween diagnoses that present differently depending on which system wants attention at any given time. It is amazing how some of these patients can even make it to their next dialysis visit if you look at their labs. There are some patients who dread the weekends since that means they must make it to Monday. I can not imagine what these patients must endure if your life depends on a 4 hour visit to a dialysis center 3x a week. 

Next time you transport a dialysis patient, see what the initial cause of their renal failure was. You might be surprised to find out they may have been "a save" from EMS from either an MI or a trauma. They may also had one of those fevers or UTIs that some take as a joke from SNFs which turns into sepsis requiring serious antibiotic therapy. Tracking from initial to recovery and the end results as well as everything inbetween might just change your mind about boring.  

Some of the things that can be learned from these patient include various venous access devices, how to take BPs around shunts and contractures, and where you might establish IV access if you needed it. You will also find many SNF and some dialysis patients with different types of G and J tubes. Some don't realize there is a peg present when they tighten the stretcher straps causing discomfort or pain.  These patients also provide great examples for heart and lung sounds. Rarely will two dialysis patients present the same or with the same underlying disease processes besides the obvious ESRD.

The van drivers who take these patients to dialysis are definitely under paid and probably catch more emergencies than some EMTs because they get to know the patients on their routes.  EMTs do have a lot of responsibility transporting SNF and dialysis patients and should be compensated well provided they do an adequate assessment and care during transport.


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## terrible one (Dec 19, 2010)

While that may be true seeing the same ones over and over and over and over is boring. I agree it is a ver interesting disease process and such,however, you can only read the chart of Mr. Smith so long before you've memorized it and it becomes montaneous boring transports


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## Acetone (Dec 19, 2010)

Just wanted to thank everyone for the insightful responses.


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## looker (Dec 19, 2010)

MusicMedic said:


> Beware of IFT companies in LA County/LA City as there are a MILLION of them and alot of them tend to be sheisty.. so research their reputation before applying
> 
> Try to get on with a company that does both IFT's and 911 such as CARE, Gerber, AMR or Bowers(they do mainly IFT's, but have a contract or two for 911)



There are million of ambulance company(s) in la? Dam, I didn't realized it was that many  If by "sheisty" you mean they are in business to make money you're correct. What is the point of having your own business, taking all of the liability if you're not going to make significant profit as result of it.


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## JPINFV (Dec 19, 2010)

looker said:


> If by "sheisty" you mean they are in business to make money you're correct. What is the point of having your own business, taking all of the liability if you're not going to make significant profit as result of it.



Oh, please. There are good companies and bad companies and it comes down to more than making a profit. Yes, everyone has to make a profit, however some companies treat their employees better than others. It's the In-N-Out vs McDonalds comparison. Sure, both are in it for a profit and to make money, but the wages at In-n-Out are a lot higher than anyone else. Even from a profit maximization point of view, there's value in reducing employee turnover in terms of higher efficiency (knowing the ropes so to speak) and a decrease in initial training costs. Similarly, there's value in keeping employee morale high. High morale decreases turnover and increases customer service (if I'm in a good mood, I'm more likely to go that extra mile), and morale goes beyond just pay. Unfortunately, some companies can't seem to look past the end of the day total and not taking into account other expenses. 

Similarly, too many employers and supervisors fail to realize that the people who do the most harm are the front line employees (EMT and paramedics in EMS). It's much easier to prevent bad customer experiences by hiring and keeping good, happy employees, than it is for a manager to swoop in after something has happened and fix it. After all, how much profit is there if no one will hire you (generic "you") because your employees are scraped off of the bottom of the barrel due to poor wages and poor management techniques and they end up providing poor service?


