LA County Enough is enough!!

[Jon]

Does this really need to be done by the school?

A 150 hour training course, how much could one actually expect to earn?

It takes longer than that to learn to cut hair.

http://www.barbercollegeonline.com/college_info.html

"Student are required and must complete (1500) hours before taking the state exam."

In some states, that's more than a paramedic too.

It is important to understand history.

EMS was developed in the US to give people a ride to the hospital.

With rare exception all treatment protocols end in transport or refusal.

Medicare/Medicade pays for transport and milage.

EMS is not recognized in the US as an independant body of specialized knowledge. It is a training.

Just like a mason, or a plumber, or a carpenter.

Before you talk about how much they make, consider there is always a nonunion person (usually a foreigner who accepts a lower standard of living than most first world citizens) who will put his very soul in to producing a quality product for next to nothing.

For the people who say EMTs are valuable, look at the national pay averages. "just in case" is worth just above minimum wage. Basically a fast food worker with a first aid course.

It is not a career to be a basic. It is a job.

Now somebody will talk about how thier agency pays basics grossly above market value. Certainly they do exist. But they are the exception, not the rule, so you are lucky to have those jobs.

There is a reason firefighters become EMT-Bs at least, it is a handful of hours on top of their other certifications. (measured in hours)

A 240 fire class, 20 hours of hazmat, and an EMT cert is still not 1/3 of a barber. Which is why there are so many fire certs. The more you can do, the more you are worth.

a 150 hour course (using the updated guidlines) is still one of, if not the lowest level of anything health care related.

I know many STNAs who are paid better. You know why?

Because it is more valuable to pay people to do the dirty work (like wiping *** and changing sheets) than it is to have a basic first aid provider "just in case," to do the minimum that will likely not cause harm, with the greatest amount of probability.

Helping your neighbors who cannot afford more is charity. Not a career, even if you are paid a pityful amount to do it.

As for the IFT EMTs, you might actually get paid more, if the state didn't mandate your employer to provide a $90k taxi equipped with stuff you will likely never use.

Unlike a taxi driver, you can't even ask for a tip.

You think it is a joke that many of us say McDs pays better? Look at the salary and benefits for a FT McDs or Starbucks employee.

I come from the generation where an EMT cert was a golden certificate that could ensure I could walk off the job today and be at work tomorrow. But those days are gone. They are not coming back.

Read this website, we constantly talk about how outdated and backwards many EMS treatments are.

In the last 15 years there has been more learned about medicine than in the entire prior history of man. What % of medicine do you think an EMT-B knows?

Mark my words, if paramedics don't shape up and advance themselves, they will be looking at the same fortune in a few years.

Great post. This is the heart of the "EMS 2.0" discussion. I'm not sure anyone has answers for all of this... But acknowledging the problem is the first step.

EMS instructors who tell you that you need experience as a basic before going on to medic are not looking out for your best interests, they are asuaging their own insecurities.

Nobody claims you should work as a line cook before becomming a chef.

Don't fall for that BS.

But don't you need some experience in a kitchen - even your own, before you go to chef's school?

I think it depends on the course. Some courses are built on the assumption you have XXXXX experience, while others are "Zero to Hero" programs. I've seen good medics, and crappy medics, produced both ways.

 

[looker]

Does this really need to be done by the school?

A 150 hour training course, how much could one actually expect to earn?

It takes longer than that to learn to cut hair.

Yes it needs to be done by school. When many people think of those people that work in healthcare they think oh they are lucky they are wealthy. That often time is true for specialist doctor but public do not know that They think that those drive ambulance must be paid good because they are carrying for people. Most would be shocked to find out that mcdonalds employee, ups drivers etc are getting paid more compare to emt's. The only real way emt's will get paid more is if industry changes in to being more complicated. For now doing assessment, writing report and taxi transportation do not require enough skills to make wages to go up.

 

[mycrofft]

I can teach you good CPR in less than one hour in person. Over the phone or the internet I could never know if you "got it" because of the lack of feedback such as seeing your technique, or watching you text and google your way through the test.
EMT's, to provide better care as a class and to start being taken seriously, need to stop using shortcuts and certif. mills. States need to use their adult education laws (if any) to shut down "mills".

