Why are Paramedics paid so little?

[NorCalEMTechB]

Just my 2 cents

I read through only a couple responses as to why are paramedics (and let's add EMTs, too) paid so little. While it is unfortunate as to why we are paid so little, I disagree with a lot of what people are saying. Yes, education and experience are going to dictate pay scales...higher education, higher pay. But look at Fire Departments. Look at Police Departments. They are paid very well (over here in the Bay Area pay upwards of 100k to start in the nicer areas, maybe 70k on the low end, all with great benefits and pensions). These public safety positions do not require high education such as nursing and higher medical positions like MD. So why do they get paid higher? Because of the danger of the job. FD and PD are community essentials that all people can agree that they need to have. Why not include ambulance?

It does suck that anyone and everyone can get their EMT/EMT-P and is ultimately the reason why the pay is so low. Everyone wants to be a firefighter and we are continuously told "go get your medic and you'll get a fire job" so now medics are easy to come by so FDs and places higher medics as EMTs to pay lower and to be able to use them for later if and when they need medics. It's just such a messed up system and time right now. Very discouraging. Other than my ramble, I still disagree that Paramedics should not be paid a similar salary to RNs. Two similar but very different occupations. Obviously a paramedic is a more dangerous job with higher risks out in the field, and have to make quicker, higher stress decisions than RNs/PAs do. Honestly, what more does an RN do for the patient (life-saving) that a Paramedic can't legally do? I agree RN/PA makes the population a lot smaller by requiring more schooling and more prereqs in a competitive field just to get into a program. It is truly scary the people who are paramedics. I think it's time for paramedic schools to get a lot tougher and weed people out before they kill someone and scare their partners on a daily basis.

No disrespect to ANY medical profession. I am just saying Paramedics deserve a lot higher pay so they can at least make a quality career out of it. Why would you other medical professionals (i.e. RN, PA, MD) who have had their say on here believe Paramedics shouldn't get paid higher? Our pay has nothing to do with your pay. I am scared that Paramedic positions will soon be the new EMT and pay dirt cheap and offer no career option (not that I believe anyone could make a great career out of being an EMT). Just giving my two cents...I have been striving towards the fire service since I was 15. I have earned an AS and a BS degree and have 5 years field experience. I have never made more than $20/hr base pay. Try to live off that in the Bay Area...lol

 

[Veneficus]

No disrespect to ANY medical profession. I am just saying Paramedics deserve a lot higher pay so they can at least make a quality career out of it. Why would you other medical professionals (i.e. RN, PA, MD) who have had their say on here believe Paramedics shouldn't get paid higher? Our pay has nothing to do with your pay. I am scared that Paramedic positions will soon be the new EMT and pay dirt cheap and offer no career option (not that I believe anyone could make a great career out of being an EMT). Just giving my two cents...I have been striving towards the fire service since I was 15. I have earned an AS and a BS degree and have 5 years field experience. I have never made more than $20/hr base pay. Try to live off that in the Bay Area...lol

I have detailed extensively over the years what paramedics have to do to increase their value and demand higher wages.

The long and short of it is as it stands paramedics may feel they are worth more, but everyone feels they should be paid more.

US paramedics have not done what is required in every modern society, which is increase the level of education, in order to get a raise.

As it stands, US society sees them as ambulance drivers. Who are pad accordingly. (Don't believe me, call medicare and ask them what they pay EMS for.)

(it is transport, not treatment. Otherwise you would be able to bill for treat and release or treat and refuse)

 

[NYMedic828]

I can't remember the last time I had to make a truly high stress decision in EMS, that's a poor argument to compare to RN level.

As far as a cop or firefighter, they don't get paid more because their job is more dangerous. You don't see it as often because it isn't as prestigious but look how many construction workers are injured and killed a year. That doesn't get them higher pay.

The difference between a paramedics and fireman/cops is that fireman and cops are their own entity. In a large portion of the country, EMT/paramedic is considered a supplement to firefighter/LEO. The standard of education is considered so low, that we actually consider it an add on to other professions.

Fireman are good at putting out fires.
Police are good at enforcing the law (usually)
I can't say the same for EMS. Not by a long shot.

