Why do medics with the FD make more?

[46Young]

http://marginalrevolution.com/marginalrevolution/2012/07/firefighters-dont-fight-fires.html
- That's not the bottom line:

http://www.rcinet.ca/en/2013/09/13/fires-in-modern-houses-burn-faster-hotter-more-toxic/

Meanwhile, fires burn much hotter, much faster than they did in the past. Collapses happen much quicker as wwll, due to the prevalence of type V construction. If anything, the residents have much less time to react, and the FD has much less time to protect exposures (sucks when a whole row of town homes goes off), or do a primary search while parts of the structure are still tenable, much less keep it to a room and contents, or just food on the stove, instead of a structure fire or full involvement, because staffing and deployment were pared back due to the infrequency of fire calls.

As far as the staffing part of the equation, four on a unit gets work done much faster than two or three. That's been proven many times over.

That's the bottom line.

 

[BEN52]

The question was asked. Many calud answers were given. Alarmingly many people jumped up and blasted the pay and defended their low pay.

Until single role providers realize their self worth, unite, and fight accordingly nothing will change.

I don't consider myself a hero. I don't think im a "god". I don't think poorly of single role / private providers. I do think I deserve to make a reasonable living wage that doesn't require ot or a side job to own a decent home and pay my bills. I do think I deserve quality health benefits and an adequate pension that allows me a comfortable retirement after 25 year. I do think I deserve safe and comfortable living quarters as well as modern, safe equipment. I do think I deserve a career ladder that allows for growth, development, and merit based promotion. I do think I deserve a management team that fosters a good work environment and a culture of quality service. If you don't think you deserve this as a provider of an essential service you undervalue yourself.

I make no apologies for defending any of this.

 

[DrParasite]

I do think I deserve to make a reasonable living wage that doesn't require ot or a side job to own a decent home and pay my bills. I do think I deserve quality health benefits and an adequate pension that allows me a comfortable retirement after 25 year. I do think I deserve safe and comfortable living quarters as well as modern, safe equipment. I do think I deserve a career ladder that allows for growth, development, and merit based promotion. I do think I deserve a management team that fosters a good work environment and a culture of quality service. If you don't think you deserve this as a provider of an essential service you undervalue yourself.

I agree.... but if you did, why would you work a job where you don't make a reasonable living wage? a job that gives you poor benefits and/or no pension? poor quarters if your lucky, posted in an ambulance for 12 hours on a street corner? no career ladder? work for a job that stresses quality service, but makes every mistake a punitive action, and an environment of suck?

I agree that ALL EMS providers deserve what you think they deserve, but many EMS workers are willing to accept less. and a lot of fire departments started off with less, and through the hard work of generations before them, ended up in the position they are in now. And the fire medics are often able to capitalize on that as well. Also note that civilian FD based medics often make much less than their supression counterparts (cough FDNY EMS cough).

As long as you are willing to accept a job for less than ideal, or someone is willing to accept that poorly paying job offer, the market won't change. Only when everyone stand up and say "No, I won't work for less than 15 an hour" will employers raise wages.

 

[Carlos Danger]

My father-in-law is a union tradesman in one of the major metro areas in the north. Good, hardworking man. Been in Local XXX since he was 18 or 19, shortly after dropping out of high school. Makes well into the six figures most years, even when he takes takes several months off to live on unemployment because work is slow, or he doesn't like the commute to the jobs that are available then, or when he just feels like taking a vacation.

On several occasions we've had discussions that go something along these lines:

Dad: I'm glad that last job is over. I told Vinnie to tell the bosses not to bid on no more work like that right now, but you know, those guys down at the hall never stop lining up work. Right now they say we've got work scheduled to start as far out as 5 years from now.

Me: 5 years from now? What project manager can wait that long to start construction? Why don't they start it sooner?

Dad (proudly): They ain't got no choice but to wait. We and the other locals are just booked up.

Me: Why don't they hire a private firm?

Dad: Cuz they can't, cuz these are either public projects (which require the use of union labor,) or they involves some big tax deals or something for somebody and part of those deals is that they agree to use union labor.

Me: So the government is forcing the people doing these projects to use union labor, even though they are unable to start the project for several years?

Dad (proudly): Yep. We cost a lot more, too, but they gotta use us. Them bosses really take care of us. Make sure we got work and that we get paid what we are worth.

Me: Why do you cost so much more?

Dad (proudly): Cuz I get $54 per hour plus (recites a whole list of great benefits and ridiculous work rules), and double time for anything over 32 hours in a week - those private firms pay their guys like $25 bucks an hour and some crappy insurance and only 2 weeks vacation.

Me: Why do you make so much more than what the private guys do, though?

Dad: Cuz I'm in the union.

Me: I know.....but what makes your labor worth more than a private guy doing the same exact job?

Dad: Cuz the union takes care of us.

Me: Yeah, obviously they do. But how do they justify forcing others to pay you guys so much more than the market rate?

Dad: Cuz the laws say that they have to use us. So we can basically charge as much as we want.

Me: But why?

Dad: Cuz union.

Me: Dad, you realize you aren't answering my question at all. So you are saying that you are legitimately worth whatever the union bosses can convince the state and local governments to force others to pay you, even if it's far more than a private firm is able to charge?

Dad: Yeah. Whatever. Stop it with your philosophy mind tricks, you prick. And pour me another drink.

Me. No mind tricks, Dad, I just like to figure out how things work they way they do. Good talk.​

 

[gonefishing]

My father-in-law is a union tradesman in a one of the major metro areas in the north. Good, hardworking man. Been in Local XXX since he was 18 or 19, shortly after dropping out of high school. Makes well into the six figures most years, even when he takes takes several months off to live on unemployment because work is slow, or he doesn't like the commute to the jobs that are available then, or when he just feels like taking a vacation.