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## MusicMedic (Dec 19, 2010)

JPINFV said:


> Oh, please. There are good companies and bad companies and it comes down to more than making a profit. Yes, everyone has to make a profit, however some companies treat their employees better than others. It's the In-N-Out vs McDonalds comparison. Sure, both are in it for a profit and to make money, but the wages at In-n-Out are a lot higher than anyone else. Even from a profit maximization point of view, there's value in reducing employee turnover in terms of higher efficiency (knowing the ropes so to speak) and a decrease in initial training costs. Similarly, there's value in keeping employee morale high. High morale decreases turnover and increases customer service (if I'm in a good mood, I'm more likely to go that extra mile), and morale goes beyond just pay. Unfortunately, some companies can't seem to look past the end of the day total and not taking into account other expenses.
> 
> Similarly, too many employers and supervisors fail to realize that the people who do the most harm are the front line employees (EMT and paramedics in EMS). It's much easier to prevent bad customer experiences by hiring and keeping good, happy employees, than it is for a manager to swoop in after something has happened and fix it. After all, how much profit is there if no one will hire you (generic "you") because your employees are scraped off of the bottom of the barrel due to poor wages and poor management techniques and they end up providing poor service?



+1 to everything you said... 

Ive worked for two IFT companies, One was awesome, and the other one sucked...

Wanna know what the difference was between those two companies? 
the better one didnt focus just on profit margin, they focused on QA/QI, Employee Morale(bbq's,parties,gift cards), Better wage compensation... as a result everyone went the extra mile, didnt complain much about their jobs... 


The crappy company, focused on mainly on making a quick buck.. they didnt care much for their employees.. nor QI/QA... Employees were disgruntled... No one seemed to care.. PCR's were half-assed.. constant call off's... Employees not looking professional.. 

The point im trying to make is: If you dont care for the Employees they wont care for you.. (and why should they?)

another point: if your employees are disgruntled.. they will be looking to jump ship the first opportunity they get.. thus higher turnover and more costs to the bottom line (as JPINV stated) 

To the OP: Try asking the employees of a company (the emts/medics) and see what they have to say... (sure there might be one or two or a few disgruntled employees so try to ask a few)


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## firecoins (Dec 19, 2010)

Journey said:


> Dialysis patients are not boring in any way. .



I am sorry but that is a matter of opinion.  As mentioned you study the same person's disease process 3 dialysis sessions a week. After 1 month of 6 transports a week, you will have their disease process memorized.


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## Journey (Dec 19, 2010)

firecoins said:


> I am sorry but that is a matter of opinion.  As mentioned you study the same person's disease process 3 dialysis sessions a week. After 1 month of 6 transports a week, you will have their disease process memorized.



Dialysis patients can have more than one disease process. ESRD is usually the end result of one of those diseases but that does not mean the others go away. Even for someone what has a history of being born with kidney disease, it does not mean that patient has not developed many other diseases along the way as a direct result or from other system failures.  Once the patient get labeled with one disease does not mean you stop monitoring it or doing as assessment  just because you have memorized all the names.


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## NomadicMedic (Dec 19, 2010)

I've learned more working as an IFT medic than I did as an IFT EMT. Transporting criticaly ill or injured patients from one facility to another can be a nerve racking experience, but one that never fails to educate. A vented patient on multiple meds on a 2 hour transport is a LOT different than dealing with a Chest Pain and having a 10 minute transport time. Luckily, the company I work IFT at is sending selected medics to a CCEMTP program. Hopefully, I'll be one that's picked.

I love running 911 calls, but it's importnat to not discount the IFT experience.

And to keep this post on topic, I make almost double what I take home as a full time 911 medic when I work as a part time/per diem IFT medic. Silly, isn't it?


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## firecoins (Dec 19, 2010)

Journey said:


> Dialysis patients can have more than one disease process. ESRD is usually the end result of one of those diseases but that does not mean the others go away. Even for someone what has a history of being born with kidney disease, it does not mean that patient has not developed many other diseases along the way as a direct result or from other system failures.  Once the patient get labeled with one disease does not mean you stop monitoring it or doing as assessment  just because you have memorized all the names.



Of course diaysis patients have more than one disease process going on.  If you find it exciting to read about high blood pressure, morbid obeisity, diabetes, cardiac hx or cancer, thats great.  I read the hx, learned from it for about 2 or 3 months. There is only so many times I can read about pt x's multiple disease processes.  