The people who do have that ambition to reach beyond the boundaries of the educational standard of EMS often move on with their lives. The doctor above me is a prime example. I myself have NO desire to stay at this level the rest of my life and am planning every day how to move away from it.

EMS is honestly a dying system in the US. If we don't re-work it on a government level, it will cease to exist at some point. (atleast the way we know it)

 

[NorCalEMTechB]

I have detailed extensively over the years what paramedics have to do to increase their value and demand higher wages.

The long and short of it is as it stands paramedics may feel they are worth more, but everyone feels they should be paid more.

US paramedics have not done what is required in every modern society, which is increase the level of education, in order to get a raise.

As it stands, US society sees them as ambulance drivers. Who are pad accordingly. (Don't believe me, call medicare and ask them what they pay EMS for.)

(it is transport, not treatment. Otherwise you would be able to bill for treat and release or treat and refuse)

I am not sure I completely see what you are saying. But I agree they need to make paramedic a more desirable and educational job. Few places make a Paramedic Associates Degree (I can only think of Foothill College in Palo Alto) and I know there is a 4 year university in Washington that offers a Bachelor's Degree in Paramedicine which is I am sure brings a lot of value to the job there in Washington state. People do see EMS as ambulance drivers...including docs and nurses! EMS obviously respects MDs and RNs, why not vice versa?

I can't remember the last time I had to make a truly high stress decision in EMS, that's a poor argument to compare to RN level.

As far as a cop or firefighter, they don't get paid more because their job is more dangerous. You don't see it as often because it isn't as prestigious but look how many construction workers are injured and killed a year. That doesn't get them higher pay.

The difference between a paramedics and fireman/cops is that fireman and cops are their own entity. In a large portion of the country, EMT/paramedic is considered a supplement to firefighter/LEO. The standard of education is considered so low, that we actually consider it an add on to other professions.

Fireman are good at putting out fires.
Police are good at enforcing the law (usually)
I can't say the same for EMS. Not by a long shot.

The people who do have that ambition to reach beyond the boundaries of the educational standard of EMS often move on with their lives. The doctor above me is a prime example. I myself have NO desire to stay at this level the rest of my life and am planning every day how to move away from it.

EMS is honestly a dying system in the US. If we don't re-work it on a government level, it will cease to exist at some point. (atleast the way we know it)

I totally agree, NYMedic828. I did not mean to say PD and FD only get paid a generous salary and pension because of risk entirely, but that does have a significant effect. And I could not agree any more that there are too many EMS people who have no ambition and no drive to move on. For me, I have always wanted to be a firefighter, and being a paramedic is turning into the norm to get into fire. With that, brings a bunch of D-bag EMTs and Paramedics who overflow the system and equates to low pay from a high supply of EMS personnel. A high turnover rate makes it even easier for ambulance companies to pay medics dirt. I do have ambition and drive to get out of this field and get with a City FD as a Fire medic, but so do thousands of others (literally, took Richmond, Ca FD test a few weeks ago had thousands of applicants for 8 positions...took FDNY's test and who knows how many 10's of thousands were there). So, ultimately, I do not think it's the problem of desire to stay as an EMT or medic for life, I don't think many lifers are 100% content with being on a box for life. It's more the harsh reality of the economy and everyone wanting to be Fire or whatever else that uses EMT and Medic as a stepping stone. I myself have been an EMT for 3 years on a transport ambulance, 2 years on a small county FD engine. So obviously it's a stepping stone job but I think it should have a better option of a career, since THERE ARE people who make risking their life and being physically and mentally demanding on their body a career. It's more frustrating than anything to see anyone and everyone get into this field. Supply and demand issue. Definitely low quality medics and EMTs resulting. As I said prior, paramedics need to have a degree option, and standards and schools/programs need to be more strict to who they pass and give the opportunity to take their NREMT-P...I personally know wayyyy tooooo many horrible and scary techs and medics

 

[Veneficus]

People do see EMS as ambulance drivers...including docs and nurses! EMS obviously respects MDs and RNs, why not vice versa?

US paramedics do not have enough education.

 

[VFlutter]

US paramedics do not have enough education.

Also I think that a lot of medical professionals, especially outside of the ER, do not really understand what paramedics actually do. They can not tell you the difference between a basic and a paramedic. The only contact some nurses get with EMS may be when they pick up a patient from the floor and take them back to the nursing home. They never see any real patient care. So to them, all they see are ambulance drivers.

