Why are Paramedics paid so little?

[atropine]

In a couple of our last academies, we had recruits from Medstar, bunch of them relocated from Texas to southern Cali, wonder why? I don't think education hours and protocols where the reason.

 

[usalsfyre]

In a couple of our last academies, we had recruits from Medstar, bunch of them relocated from Texas to southern Cali, wonder why? I don't think education hours and protocols where the reason.

Funny, I sat in on a MedStar academy a couple months ago and there were at least three from So Cali in there. Perhaps they're just hanging out till they hit the fire loto?

 

[NomexMedic]

For EMS... yes. How often is the standard people are held to is the bare minimum in thought, and anyone who acts different is the "dangerous" one. Somehow I doubt that Texas is any different from other states in that regard.

Oh it's different alright... Almost special. All my ex's live there after all! :rofl:

 

[BillyNightNurse]

Career Change

I am a nurse and considering what I think would be a more exciting career in EMS. I am in my late 30's. Is that too old? I still have tons of energy.

 

[Christopher]

I am a nurse and considering what I think would be a more exciting career in EMS. I am in my late 30's. Is that too old? I still have tons of energy.

I've got volly's in their 60's at my department.

Provided you can lift and move, hear, and see Ok, age is not a limiting factor.

 

[crashh]

Billy, I'm 42 and just going to Paramedic shool...and nursing school next year if all works out ok. My bf is 48 and he's a nursing student. it's never too late!

 

[NYMedic828]

I've got volly's in their 60's at my department.

Provided you can lift and move, hear, and see Ok, age is not a limiting factor.

We have vollies in their 70s....

 

[VirginiaEMT]

Why, with the advanced skill level, are paramedics paid so little?

The same reason that airline pilots are paid so little. Airline owners know that pilots LOVE to fly and are willing to sacrifice just about everything to be able to do it, so they know they will do it for little pay. EMS agencies know that medics are willing to do it for little pay because of their love for it and they would rather work for $15 an hour doing what they love verses making $20 an hour at a factory or such.

 

[Veneficus]

Some time ago I think we all came to a conclusion on what level of training would make the ideal 911 providers. If memory serves me right it was a PA and an RN working together. To me and I think most of you this would be ideal of course both would have to have specific training in pre hospital emergency medicine.

Having never been involved in the actual budgeting of staff for a 911 agency I can only throw out numbers off the top of my head. We do have some community members who have been in that position and maybe they could jump in and offer more precise numbers. In order to staff a crew consisting of a PA and an RN I would think it would be more than triple the cost of what it takes to run a basic and a medic.

One option could be to only staff a certain number of cars at that level with the remaining maybe being units staffed by a cc medic and a traditional medic eliminating basics all together. BLS could be covered by fire either paid or volunteer as it is now in many places. Once again we are faced with the problem of where would the extra money come from and what about the areas that really have no extra revenue for such an expensive venture.

Maybe looking at it from the angle of what percentage of all calls placed to 911 require traditional ALS. Once again Im working with rough numbers but I think it an 80/20 split in most areas. A far as the medi taxi (non emergent) end of the business goes I think they would work it out with the funding currently available. Im not real sure what the profit margin is for the dialysis and IFT ends of the business but perhaps they should be seperated fom 911.

Actually, if it were up to me, I would ditch the PA. It is a useless position anyway.

Recently I had the opportunity to work with a prehospital RN. Basically I would call it an RN with some paramedic training and undoubtably it is more than adequete. Even for treat and refer or treat and release.

 

[Veneficus]

I have too much time this weekend.

Wow... Just wow. This is what we have to deal with? Nursing students who are of the belief they are higher than a Paramedic. Look, it's a profession. I have continuing education, and a college degree. As of the next two years, it becomes a mandatory degree program to take your NREMT and the majority of programs in the nation now are through an accredited college requiring an Associate's degree.

I am going to have to respectfully disagree on this one.

It is a vocation. It will continue to be a vocation until 2 things come to pass.
1. Higher education is mandatory.
2. It is a unique body of knowledge that is so expansive that it cannot be a cert added on to a fire cert.

Just because a degree comes from a college doesn't mean it is a valuable education.

I have taught for an institution that to meet this degree requirement for NREMT, they pay a fee to a community college to be "a remote campus" that isn't in the state and doesn't even boarders the state. (infact it is more than 3 states away)

Second, the ole national fire academy and all of the online "fire science" stuff I have seen over the years is basically filling out a highschool level workbook and in the later case, because fire academy doesn't actually grant credit, you have to beg for it to be recognized by a real institution, isn't undergrad university level education by any length of the imagination. Even the fire officer books are so simple they don't even require opening to pass the exams because it is intuitive.