ANYWAY, LA is acting like the impacted metropolis it has become. There is a lot of country outside the basin, go to some conventions or just a road trip to see, and contemplate getting out of it. (LA would be the finest place in the USA if it could get rid of fifty years of infrastructure and 7/8 of its population...only one major earthquake away).

 

[Veneficus]

Great post. This is the heart of the "EMS 2.0" discussion. I'm not sure anyone has answers for all of this... But acknowledging the problem is the first step..

I am glad to see I am not the only one who sees it. Charge your advertisers more here for exlusive location rights to my posts.

The answers we have discussed ad nausum, Simple. Somebody is going to have to bite the bullet and get a real education. Just like nursing, respiratory, x-ray, etc. (you see what x-ray gets paid? for their actual labor?)

Then they are going to have to lobby to be paid for that knowledge base, just like PAs and NPs did.

They may even go so far as to legally mandate their services, like nursing did.

But like anything worth doing, it will take time, hard work, and sacrifice.

It cannot be a culture of "everyone but me should sacrifice."

Compounding this problem is nobody listens to the people who found the out. I am not exclusive the list of people who wanted to be a career fire/EMS provider that had to move out of the profession.

I may be unique in that I did it for personal satisfaction and out of peer pressure, not the money.

I think ditching the paramilitary uniform would help too. Just my opinion.

But don't you need some experience in a kitchen - even your own, before you go to chef's school?

I think it depends on the course. Some courses are built on the assumption you have XXXXX experience, while others are "Zero to Hero" programs. I've seen good medics, and crappy medics, produced both ways.

Does a pastry chef benefit from making burgers?

My position on this hasn't changed. WHile it is possible to get useful experience and knowledge being an EMT,(I know I did) it was date dependant.

Then an EMT was a rare and mysterious commidity. Paramedics were more rare than leprecauns and highly valued and sought after. Today, it has boiled down to the equation of money. Minimum skill+ maximum saturation= minimum pay.

It is saturated because as looker said, people think healthcare providers are all rich.

Most students entering the school I teach part time at are people changing careers. They are quick to point out EMT and even on to Medic is the quickest way to enter the healthcare profession.

All of the schools I am familiar with, EMT is considered nothing more than the class you have to take before getting to medic class. They don't expect you to even apply for a job as a Basic. Ever.

Unfortunately, spending time as a basic, in addition to being statistically more likely to fail paramedic class at multiple institutions I taught at, seems to impart an attitude they already know it all, that book learnin' isn't important, and all you are going to do is perform the skills laid down in protocol anyway, who you will ultimately drive to the hospital.

Old wisdom does not apply in a new world. Just as the knowledge of the Dark Ages did not apply to Renaissance, the wisdom of the industrial age does not apply in the information age.

Don't believe me, look at your parents reality vs. yours.

We are at a turning point in history and civilization.

We must adapt to the realities of the age, regardless of how we feel about them.

 

[mycrofft]

The has reached the Event Horizon we call "What's Wrong With EMS (and how come we don't get any respect or money?)".

So be it. I'd prefer to discuss how LA's streets have become the next best thing to BLADERUNNER.

Lots of people want to be EMT's. Lots of people want to be commercial pilots too.

Most people can become an EMT. Few people can become a commercial pilot.

Commercial pilots potentially make lots more money than EMT's because....

No. Not just because the training is more stringent. It is because they practice at a higher level. A pilot has to think of/know many things, use math, know many many regulations, perform documentation like crazy, even learn a foreign language (if they don't speak English).

EMT-B (originally known as 'EMT-A", for "ambulance") was a basic level certification aimed at teaching the most to the lowest common denominator the fastest it could be disseminated to combat the death rate on American highways.

THAT is why so many people can be certified as EMT's, and because lax laws and inefficient inspection and examination laws allow substandard mills to operate. Now, an individual graduate may think and act professionally, but the mills push out many more who will either learn it later, or never learn it at all. Many will not achieve adequate employment.

Employers capitalize upon this to get cheap unbenefited labor, same as they are using nursing mill grads, and have used LVN's/LPN's since they were "temporarily" certified during wartime to boost the nursing pool.