I don't discount the IFT experience. its important.  SNF emergencies are a great experience.  I can't tell you how many times I ran into a train wreck both BLS and ALS.  Nurses never seem to know much.  

I would even go as far to say that most 911 calls are boring. The "exciting" calls are few and far between.  The calls I found exciting 2 years ago are run of the mill now.


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## Journey (Dec 19, 2010)

firecoins said:


> Of course diaysis patients have more than one disease process going on.  If you find it exciting to read about high blood pressure, morbid obeisity, diabetes, cardiac hx or cancer, thats great.  I read the hx, learned from it for about 2 or 3 months. There is only so many times I can read about pt x's multiple disease processes.
> 
> I don't discount the IFT experience. its important.  SNF emergencies are a great experience.  I can't tell you how many times I ran into a train wreck both BLS and ALS. * Nurses never seem to know much.  *
> 
> I would even go as far to say that most 911 calls are boring. The "exciting" calls are few and far between.  The calls I found exciting 2 years ago are run of the mill now.



Dialysis patients can change quickly. It is more than just reading the face sheet or the brief summary of diagnoses. You have to actually assess the patient and talk to them. Find out if anything is different since their last visit. Several EMTs have rolled into the ED with a critically ill dialysis patient without any recent information including the BP because they figured that was also the same as the previous trip.  They didn't bother to ask how the patient had been feeling after their last dialysis or they might have learned things like their glucose was up and down or they felt weaker or felt like they had a chest cold coming on. 

If you are not doing an assessment, I would say you and your company are being paid too much. 

All of things you mentioned (high blood pressure, morbid obeisity, diabetes, cardiac hx or cancer) should play a role in your assessment and should not be discounted.   But, you also need to do an assessment for the present. 

I see you want to make an attack on nurses.   But, they did call for an ambulance so they must have known something.  Patients in SNFs are very fragile and can deteriorate in minutes even before the nurse is off the telephone from calling an ambulance. One nurse may also have 30 patients to care for in one shift in a nursing home or SNF.  Some of those patient with fevers and UTIs you may have considered to be boring calls may have died within a few hours at the hospital. That is how rapidly some deteriorate.  Unless you have worked alongside these patients for a greater length of time than just the drive to the hospital, you may not be aware of this. I can not fault you if this was not in your education. Geriatrics and chronic patients have medical concerns that an EMT and Paramedic must put forth a little extra effort to learn more about beyond their EMT or Paramedic courses. I could also add pediatrics to that list.


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## Shishkabob (Dec 19, 2010)

As firecoins said... IFT experience is useful... to a point.  Then it just becomes a detriment if it's all you do.


Doing IFT for 8 months hurt my assessment skills.  It hurt my ability to critically think.  It hurt my manual skills.    It hurt my ability to deal with acute situations.  It hurt my ability to control a scene.  It hurt my ability to interact with other agencies.  


Yes, you still have to do an assessment, and yes you do learn the long term disease process, and there are still times where something can go drastically wrong that you have to correct, but even compared to 911, it's rather small.  

There truly is only so much you can do on a BLS transfer.  ALS transfer are a much better learning experience for medics, but true ALS transfers (beyond "They have a liter of saline going TKO") are rare.  



The best thing would be to do an agency that does 911 AND IFT, best of both worlds.  If you do just one, you could suffer atrophy in something.


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## Journey (Dec 19, 2010)

Linuss said:


> There truly is only so much you can do on a BLS transfer.  ALS transfer are a much better learning experience for medics, but true ALS transfers (beyond "They have a liter of saline going TKO") are rare.



What we find on the hospital side is that many of the patients EMS labels as BLS actually require many advanced life support measures but just not the type you in EMS can detect or  have to offer on your ambulance regardless of whether it is ALS or BLS.  But, again that is just due to the limitations of EMS and probably it should not be your fault nor can you be held accountable for something you do not know or have been trained for.  You do not have access to diagnostic equipment or lab values so you may not be able to detect bilateral pneumonia, sepsis or any of the many medical conditions that land these patients in the ICU. So it is not because these patients are not sick, it is that you do not have to ability to know just how sick they are until they present with emergent symptoms and by that time, it will probably be too late for the patient and surviving this trip to the hospital will probably not be likely.  It also isn't about how many drips the patient has but the condition that requires closer monitoring. If you are judging a patient only by the meds, you may be missing the bigger picture.  But again that goes back to the EMS education where the focus is very narrow for just the emergent and the more skills you can do on one call is how you rate the patient.