There is a host of ways medic mills are getting around the "degree" requirement. Especially in states that don't require a national registry cert. (Like Ohio where registry is based.) In fact it would take me pages to describe how EMS training institutes are getting "around" this requirement. But it all comes down to throwing enough money at the right benefactor.

There is also the matter of language. There is a difference in requiring a "degree" and requiring the teaching to be done at an "accredited" institution. So you can still take your paramedic class at the local CC, never get a degree and still meet the criteria to take registry.

I even know of 1 instance of a program accredited through a medical school that stopped paying that school because they were making "unreasonable demands" (a program director with a college degree)on the EMS institution and got a local community college to offer them "remote capus" accreditation for less money. (Not exactly professional pride there)

The only legitimacy anyone I personally know will give registry is that it is a testing agency. In fact, if you have an Ohio card instead of national registry, the CE requirements are double for Ohio comparitively.

If you are looking for the defenders of the true faith in EMS, it is certainly not National Registry. They put on a really great dog and pony show though.

Until we demand higher wages, people aren't going to pay $15,000 to become paramedic when they can walk into Jiffy Lube off the street and make more money changing oil. People with your mindset are exactly what's wrong with the profession.

I am always interested to hear why/that I am a discredit to anything I choose to get/stay involved in.

 

[Veneficus]

Chances are any Paramedic who works for a city or county will belong to a union which also raises the number higher..

If I could just add my support to this?

Most firefighters are municiple employees.

There are relatively very few others in any healthcare discipline that actually work for a government entity and not a private orgaization. (Really wealthy NPOs included)

It should not be overlooked there is a climate of unrest in the US about what public workers earn.

In both Wisconsin and Ohio, public safety workers (Police, EMS, and fire) largely supported a political party that was targeting "overpaid government workers."

Ask them how that worked out for them.

 

[emtCstock]

Being an EMT-b, I don't make much, I knew that going into the field. I always have people telling me, "why don't you do something that pays better". I however see it as I love to do this, when i'm on a unit working, it doesn't even seem like work for me, so whatever money I do get from it is an added bonus.

 

[VirginiaEMT]

Being an EMT-b, I don't make much, I knew that going into the field. I always have people telling me, "why don't you do something that pays better". I however see it as I love to do this, when i'm on a unit working, it doesn't even seem like work for me, so whatever money I do get from it is an added bonus.

This is exactly why pay is so low.. I would say a large portion of us, including me, feel this way so why would they pay more if we are willing to do it for free.

 

[Level1pedstech]

Actually, if it were up to me, I would ditch the PA. It is a useless position anyway.

Recently I had the opportunity to work with a prehospital RN. Basically I would call it an RN with some paramedic training and undoubtably it is more than adequete. Even for treat and refer or treat and release.

Your thoughts on PA's suprises me. Maybe it was a WA/OR thing but in my level one you couldnt swing a bag of saline without hitting a PA. For years my personal providers have been PA's. Yes I know they work under the supervision of an MD but patients dont always know that.

My observations have been that PA's tend to be young and some what "new school". Being more receptive to patients needs and more willing to work outside the box. My new provider here in CA is a young some what new MD,very bright but pretty much by the book. We talk and I can tell he has spent alot of time away from us regular folk. To me having a provider that able to communicate well with patients is as important as a first class education.

What is your reason for wanting to ditch PA's?

 

[Veneficus]

Your thoughts on PA's suprises me. Maybe it was a WA/OR thing but in my level one you couldnt swing a bag of saline without hitting a PA. For years my personal providers have been PA's. Yes I know they work under the supervision of an MD but patients dont always know that.

My observations have been that PA's tend to be young and some what "new school". Being more receptive to patients needs and more willing to work outside the box. My new provider here in CA is a young some what new MD,very bright but pretty much by the book. We talk and I can tell he has spent alot of time away from us regular folk. To me having a provider that able to communicate well with patients is as important as a first class education.

What is your reason for wanting to ditch PA's?

I have never encountered one who wasn't arrogant beyond thier ability.

I have determined they are people who want to play doctor without the dedication. I have heard all the excuses, why get loans, takes too much time to go to med school, want time with family, you name it.

They are basically glorified medics who can't function without their slightly expanded cookbook which they claim is practicing medicine.

 

[NYMedic828]

I have never encountered one who wasn't arrogant beyond thier ability.

I have determined they are people who want to play doctor without the dedication. I have heard all the excuses, why get loans, takes too much time to go to med school, want time with family, you name it.