 

[46Young]

I have read all the reply's and feel like I should ask do any of you know how company get IFT patient? Does it cost them anything in order to get that patient? How about being able to transport every month to month instead of another company getting that patient? Think about what i am asking and reply.

Regarding IFT not being part of EMS. You have a problem here. You need to get state/federal on board. The way system works now been going on for so long that it's unlikely to change anytime soon if ever.

I wish on day one, in every emt school they would display pay scale. Tell the students the real truth about how much they will make. I got a feeling most would not continue with the class.

I know that you have to secure contracts with the various facilities, that you're expected to txp to the facility where the sending MD is affiliated, that a certain on time performance is required. For example, Physicians Transport Service in Virginia was required to place an additional ambulance dedicated to the INOVA Springfield Healthplex from 1000-2200, M-F, to handle discharges and transfers, for no additional compensation. The company does a large amount of their business from this Health System, so they would not risk losing the contract by telling them no on this matter.

Other than that, I'm largely ignorant to the business side of IFT. What can you add to help us understand the financials of running an IFT company?

 

[46Young]

Interesting I wasn't aware that students get informed as it seems a lot of them are shocked when they find out how much we pay.

Where I come from, most people know about the salaries in EMS before enrolling in the class, mostly through word of mouth.

For example, in NYC, we all know that the privates start at around $10/hr (that hasn't changed in over ten years BTW), that FDNY EMS starts in the upper 20/s/yr, and that the hospitals pay around $15/hr to start.

In VA, the privates start at around $9-$11/hr, and that to make any decent money in EMS you have to join a fire department.

Most people that get into EMS probably knows someone who does EMS, or knows someone who knows someone (or finds this forum). Thw word of mouth about salaries comes from there.

 

[46Young]

Let me ask you another way, why do you think you are the only company that does all this transports? You might say contract but I would call it something else as without it someone else would already gotten some of the contracts.

Licensing/permits/under the table transactions?

 

[Veneficus]

5=4

(sorry always wanted to say that since talking to you)

The has reached the Event Horizon we call "What's Wrong With EMS (and how come we don't get any respect or money?)".

Nice to know there are simple problems and simple solutions though.

It is because they practice at a higher level. A pilot has to think of/know many things, use math,

Damn those people and their math

EMT-B (originally known as 'EMT-A", for "ambulance") was a basic level certification aimed at teaching the most to the lowest common denominator the fastest it could be disseminated to combat the death rate on American highways.

Well said.

But as I seem to have to keep pointing out, it needs to become much more than the lowest common denominator. EMS is used with great effectiveness to patients and healthcare costs in many nations. It is time the US joins the modern world.

Otherwise, as people once braved great challenges to get there, likewise they will be begging to get out. To a world who will not pay them what they desire.

 

[18G]

True, we did not have AEDs at the BLS IFT company I worked for.

Sad. Even my son's Dentist office has an AED.

 

[Joe]

everywhere had aed's now. the supermarket i was at had one.

 

[triemal04]

Nobody claims you should work as a line cook before becomming a chef.

Don't fall for that BS.

Yeeeaah...do you know any chef's and/or professional cooks? Because if you do you should know how patently false that is.

Nothing against the rest of the post.

 

[Veneficus]

Yeeeaah...do you know any chef's and/or professional cooks? Because if you do you should know how patently false that is.

Nothing against the rest of the post.

I was trying to keep the kitchen analogy

But I do not stipulate do over should

Lots of Basics do work before medic class, as i am sure a lot of people cook prior to culinary school.

But to the best of my knowledge, nobody "has to" in order to qualify.

 

[Marinelayer]

I had the great misfortune of working for a Russian owned IFT company here in LA county, I hated going to work, and everybody else hated going to work. Group morale was very low. 99% of our job was transporting people to and from dialysis, one after the other, often without a proper break. Management was disorganized, and had little interest in patient care, community service, and medicine. Some shifts we went without gloves because we ran out in the supply room, having to swipe whatever we could from a dialysis center. There were a million reasons for me to moan about the working conditions and how under-valued I was, and believe me, I did. But at some point I got really tired of hearing myself complain, so I quit.