> Doing IFT for 8 months hurt my assessment skills. It hurt my ability to critically think. It hurt my manual skills. It hurt my ability to deal with acute situations. It hurt my ability to control a scene. It hurt my ability to interact with other agencies.



That comment explains alot about the reports we get from IFT EMTs and Paramedics. It seems they just provided ride and little more. Even for the amount of fluids or meds given during transport is rarely relayed. That would also account for the interaction with other agencies. Thank you for giving me some insight on these problems.  I think we do need more RN based CCTs through the hospital and I don't mean that as an insult to you but the RN would have to ability to maintain these skills with hospital experience and more patients.


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## Shishkabob (Dec 19, 2010)

Journey said:


> What we find on the hospital side is that many of the patients EMS labels as BLS actually require many advanced life support measures but just not the type you in EMS can detect or  have to offer on your ambulance regardless of whether it is ALS or BLS.  But, again that is just due to the limitations of EMS and probably it should not be your fault nor can you be held accountable for something you do not know or have been trained for.  You do not have access to diagnostic equipment or lab values so you may not be able to detect bilateral pneumonia, sepsis or any of the many medical conditions that land these patients in the ICU. So it is not because these patients are not sick, it is that you do not have to ability to know just how sick they are until they present with emergent symptoms and by that time, it will probably be too late for the patient and surviving this trip to the hospital will probably not be likely.  It also isn't about how many drips the patient has but the condition that requires closer monitoring. If you are judging a patient only by the meds, you may be missing the bigger picture.  But again that goes back to the EMS education where the focus is very narrow for just the emergent and the more skills you can do on one call is how you rate the patient.



I'm sorry, but taking granny HOME after he UTI treatment is neither a good use of taxpayer money, nor EMS resources.

There is no "hidden need" there.  





> That comment explains alot about the reports we get from IFT EMTs and Paramedics. It seems they just provided ride and little more. Even for the amount of fluids or meds given during transport is rarely relayed. That would also account for the interaction with other agencies. Thank you for giving me some insight on these problems.  I think we do need more RN based CCTs through the hospital and I don't mean that as an insult to you but the RN would have to ability to maintain these skills with hospital experience.



When you provide little more than a taxi ride for the lazy, or for the family of the lazy, that is what it is:  A useless, expensive taxi ride.

This is not including legit ALS transfers.  This is not including psych transfers.  This is not including CCT transfers.  This is not including movement to higher-level of care transfers.  This is only including the waste that Medicare / insurance companies / taxpayers are expected to pay for, that have no legit medical need.

THAT is what I was commenting on.  




Quit placing the blame on education when the matter at hand has nothing to do with such.  Not every complaint from an EMS provider stems from us not knowing what we're talking about, thank you.


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## looker (Dec 19, 2010)

JPINFV said:


> Oh, please. There are good companies and bad companies and it comes down to more than making a profit. Yes, everyone has to make a profit, however some companies treat their employees better than others. It's the In-N-Out vs McDonalds comparison. Sure, both are in it for a profit and to make money, but the wages at In-n-Out are a lot higher than anyone else. Even from a profit maximization point of view, there's value in reducing employee turnover in terms of higher efficiency (knowing the ropes so to speak) and a decrease in initial training costs. Similarly, there's value in keeping employee morale high. High morale decreases turnover and increases customer service (if I'm in a good mood, I'm more likely to go that extra mile), and morale goes beyond just pay. Unfortunately, some companies can't seem to look past the end of the day total and not taking into account other expenses.
> 
> Similarly, too many employers and supervisors fail to realize that the people who do the most harm are the front line employees (EMT and paramedics in EMS). It's much easier to prevent bad customer experiences by hiring and keeping good, happy employees, than it is for a manager to swoop in after something has happened and fix it. After all, how much profit is there if no one will hire you (generic "you") because your employees are scraped off of the bottom of the barrel due to poor wages and poor management techniques and they end up providing poor service?