Kind of a side comment. I was trying to explain the difference between an EMT and paramedic to a nursing classmate and I made the comment that paramedics can intubate. and her response was "Wow, how long do you have to go to school to do that?" She was shocked to find out how little you are actually required to do. With all of the invasive procedures paramedics are allowed to do there is a general expectation that they have a substantial amount of education and training. Without the education, we just look like cookbook technicians who can only follow an algorithm and have no understand of why we are doing it.

 

[Level1pedstech]

US paramedics do not have enough education.

Like it or not they actually do for the way the system is currently set up. Replacing or adding additional education is not something that sits high on the list of things to do for most people.

What would happen to the people that get displaced because they are not able to advance their education due to cost or available time. Wait I know we can have another grand government program sold to us with the promise of EMS jobs for everyone. What about those that think the educational requirements are just fine for those providing pre hospital EMS?

Once again the bottom line is where is the return on investment for people that put in the extra time and effort to advance their education? Why should anyone put any extra effort into obtaining above what is required to meet certification?If people want to advance their education because they get all warm and fuzzy then have at it. Glad they have the money and free time. For those of us that would like to be able to make a decent living,show us the money.

 

[VFlutter]

Like it or not they actually do for the way the system is currently set up.

Once again the bottom line is where is the return on investment for people that put in the extra time and effort to advance their education? Why should anyone put any extra effort into obtaining above what is required to meet certification?If people want to advance their education because they get all warm and fuzzy then have at it. Glad they have the money and free time. For those of us that would like to be able to make a decent living,show us the money.

This has been brought up so many times but I will say it again; Unfortunatly that is why paramedics will be stuck where they are. That is not the way things work. The education must come first. No one is going to "show you the money" with the hopes that the profession will eventually catch up. Why would you pay someone more money without them improving their marketability first? Again look at the numerous medical professions that faced this exact same problem....


Again going back to the intubation example. How much education does a resident have to receive before they are allowed to intubate?

 

[JPINFV]

Like it or not they actually do for the way the system is currently set up. Replacing or adding additional education is not something that sits high on the list of things to do for most people.

True, but the things that higher education can justify (increased reimbursment, increased scope, increased autonomy) does generally rank higher. It's like a kid who wants dessert without eating dinner first.

What would happen to the people that get displaced because they are not able to advance their education due to cost or available time. Wait I know we can have another grand government program sold to us with the promise of EMS jobs for everyone. What about those that think the educational requirements are just fine for those providing pre hospital EMS?

No one is crying about the computer putting typewriter companies and typewriter repair companies out of business. There's no outrage that the car destroyed many buggy whip manufactueres and retailers. Evolving EMS isn't going to be painless either, however maintaing the status quo is unacceptable.

Once again the bottom line is where is the return on investment for people that put in the extra time and effort to advance their education? Why should anyone put any extra effort into obtaining above what is required to meet certification?If people want to advance their education because they get all warm and fuzzy then have at it. Glad they have the money and free time. For those of us that would like to be able to make a decent living,show us the money.

...and here's the problem with EMS. The minimum is treated as the maximum. Why learn anything more if you can't actually use it, and it's an extremely valid point.

 

[JPINFV]

Again going back to the intubation example. How much education does a resident have to receive before they are allowed to intubate?

Depends... I have an anestheiology rotation near the end of 3rd year of medical school (elective rotation), and I should be intubating during that rotation. Similarly, I imagine most EM physicians end up intubating sometime during their audition rotations during 4th year. The bigger question is what about non-ENT, non-EM, non-anesthiology physicians where intubation isn't really in their skill set.

 

[Level1pedstech]

This has been brought up so many times but I will say it again; Unfortunatly that is why paramedics will be stuck where they are. That is not the way things work. The education must come first. No one is going to "show you the money" with the hopes that the profession will eventually catch up. Why would you pay someone more money without them improving their marketability first? Again look at the numerous medical professions that faced this exact same problem....


Again going back to the intubation example. How much education does a resident have to receive before they are allowed to intubated?