They are basically glorified medics who can't function without their slightly expanded cookbook which they claim is practicing medicine.

My sort of uncle (they arent married) is a recently retired pediatrician who practiced for around 40 years. We were all out at lunch the other day and he asked me how my career was going and whatnot and I expressed my interest to him to return to school for nursing or PA once I was promoted to firefighter.

His immediate response was he does not like what has happened with PA usage and feels it is a blatant abuse of a broken system. He told me how he has sent patients to see a specialist such as an otolaryngologist and he was disgusted when he found out the patient never even saw the doctors face, but rather his PA.

Many places now are hiring one doctor for an army of PAs. Essentially, a medical director with paramedics beneath him. (I was told it basically is a loophole in having to pay malpractice insurance for a bunch of doctors)

The result of the conversation was go for nursing, work my way up to NP when I can.


In my eyes, the benefit of having a body of doctors is that you end up with a larger combined brain to establish treatment plans/goals for the more complicated patients. Certainly a PA has medical knowledge just as anyone in the medical field does, but at their own level. A doctor does not go for school for 8 years and then another few of residency for nothing.

 

[Veneficus]

My sort of uncle (they arent married) is a recently retired pediatrician who practiced for around 40 years. We were all out at lunch the other day and he asked me how my career was going and whatnot and I expressed my interest to him to return to school for nursing or PA once I was promoted to firefighter.

His immediate response was he does not like what has happened with PA usage and feels it is a blatant abuse of a broken system. He told me how he has sent patients to see a specialist such as an otolaryngologist and he was disgusted when he found out the patient never even saw the doctors face, but rather his PA.

Many places now are hiring one doctor for an army of PAs. Essentially, a medical director with paramedics beneath him. (I was told it basically is a loophole in having to pay malpractice insurance for a bunch of doctors)

The result of the conversation was go for nursing, work my way up to NP when I can.


In my eyes, the benefit of having a body of doctors is that you end up with a larger combined brain to establish treatment plans/goals for the more complicated patients. Certainly a PA has medical knowledge just as anyone in the medical field does, but at their own level. A doctor does not go for school for 8 years and then another few of residency for nothing.

What is worse is when a hospital has you seen by a PA, the doctor comes in to see you and you are billed for both.

In my experience they are the ultimate cookbook medicine.

If you don't fit into their protocol, they will treat you the same anyway until it doesn't work.

 

[DrParasite]

The result of the conversation was go for nursing, work my way up to NP when I can.

oddly enough, when I discussed PA vs NP with a doctor friend of mine, he told me there were pretty much the same jobs, except the PAs were trained by the boys, while the NPs were trained by the girls. His words not mine, but the PAs are trained to think as doctors were taught, while NPs were trained to think as nurses were taught. in the end, they were very similar.

Just something to keep in mind.

 

[Sublime]

The result of the conversation was go for nursing, work my way up to NP when I can.

At least in the hospital I work at in Texas... NP's and PA's function in the exact same manner, just with different letters on their badge. I don't know much about how their training compares, but from what I've seen they seem to have a pretty comparable knowledge base.

I know NP is soon going to become a Doctorates degree, that will be interesting.

I have never encountered one who wasn't arrogant beyond thier ability.

I have determined they are people who want to play doctor without the dedication. I have heard all the excuses, why get loans, takes too much time to go to med school, want time with family, you name it.

They are basically glorified medics who can't function without their slightly expanded cookbook which they claim is practicing medicine.

I don't see anything wrong with someone who has been in the medical field as a paramedic or nurse and wants to progress in their career, so they decide to go to PA / NP school. For many people who have already spent years in school and established themselves in a career, it is not possible to go to med school.

This is how it seems to be for most people I talk to. Obviously all NP's start out as nurses, but I know PA's who started out as medics also. By the time some people decide being a physician or practitioner is what they really want, med school is not possible.

I think some individuals choose to be cook book providers because its easy... be it a medic, PA or even MD. I don't believe its fair to say all PA's are this way (though I've worked with some who fit your description).

 

[Veneficus]

I don't see anything wrong with someone who has been in the medical field as a paramedic or nurse and wants to progress in their career, so they decide to go to PA / NP school. For many people who have already spent years in school and established themselves in a career, it is not possible to go to med school.

This is how it seems to be for most people I talk to. Obviously all NP's start out as nurses, but I know PA's who started out as medics also. By the time some people decide being a physician or practitioner is what they really want, med school is not possible.

Are you really suggesting that people who don't have what it takes to be a doctor should get to play doctor because they want to?