Lets go with McDonalds vs In-n-out comparison. McDonalds is probably 100 or 1000 times bigger compare to in-n-out. They are present all over usa and the world, In-n-out is in California and couple of other states. In this economy as emt you're lucky to have a job, period. Even experience emt is replaceable very quickly. Unless you're in right to work state, it is advisable to do good work and keep management happy as you will be replaced quickly if you half *** job on transport and/or paperwork.


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## looker (Dec 19, 2010)

Linuss said:


> I'm sorry, but taking granny HOME after he UTI treatment is neither a good use of taxpayer money, nor EMS resources.
> 
> There is no "hidden need" there.



So what would you like Hospital to do, call a taxi?


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## firecoins (Dec 19, 2010)

Journey said:


> I see you want to make an attack on nurses.


 No you don't see. ER nurses and doctors constantly attack their SNF counterparts for the same reason I do.  Very few SNF nurses have demontrated any knowledge equivalent to nurses anywhere else. 



> But, they did call for an ambulance so they must have known something.


The doctor ordered the patient out. On questioning, the nurses admit they know nothing.  It isn't their patient. They are covering someone. Their shift just started.  The CNA said something.  The family member complained. Lab result came back with something elevated.  The patient's "chief complaint" is they are "sick" and this all we have to tell the ED whose nurses understand our view point because they received report from the same SNF nurses who told them the same thing.    



> One nurse may also have 30 patients to care for in one shift in a nursing home or SNF.  Some of those patient with fevers and UTIs you may have considered to be boring calls may have died within a few hours at the hospital.


 Death is a part of life and these patients are near death on a regular basis.  This again has nothing to do with the call being exciting or boring. There may be nothing to do from an EMS standpoint.  



> Unless you have worked alongside these patients for a greater length of time than just the drive to the hospital, you may not be aware of this


. Your not in a position to comment on ayone's awareness.



> I can not fault you if this was not in your education


.Whats my "education" level?  I am not sure you have the education level to be as arrogant as you are on the internet.


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## firecoins (Dec 19, 2010)

IFT is educational.  Reading about multiple disease processes is fine.  It does not make IFTs exciting.  Without the proper guidance readingabout these multiple disease processes is of limited value.   Need classroom education.


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## JPINFV (Dec 19, 2010)

looker said:


> Lets go with McDonalds vs In-n-out comparison. McDonalds is probably 100 or 1000 times bigger compare to in-n-out. They are present all over usa and the world, In-n-out is in California and couple of other states. In this economy as emt you're lucky to have a job, period. Even experience emt is replaceable very quickly. Unless you're in right to work state, it is advisable to do good work and keep management happy as you will be replaced quickly if you half *** job on transport and/or paperwork.



Yes, McDonalds is extremely large, however In-N-Out is expanding and is being limited essentially by their own quality controls. You can't just expand willy-nilly if you require all of your meat to be delivered daily. Similarly, I've never had bad service or someone who barely spoke English at In-N-Out. McDonalds, on the other hand... Additionally, In-N-Out is generally more expensive and takes significantly longer on average for the food to be finished. Why do so many people eat there? Because the food is tasty and the service is good. 

As far as how easy it is to replace EMTs, I'm not arguing that they aren't easily replaceable, generally regardless of the economy. I will argue, though, that considering the workforce to be disposable, even if they generally are, isn't necessarily in the best interest of the company and keeping employees is not necessarily hard or expensive. As I mentioned in other threads, the OC company I worked for spent about $600 for initial training per employment (using the starting wage circa 2007, I imagine it's higher by now), and another $400 in driver training per employment (numbers calculated since initial field training and driver training was done on a 3 man unit). I can't imagine how $600/attendant or $1000/driver doesn't start to add up if turnover is high.