Really I should have said there is no money to show and in the future its only going to get worse. When the press is giving mass coverage to the bodies piling up on the streets due to the lack of education of the nations EMS providers you might get some change. You need to show proof that change to a better system is needed. By proof I dont mean a comparison to the EMS system in some socialistic hell hole that provides your idea of dream service for 25 million people. We have a current population of 300 million give or take a few illegals in case you didnt know.

Again there is no money for agencies to up the pay for advanced education. Put them in a position where they have to pay more and the doors will close. Lay offs are becoming more common than hirings and the market is flooded with people jumping at the chance to work for chump change.

After all the time and effort you have put into your education would you be willing to give up nursing and go hit the streets as a full time medic for 25k a year?

 

[NYMedic828]

I'm going to state the painful truth as bluntly as I can.

EMS IS GOING TO DIE A PAINFUL DEATH.

That's all there is to it. There is no need to argue about it, just accept the facts.

It may not be now or any time soon but EMS can not go on this way. I dont mean the concept of EMS will die, but the current system certainly will. Unfortuntately the only way to fix it is to completely throw it away and start over.

The medical world is advancing FAR too quickly for a bottom of the food chain service to keep up. We are already behind and it only gets worse from here.

Go ahead and tell me I'm wrong and my attitude is poor but I have accepted reality. That's all their is to it.

Grab some popcorn, buckle your seatbelt and just wait.

 

[VFlutter]

After all the time and effort you have put into your education would you be willing to give up nursing and go hit the streets as a full time medic for 25k a year?

Of course this will sound like proof of your argument but Nope, because I feel like my education deserves a higher pay. And since I do have an education I have leverage to bargain with to demand higher pay. I would not settle for anything less, and I am sure there are companies out there that would gladly pay more so that they can say they have the most educated employees. Think if an ambulance company could say all their paramedics are bachelors educated... Do you think public image would be better? Would they get more contracts? Would hospitals give them all the CCT?

On the flip side I spent an extra ~$15k+ to get a BSN when I could have saved the money getting an ADN and still made the same amount as an RN. But I wanted to get the highest education possible for myself and set my self up for advancement in the future.. Personal choice with no monetary incentive.

 

[rescue1]

You need to show proof that change to a better system is needed. By proof I dont mean a comparison to the EMS system in some socialistic hell hole that provides your idea of dream service for 25 million people. We have a current population of 300 million give or take a few illegals in case you didnt know.

Why would comparison to a functioning and effective EMS system be a bad thing? Obviously there are differences due to size, taxes, and government structure, but EMS is funded similarly in most western countries--municipal taxes.

Besides, I was in Canada last week, and it didn't seem too hellish. Kind of chilly, actually.

 

[usalsfyre]

Really I should have said there is no money to show and in the future its only going to get worse. When the press is giving mass coverage to the bodies piling up on the streets due to the lack of education of the nations EMS providers you might get some change. You need to show proof that change to a better system is needed. By proof I dont mean a comparison to the EMS system in some socialistic hell hole that provides your idea of dream service for 25 million people. We have a current population of 300 million give or take a few illegals in case you didnt know.

Again there is no money for agencies to up the pay for advanced education. Put them in a position where they have to pay more and the doors will close. Lay offs are becoming more common than hirings and the market is flooded with people jumping at the chance to work for chump change.

After all the time and effort you have put into your education would you be willing to give up nursing and go hit the streets as a full time medic for 25k a year?

This is attitude is why EMS will die the painful death referenced above. Level1pedstech, you've referenced in the past your at the end of your career. Understanding that's your point of view, please try not to influence too many of the younger generation of providers.

 

[lateralligator]

So hang on...an EMT-P with an associates degree makes $10-$17/hr? Or is that for an EMT-B?

Sorry for the confusion...I make about $36k as a massage therapist and will top out in a couple more years at maybe $40k. Im interested in paramedic training for more/ new challenges, very good health benefits (have none now) and MORE income (as in 50k+).

Am I barking up the wrong tree as far as income?

Im 48. Time's a-wastin.' :blink:

 

[Level1pedstech]

Of course this will sound like proof of your argument but Nope, because I feel like my education deserves a higher pay. And since I do have an education I have leverage to bargain with to demand higher pay. I would not settle for anything less, and I am sure there are companies out there that would gladly pay more so that they can say they have the most educated employees. Think if an ambulance company could say all their paramedics are bachelors educated... Do you think public image would be better? Would they get more contracts? Would hospitals give them all the CCT?