I now work for a 911 provider in both LA and OC. I took a pay cut, but gained benefits. My hours are better, and I work with people who enjoy their jobs. My company has strong ties with the community, and I feel good representing the company. I know that EMT Basics don't get an opportunity to do as much on emergency calls here as opposed to other places around the country, but for me that doesn't matter, not now anyways. This job is finally challenging and rewarding, and I couldn't have gotten to this point without the willingness to be pro-active about my circumstances.

 

[Veneficus]

I had the great misfortune of working for a Russian owned IFT company here in LA county, I hated going to work, and everybody else hated going to work. Group morale was very low. 99% of our job was transporting people to and from dialysis, one after the other, often without a proper break. Management was disorganized, and had little interest in patient care, community service, and medicine. Some shifts we went without gloves because we ran out in the supply room, having to swipe whatever we could from a dialysis center. There were a million reasons for me to moan about the working conditions and how under-valued I was, and believe me, I did.

I assure you, this is not exclusive to Russians or any other ethnic group or nationality.

One of my EMS jobs as a basic was working for an American family who figured out there was decent money in IFT.

They changed their former business to "medical transport."

What was that former business you may wonder?

Trucking.

The only good thing I could say about that family is they are good at it. Ruthless efficency of loads hauled to revenue.

I worked in trucks that had bumpers held together with O2 tubing. Repaired/serviced by an inhouse mechanic who I swear was paid in cheap whiskey every hour.

There were patients and crews getting sick from CO entering the driving and patient compartments. (one of the part time guys worked for a FD and brought in an AIM meter once. He was fired immediately. Not one truck in the fleet didn't register high CO levels inside.)

On some days there were no batteries for the monitors. The drugs were constantly out of date. They simply called it a BLS rig for the day and any medic working on it was payed as an EMT-B for the day since he couldn't "function" as a medic.

When the place finally lost all contracts from being an embarassment to the facilities they served, you know what they did?

Repainted about 1/4 of their fleet, registered with a different name, and are back in business today. Operating as before.

They prey on desperate and reject employees. You either want a job or you don't. In a delapitated manufacturing town, jobs are scarce and you take what you can get or you get nothing.

Back on point.

Any company can act like that. The purpose of business is to make money. As much as possible while spending as little as possible to make it.

IFT is in its basic form. Trucking.
Loads hauled over time and milage.

While some employers will see an economic benefit to providing the most basic level of medical care, public relations, advertising, and employee retention from nice equipment and professional employees, that doesn't always pay dividends, or at least not enough to justify the cost.

Read the words:

Inter-Facility Transport.

Nothing medical is stipulated.

Even in some modern countries, IFT is handled like trucking, because a majority of time, no medical intervention or care is needed. If it is, there is always 999. Which will get you an ambulance with at least 2 paramedics and maybe even a doctor who will skillfully intervene with equipment that makes US EMS look like a kiddy car.

The fact of the situation is thus: People unable to ambulate need hauled around the like cattle in modern countries. Sometimes for no other reason than family unwillingness to let them die in peace.

IFT is, for all intents and purposes, the hauling of people in order to maximize profit doing it.

Companies show compassion only if it economically benefits them to.

Welcome to being an EMT. Not quite the life saving job people expect.

But true as rain, once the novelty of 911 response wears off, you will find that at the basic level, it really isn't much different.

 

[Marinelayer]

Although I don't agree with everything in your post, I think you have a lot of great points.

And you are correct, ethnicity and nationality have nothing to do with it. My
apologies if I offended anyone.

 

[Veneficus]

Come to think of it...

I wonder if IFT would be better handled by the US Postal Service?

Certainly is cheaper than the BLS rate to send a package weighing 100kg across town.

 

[Marinelayer]

Ha! Well stated

 

[EMSLaw]

Come to think of it...

I wonder if IFT would be better handled by the US Postal Service?

Certainly is cheaper than the BLS rate to send a package weighing 100kg across town.

I think they only ship packages up to 70 lbs. Alas.

 

[Veneficus]

I think they only ship packages up to 70 lbs. Alas.

I am sure that can be adjusted to keep the agency afloat.