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## looker (Dec 19, 2010)

JPINFV said:


> As far as how easy it is to replace EMTs, I'm not arguing that they aren't easily replaceable, generally regardless of the economy. I will argue, though, that considering the workforce to be disposable, even if they generally are, isn't necessarily in the best interest of the company and keeping employees is not necessarily hard or expensive. As I mentioned in other threads, the OC company I worked for spent about $600 for initial training per employment (using the starting wage circa 2007, I imagine it's higher by now), and another $400 in driver training per employment (numbers calculated since initial field training and driver training was done on a 3 man unit). I can't imagine how $600/attendant or $1000/driver doesn't start to add up if turnover is high.



If company want to provide training that is their choice unless required by law. A company hires professional that is certified and should be ready to go. There is no real need to provide training to a professional personal. As such they can save that 1k that they spend on training.


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## JPINFV (Dec 19, 2010)

looker said:


> If company want to provide training that is their choice unless required by law. A company hires professional that is certified and should be ready to go. There is no real need to provide training to a professional personal. As such they can save that 1k that they spend on training.




So your employees come in knowing how the company is set up, how to write PCRs, including narratives, how to fill out PCRs, and so forth? Do you have a field training program? If so, how long is your field training for new hires? How do you go about making sure your employees understand your companies policies and procedures, including company specific issues such as radio operations? Alternatively, do you just hand them the keys to your ambulances on day one after watching the mandatory OSHA pathogen videos and filling out the HR paperwork?


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## looker (Dec 19, 2010)

JPINFV said:


> So your employees come in knowing how the company is set up, how to write PCRs, including narratives, how to fill out PCRs, and so forth? Do you have a field training program? If so, how long is your field training for new hires? How do you go about making sure your employees understand your companies policies and procedures, including company specific issues such as radio operations? Alternatively, do you just hand them the keys to your ambulances on day one after watching the mandatory OSHA pathogen videos and filling out the HR paperwork?



I do not hire "noobs" meaning someone that just finished. As such i generally do not need to provide much if any training regarding pcr's, narratives etc. All new hires are partnered with experience employee. So basically yes they start working pretty much on first day. Radio use is easy, we like most company around here use nextel. If they got any question while in the field, they can ask their partner.


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## Shishkabob (Dec 19, 2010)

looker said:


> So what would you like Hospital to do, call a taxi?



Idealy, yes.


Heck, id be willing to cede a medi-van.


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## looker (Dec 19, 2010)

Linuss said:


> Idealy, yes.
> 
> 
> Heck, id be willing to cede a medi-van.



A medi-van is not covered by private insurance and/or medicare. An ambulance is.


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## JPINFV (Dec 19, 2010)

looker said:


> I do not hire "noobs" meaning someone that just finished. As such i generally do not need to provide much if any training regarding pcr's, narratives etc. All new hires are partnered with experience employee. So basically yes they start working pretty much on first day. Radio use is easy, we like most company around here use nextel. If they got any question while in the field, they can ask their partner.





Well, saying you hire only people with experience is different than saying you expect employees to hit the ground running simply because they are certified. Similarly, if you run a small enough operation that you don't need a training department, that tells me that your operation is very small. I remember you mentioning in the past that your company doesn't run 911 calls, which rules out a lot of the larger companies. However you essentially saying that you don't have a field training program also rules out essentially all of the larger IFT operations in LA County.


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## looker (Dec 19, 2010)

JPINFV said:


> Well, saying you hire only people with experience is different than saying you expect employees to hit the ground running simply because they are certified. Similarly, if you run a small enough operation that you don't need a training department, that tells me that your operation is very small. I remember you mentioning in the past that your company doesn't run 911 calls, which rules out a lot of the larger companies. However you essentially saying that you don't have a field training program also rules out essentially all of the larger IFT operations in LA County.



Depending on your definition of "larger ift operations". You're correct i do not do 911, i only do IFT.


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## Shishkabob (Dec 19, 2010)

looker said:


> A medi-van is not covered by private insurance and/or medicare. An ambulance is.



Point?  It should cost much less than $100.


No reason to pay a Paramedic and an EMT, and pay for an ambulance, for the vast majority of the transports that IFT companies do.  

