New Medic-ideal EMS system

[Angel]

question for the vets...

i have 3 test/interviews for medic positions coming up. and am waiting for a response from another one. as a new medic i find myself wanting to be picky because i want the most experience as possible, ideally in an area with few(er) ALS providers, high call volume and fairly lax protocols. Ive considered rural (american, hall ect) but pay is a huge deal for me because i want to live on my own and be able to have decent things (not struggling check to check).

anyway what are some things you guys would advise for me to help make a decision?

one area is a dual medic system with mostly als fire (ca coast) (commute like 2 hrs, 24 hr shifts) (decent protocols)
another is remsa (move) (best protocols)
the third is 1 emt/1 medic, bls fire in an area mostly filled with poverty and drug abusers. rural (commute about 40 mins) (ok protocols, a little more restrictive than my internship time)

pay varies by 2-3 dollars and for 12 hr shifts

the one im waiting on a response from pays crap ($12hr) and runs a lot of SNF scene calls in a metro area

what do you guys think?

 

[TransportJockey]

question for the vets...

i have 3 test/interviews for medic positions coming up. and am waiting for a response from another one. as a new medic i find myself wanting to be picky because i want the most experience as possible, ideally in an area with few(er) ALS providers, high call volume and fairly lax protocols. Ive considered rural (american, hall ect) but pay is a huge deal for me because i want to live on my own and be able to have decent things (not struggling check to check).

anyway what are some things you guys would advise for me to help make a decision?

one area is a dual medic system with mostly als fire (ca coast) (commute like 2 hrs, 24 hr shifts) (decent protocols)
another is remsa (move) (best protocols)
the third is 1 emt/1 medic, bls fire in an area mostly filled with poverty and drug abusers. rural (commute about 40 mins) (ok protocols, a little more restrictive than my internship time)

pay varies by 2-3 dollars and for 12 hr shifts

the one im waiting on a response from pays crap ($12hr) and runs a lot of SNF scene calls in a metro area

what do you guys think?

I'd say REMSA. Keep in mind that it'd be a raise even if you made teh same amount of money as you do in Cali, as there's no state tax... and I just personally don't like EMS in Cali. REMSA has a decent reputation, good protocols, good autonomy, and the pay seems good.

 

[NomadicMedic]

I'd tell you to investigate my service, but we're not hiring. Good luck in your search.

 

[BeachMedic]

question for the vets...

i have 3 test/interviews for medic positions coming up. and am waiting for a response from another one. as a new medic i find myself wanting to be picky because i want the most experience as possible, ideally in an area with few(er) ALS providers, high call volume and fairly lax protocols. Ive considered rural (american, hall ect) but pay is a huge deal for me because i want to live on my own and be able to have decent things (not struggling check to check).

anyway what are some things you guys would advise for me to help make a decision?

one area is a dual medic system with mostly als fire (ca coast) (commute like 2 hrs, 24 hr shifts) (decent protocols)
another is remsa (move) (best protocols)
the third is 1 emt/1 medic, bls fire in an area mostly filled with poverty and drug abusers. rural (commute about 40 mins) (ok protocols, a little more restrictive than my internship time)

pay varies by 2-3 dollars and for 12 hr shifts

the one im waiting on a response from pays crap ($12hr) and runs a lot of SNF scene calls in a metro area

what do you guys think?

Which is the third?

And do you really want to live in Reno?

 

[46Young]

question for the vets...

i have 3 test/interviews for medic positions coming up. and am waiting for a response from another one. as a new medic i find myself wanting to be picky because i want the most experience as possible, ideally in an area with few(er) ALS providers, high call volume and fairly lax protocols. Ive considered rural (american, hall ect) but pay is a huge deal for me because i want to live on my own and be able to have decent things (not struggling check to check).

anyway what are some things you guys would advise for me to help make a decision?

one area is a dual medic system with mostly als fire (ca coast) (commute like 2 hrs, 24 hr shifts) (decent protocols)
another is remsa (move) (best protocols)
the third is 1 emt/1 medic, bls fire in an area mostly filled with poverty and drug abusers. rural (commute about 40 mins) (ok protocols, a little more restrictive than my internship time)

pay varies by 2-3 dollars and for 12 hr shifts

the one im waiting on a response from pays crap ($12hr) and runs a lot of SNF scene calls in a metro area

what do you guys think?

Who offers the best retirement, job security, and working conditions?

No sense wasting a few years working somewhere just because it's busy, when you could apply those years towards retirement.

There will come a time in your career where retirement income suddenly becomes very important. Getting married and having a kid is what made me leave the NYC 911 system for a more lucrative career in Northern Virginia.

You don't want to be looking for an employet with better benefits when you're in your 40's. I've seen that happen many times.

 

[MonkeyArrow]

If you're looking to use your advanced skills more frequently, I would suggest going with the third one. The rural setting will give you more time to attend to the more critical patents while transporting to a hospital. The BLS fire scene, even assuming that they don't transport, will make you the only ALS provider in a X mile radius, which is what it seems that you want. The pt. demographic would also lead to some ODs and cardiac arrests as well as your fair share of BS calls.

 

[Angel]

Who offers the best retirement, job security, and working conditions?

No sense wasting a few years working somewhere just because it's busy, when you could apply those years towards retirement.

There will come a time in your career where retirement income suddenly becomes very important. Getting married and having a kid is what made me leave the NYC 911 system for a more lucrative career in Northern Virginia.