On the flip side I spent an extra ~$15k+ to get a BSN when I could have saved the money getting an ADN and still made the same amount as an RN. But I wanted to get the highest education possible for myself and set my self up for advancement in the future.. Personal choice with no monetary incentive.

So your education deserves better pay,got it. As far as having leverage to bargain,last time I checked there were not 100 or so RN applicants per job. The proof to my arguement is that when you have a medical emergency in most developed areas of the country you dial 911 you get help. Now the educational level of those providers responding may not be up to the expectations of some or even all of those in the EMS community but most people could give a rats butt.

The point is that people know when they dial 911 they get the help they need,until it gets to the point of a mass system failure (think the massive power failure in India) there will be no large scale change. Besides change should be started at the local level and if sucessful would serve as a model for national change.

Personal choice with no monetary incentive is how it should be. Like I said if people want to become better educated providers then have at it. Forcing an increase in education standards thinking employers will reward that education is naive to say the least.

 

[triemal04]

So hang on...an EMT-P with an associates degree makes $10-$17/hr? Or is that for an EMT-B?

Sorry for the confusion...I make about $36k as a massage therapist and will top out in a couple more years at maybe $40k. Im interested in paramedic training for more/ new challenges, very good health benefits (have none now) and MORE income (as in 50k+).

Am I barking up the wrong tree as far as income?

Im 48. Time's a-wastin.' :blink:

I have a degree and make considerably more than that; not because of my degree though.

There's probably some exceptions, but off the top of my head I can't think of any place where having a degree will automatically get you a raise. If it's a field job with a variable starting pay it might be taken into consideration, but still probably not a gaurentee.

Most people will tell you that paramedics get paid ****...and they aren't completely wrong, but they aren't completely right either. Everybody can bring up stories about medic's getting paid $10-12/hr, but just because that's what happens in that particular area doesn't make it the norm, or mean that every place is like that.

There are plenty of well paying jobs with good benefits and decent retirement plans out there. You just have to a)put in the time and effort in finding them, b)be willing to go to the job, not expect it to come to you; ie move, and c)have the qualities/experience/education/personality that the service wants. Way to many people aren't willing to do these things and think their area is representative of the whole; hence why you get the line about how all paramedics don't get paid squat.

You can easily make close to 50K a year without killing yourself with overtime as a medic; for a job that pays that much you probably won't have to search to hard (depending on your area of course).

Average pay may be lower than it should be, but with a bit of effort and some brains you can easily increase that for yourself.

 

[VFlutter]

So your education deserves better pay,got it. As far as having leverage to bargain,last time I checked there were not 100 or so RN applicants per job. The proof to my arguement is that when you have a medical emergency in most developed areas of the country you dial 911 you get help. Now the educational level of those providers responding may not be up to the expectations of some or even all of those in the EMS community but most people could give a rats butt.

The point is that people know when they dial 911 they get the help they need,until it gets to the point of a mass system failure (think the massive power failure in India) there will be no large scale change. Besides change should be started at the local level and if sucessful would serve as a model for national change.

Personal choice with no monetary incentive is how it should be. Like I said if people want to become better educated providers then have at it. Forcing an increase in education standards thinking employers will reward that education is naive to say the least.

Actually the large magnet hospital in my area just had an graduate nurse application session this summer. 700 people applied for 100 jobs. So they got to be as selective as they wanted. A large majority of those hired were BSN nurses, many ADN new grads didn't even get an interview.

I do not think it is that naive with how competitive healthcare is becoming. Hospitals, ambulance companies, HEMS are going to have a much harder time getting reimbursement and will need to work harder to attracted "costumers".

 

[Level1pedstech]

This is attitude is why EMS will die the painful death referenced above. Level1pedstech, you've referenced in the past your at the end of your career. Understanding that's your point of view, please try not to influence too many of the younger generation of providers.

These younger people coming into the field need to be aware of what awaits them in the real world. Low wages,crappy benefits,poor working conditions and fellow workers with horrible attitudes is just the start.

I highly suggest a bypass around field EMS and a path into the higher levels of health care. Besides what kind of message do you think the doom and gloomers are sending.