You want healthcare costs fixed?  Look at the waste just associated right there.


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## looker (Dec 19, 2010)

Linuss said:


> Point?  It should cost much less than $100.
> 
> 
> No reason to pay a Paramedic and an EMT, and pay for an ambulance, for the vast majority of the transports that IFT companies do.
> ...



People do not want to pay for it. I run both nemt (medi-van) and ems. After telling them our rates, they usually say thank you and hang up. That is the last we hear from them. They do not see a reason to pay when they have medicare and can have private ambulance respond and do transport. Both small and big ems will do transport without any issue.


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## Shishkabob (Dec 19, 2010)

JPINFV said:


> As I mentioned in other threads, the OC company I worked for spent about $600 for initial training per employment (using the starting wage circa 2007, I imagine it's higher by now), and another $400 in driver training per employment (numbers calculated since initial field training and driver training was done on a 3 man unit). I can't imagine how $600/attendant or $1000/driver doesn't start to add up if turnover is high.



Heck, look at my agency.  They send medics to an academy for nearly a month, then 2 months of FTO time before they could potentially be cleared.


That's 3 months, minimum, of paying a Paramedic their full salary without getting any actual return.  Let's figure $10,000, per Paramedic, before they are released.


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## Shishkabob (Dec 19, 2010)

looker said:


> People do not want to pay for it. I run both nemt (medi-van) and ems. After telling them our rates, they usually say thank you and hang up. That is the last we hear from them. They do not see a reason to pay when they have medicare and can have private ambulance respond and do transport. Both small and big ems will do transport without any issue.



And how is that opposite of anything I've stated?


The vast majority of current IFTs should be by taxi, medivan or the like.



I know it's cutting in to your bottom dollar as a business owner, but that's ideally what it should be.


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## JPINFV (Dec 19, 2010)

looker said:


> Depending on your definition of "larger ift operations". You're correct i do not do 911, i only do IFT.



Pacific and Lynch size companies to use two of the larger IFT only companies in So. Cal. It would be interesting to see how a company could get around putting 40+ units on the road during a weekday without a FTO program with the "since there's a huge supply, I can act like my employees are as disposable as a pure labor market analysis says they are."


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## looker (Dec 19, 2010)

JPINFV said:


> Pacific and Lynch size companies to use two of the larger IFT only companies in So. Cal. It would be interesting to see how a company could get around putting 40+ units on the road during a weekday without a FTO program with the "since there's a huge supply, I can act like my employees are as disposable as a pure labor market analysis says they are."



hehehe, most companys with except of amr are not any anywhere close to the size of Pacific. Do not know about lynch, but pacific currently operates 50 ambulance in the city of la, and more in la county.


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## Acetone (Dec 19, 2010)

I have another question relating to employment.  In LA-county, to be a paramedic you must also be a firefighter.  Is this true for all of California or just LA?  Say if I go to San Francisco, am I able to try to become a paramedic w/o becoming a firefighter?


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## JPINFV (Dec 19, 2010)

looker said:


> hehehe, most companys with except of amr are not any anywhere close to the size of Pacific. Do not know about lynch, but pacific currently operates 50 ambulance in the city of la, and more in la county.



Out of the IFT only companies, true, most aren't the size of Pacific or Lynch, or Priority 1 (considering that their 911 contract isn't in So. Cal), but once you start throwing in the 911+IFT companies, the field of larger ambulance companies starts to expand. Care, Doctors, Schaefer, etc are all larger companies that do their share of IFT work in addition to their 911 contracts. Similarly, I never commented on the average size, just a comment about the larger size. 

So, I have to ask, if you were one of the larger ambulance companies in So. Cal, how would you go about hiring enough employees without a field training program? Even with these companies who do an insane number of daily runs when compared to the companies with 4 or 5 ambulances (how many does your company run?), a high turnover can put a decent size dent into profit margins.