You don't want to be looking for an employet with better benefits when you're in your 40's. I've seen that happen many times.

I haven't even considered that. I will have to look into it for sure because I don't know what any of them offer.

The third place is bi county (yuba city, marysville area) which my assumption would be no retirement or anything like that due to their size, but ill have to ask since there's no info online.
About Reno, I've never even been h34r: I've heard nothing but positive things about their ems system but don't know much about the town other than it snows and can get really hot in the summer. I imagine there's a lot to do as far as outdoorsy things but that's not a make or break for me.

 

[46Young]

I haven't even considered that. I will have to look into it for sure because I don't know what any of them offer.

The third place is bi county (yuba city, marysville area) which my assumption would be no retirement or anything like that due to their size, but ill have to ask since there's no info online.
About Reno, I've never even been h34r: I've heard nothing but positive things about their ems system but don't know much about the town other than it snows and can get really hot in the summer. I imagine there's a lot to do as far as outdoorsy things but that's not a make or break for me.

A wise man once told me that it's all about the best retirement. When I started in EMS, I couldn't care less about benefits - I just wanted to do 911. After a couple of years, I became a medic, but by that time I was already growing tired of high cost of living (NYC), posting on street corners, no job security, and no pension. This was/is a prestigious NYC 911 participating hospital employer, and they paid well, but that system is not where I saw myself working for 25 years straight.

There are several things that you must consider when choosing an employer to work for an entire career:

The work hours - employers frequently post a yearly or monthly salary, instead of an hourly rate. The higher your weekly average hours are, the less your hourly rate will be, which also causes your OT rate to be lower. For example, I made $30/hr as a medic in NYC before I left for SC. NY was a 40 hour work week, so my yearly salary was a little over $60k/yr, and my OT was $45/hr. In SC, it was a 56 hour workweek, and the yearly pay was $38k (up to $45k after clearing as a crew chief), so my hourly rate was an abysmal $11.50 (approx.), which made my OT rate less than $18/hr! Don't get caught in that trap. Many Southeastern departments have lousy pay like that, with medics starting in the low to mid $30k/yr.

Job security - is the employer municipal, hospital based, or private? The municipal employer should be the most stable, and typically has a pension and the best benefits. The hospital based employer may pay more per hour than municipal, but the benefits may be inferior, although the work hours and working conditions may be better. In a hospital based system, there is room for career advancement within the health system, although it may not be in the EMS department where you started. What is there for career advancement in EMS anyway? EMT>medic>supervisor (rare), maybe dispatcher, training, or support services? That's not a whole lot of variety. The hospital based system is most likely to rearrange your work hours to conform to a school schedule. I find it foolish to try to make a career in private EMS. The job security is abysmal. You have to worry about getting let go for a new person that commands a lower salary and will not be likely to complain. More importantly, you'll always have to worry about the company losing it's contracts. How many threads have been started about XYZ company losing it's contract, or being pushed out by the fire service?

Retirement - 401k/403b, pension, or hybrid? If you're going to work for the privates or the hospitals, your 401k or 403b are portable. The problem is, hardly anyone knows how to invest, and most people wait until too long to begin contributing. It's time in, not timing, as they say. Let's assume that you're making $75k/yr as a medic. Conventional wisdom says to save 10% of your pay from day 1. No one does this, but everyone should. You'll be deferring $7,500 gross + whatever employer match, 6% being generous. If you're contributing $8,000 (yours + match) per year, with an 8% ROI, for 25 years, you'll have $631,635.32. It's typical to live off of 5% of that without touching principal, so your retirement income is $31,600/yr, before tax. Or, you could work for 40 years, and have $2,238,248.32, for a retirement income of $112k/yr. That's pretty good, but who can last 40 years in EMS? I'll stick to my pension and 457.

Pay - pop quiz - assume two potential jobs - one pays $50k/yr, with a cost of living of $30k/yr. The second employer pays $100k/yr, with a cost of living of $60k/yr. Both have a 25 and out @75%. Who do you choose? You choose the employer in the area with the higher cost of living with the higher pay. I'd much prefer 75% of $100k vs 75% of $50k. You can always locate somewhere less expensive after you retire.

 

[46Young]

I've talked negatively about Charleston County EMS (SC) in the past, and a lot of that was due to being run ragged with high call volume coupled with 24 hour shifts which were frequented with 12-24 hour holdovers for 36-48 hour shifts. I've noticed that they've just went to all-12 hour shifts, so it might not be so bad to work there now. Too bad that they didn't do that while I was down there in '07-'08. Maybe I would've stayed. Their hourly starting pay was advertised as $16-$20/hr. Much better than $11.50.

One thing though, SC got rid of their TERI (DROP up here).

 

[Angel]

thanks so much for that insight. id love to get on a third service somewhere but in CA its all fire. so there's that.
ive done privates so far and know and despise it. its everything you said and more, so the sooner i can get out the better.
im not against moving out of state but itd take a lot of research on my end.

this definitely isnt as simple as i thought.

 

[TransportJockey]

thanks so much for that insight. id love to get on a third service somewhere but in CA its all fire. so there's that.
ive done privates so far and know and despise it. its everything you said and more, so the sooner i can get out the better.
im not against moving out of state but itd take a lot of research on my end.

this definitely isnt as simple as i thought.

Come to texas lol