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## looker (Dec 19, 2010)

JPINFV said:


> Out of the IFT only companies, true, most aren't the size of Pacific or Lynch, or Priority 1 (considering that their 911 contract isn't in So. Cal), but once you start throwing in the 911+IFT companies, the field of larger ambulance companies starts to expand. Care, Doctors, Schaefer, etc are all larger companies that do their share of IFT work in addition to their 911 contracts. Similarly, I never commented on the average size, just a comment about the larger size.
> 
> So, I have to ask, if you were one of the larger ambulance companies in So. Cal, how would you go about hiring enough employees without a field training program? Even with these companies who do an insane number of daily runs when compared to the companies with 4 or 5 ambulances (how many does your company run?), a high turnover can put a decent size dent into profit margins.


Once you get to size of 20-30 units you probably will have to get some training going.


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## Probi (Dec 24, 2010)

terrible one said:


> Have to disagree, IFT is crazy boring! Sure you can learn a lot from the transfers you mentioned, however, IFTs in LA are mainly dialysis and SNF discharges, a lot of pts that could have done with out an ED to begin with. You can only learn so much from Mr. Smith with ESRD who you see every M, W, F.
> While I recommend doing IFTs to begin just to get basic gurney ops, driving, and hospital roles down eventually I'd move on.
> As fas as pay I make $22/hr as an IFT medic. Job isn't fun but I have learned a lot and it's nice to take a break while I'm in school and have other things going on. But come end of next semester I'll take less pay to play with lights and sirens



Man the small amount of money they pay you guys in the states should be a crime.  Is it diff. if you get on as a fire medic?  I know here where I live paramedics start at around 30.   Still think there should be wage parity with nurses, but untill we get better unions.. what can ya do    btw im in Canada


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## looker (Dec 24, 2010)

Probi said:


> Man the small amount of money they pay you guys in the states should be a crime.  Is it diff. if you get on as a fire medic?  I know here where I live paramedics start at around 30.   Still think there should be wage parity with nurses, but untill we get better unions.. what can ya do    btw im in Canada



I have yet to see anyone explain what makes emt so special that their wage should on parity with nurses. EMT are nothing special and as such do not make much money as anyone can easily become emt in very short period.


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## Probi (Dec 24, 2010)

im refering to paramedics, I mean I may be wrong cause im pretty noobie but paramedics where im from have a much larger scope to deal with cardiac issues.    Im pretty sure nurses cant even intubate,  unless that just because they can but a collective agreement for Respiratory Therapists prevents them from this.  hmm.


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## jjesusfreak01 (Dec 24, 2010)

Probi said:


> im refering to paramedics, I mean I may be wrong cause im pretty noobie but paramedics where im from have a much larger scope to deal with cardiac issues.    Im pretty sure nurses cant even intubate,  unless that just because they can but a collective agreement for Respiratory Therapists prevents them from this.  hmm.



This is an IFT vs 911 thread, so scope of practice should hardly be a part of the discussion. Worry not, there are lots of other threads to argue over scope.


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## Probi (Dec 24, 2010)

lool sorry for hi jacking ur thread O.P.   anyways id try 9/11 thats where you'll likely gain most of your skills


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## MusicMedic (Dec 24, 2010)

Acetone said:


> I have another question relating to employment.  In LA-county, to be a paramedic you must also be a firefighter.  Is this true for all of California or just LA?  Say if I go to San Francisco, am I able to try to become a paramedic w/o becoming a firefighter?




Its true mainly for Metropolitan areas in CA.. I know San Fran is Firebased EMS.. Same with LA County, Orange County, and maybe San Deigo county?

There are a few Counties in CA that have Private Company Medics run the calls (eg:AMR,Hall Ambulance) in Riverside,Kern,Alameda,San Bernadino counties..


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## MusicMedic (Dec 24, 2010)

Probi said:


> Man the small amount of money they pay you guys in the states should be a crime.  Is it diff. if you get on as a fire medic?  I know here where I live paramedics start at around 30.   Still think there should be wage parity with nurses, but untill we get better unions.. what can ya do    btw im in Canada



in Orange County (So Cal) Fire Medics make around 80k-100k a year
Fire Medics make considerably more amount of money here than private medics..

private company medics make anywhere from $14-20/hr


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