On several occasions we've had discussions that go something along these lines:

Dad: I'm glad that last job is over. I told Vinnie to tell the bosses not to bid on no more work like that right now, but you know, those guys down at the hall never stop lining up work. Right now they say we've got work scheduled to start as far out as 5 years from now.

Me: 5 years from now? What project manager can wait that long to start construction? Why don't they start it sooner?

Dad (proudly): They ain't got no choice but to wait. We and the other locals are just booked up.

Me: Why don't they hire a private firm?

Dad: Cuz they can't, cuz these are either public projects (which require the use of union labor,) or they involves some big tax deals or something for somebody and part of those deals is that they agree to use union labor.

Me: So the government is forcing the people doing these projects to use union labor, even though they are unable to start the project for several years?

Dad (proudly): Yep. We cost a lot more, too, but they gotta use us. Them bosses really take care of us. Make sure we got work and that we get paid what we are worth.

Me: Why do you cost so much more?

Dad (proudly): Cuz I get $54 per hour plus (recites a whole list of great benefits and ridiculous work rules), and double time for anything over 32 hours in a week - those private firms pay their guys like $25 bucks an hour and some crappy insurance and only 2 weeks vacation.

Me: Why do you make so much more than what the private guys do, though?

Dad: Cuz I'm in the union.

Me: I know.....but what makes your labor worth more than a private guy doing the same exact job?

Dad: Cuz the union takes care of us.

Me: Yeah, obviously they do. But how do they justify forcing others to pay you guys so much more than the market rate?

Dad: Cuz the laws say that they have to use us. So we can basically charge as much as we want.

Me: But why?

Dad: Cuz union.

Me: Dad, you realize you aren't answering my question at all. So you are saying that you are legitimately worth whatever the union bosses can convince the state and local governments to force others to pay you, even if it's far more than a private firm is able to charge?

Dad: Yeah. Whatever. Stop it with your philosophy mind tricks, you prick. And poor me another drink.

Me. No mind tricks, Dad, I just like to figure out how things work they way they do. Good talk.​

It's like in LA county. There are rules on the book that went in place by the IAFF (fire union) that prevent any private ambulance service from responding to an emergency. Such as in OC the fire union fought AGAINST private paramedics long and hard! And they lost! they don't want large budgets going bye bye and ems has become fires bread and butter. Without it they lose jobs and those big beastly dodge unnecessary ambulances they use.

 

[Tigger]

All this bickering about wage discrepancy is so silly in my mind. Why shouldn't fire medics make more? Their job description alone says they do two jobs, so yeah.... I know this isn't the case and there's evidence for both sides, but my antedoctal so cal evidence is that private ambulance providers, if not running calls are usually not doing anything but watching TV, playing games, doing non job duty work, or sleeping.

Now I know this same behavior also happens in some fire stations but the vast majority of stations I've worked in do not make this the norm.

Everyone's experience varies so this is just my experiences versus your experiences, so take a grain of salt with all this.

If you do a really poor job at providing one of the services and an acceptable job at the other, how much more money should you be making?

 

[46Young]

If you do a really poor job at providing one of the services and an acceptable job at the other, how much more money should you be making?

I expect to be compensated at a figure appropriate for my job description. More skill sets, more pay.

People sometimes tell me that I'm overpaid where I work. Firemedics out of fire school, who have completed the four month ALS internship that follows fire school, are earning somewhere in the low to mid $70k/yr. I reference NYC, where I started at $22.02/hr, and went up to $26.72/hr after the six month probationary period. That's $45k - $55k in the first six months, on a 40 hour/week work schedule. The fire service has FLSA, where we don't get OT until we hit 212 hrs in a four week cycle, which averages 56 hrs/week straight time. We work a 56 hour week, so if we took 40 hrs/week of our hourly rate, that would be only $40k/yr. So, I'm already underpaid if I were a single role medic, since the cost of living in Fairfax County is roughly equal to the outer boroughs of NYC. And then I'm responsible for maintaining a skill set as a firefighter. FDNY guys get $39,7370 to start. Combined, that's $84k - $94k if you combine the two jobs. For sake of argument, if you combine the starting pay of a FDNY medic and a FDNY FF, you get $82k/yr. My pay was from a hospital based NYC 911 participating member.

Some might divide the pay of each job by two since you can't do both at once, but to follow that logic, a medic in a busy house should get paid more than a medic in a slow house that runs 1 call per day, since the busier medic uses their skill sets more often. In emergency services we're paid to maintain our skill sets, and be able to use them at any time. We're not paid by the call, unless we're volunteers and that's the arrangement. The provider may be better at one than the other, but the onus is on that provider to improve until their proficiency is balanced.

When we promote to a technician, it's either Apparatus Driver, EMS, Hazmat, or TROT. The promotion comes with a step increase, and a grade increase in pay, around 10%. Same mentality - more responsibility, more pay.

 

[46Young]

FF's in the Southeast make anywhere from $22k/yr to $30k/yr starting, medics typically $30k - $35k, with Charleston County EMS (SC) paying a little more. The work hours are typically 56/wk, so these poor souls are getting $8 to $11/hr to start. I live in a right-to-work state, but we are IAFF, and have political influence, so we do quite well. I agree with the assessment that EMS and fire in Union states get a better deal than right-to-work states. Even if you're not union, you'll benefit from having union employers in your vicinity. I experienced this in NYC. My hospital was non-union, but basically my employer would beat whatever FDNY EMS was offering in regards to salary and working conditions, except for the pension. In my region, Maryland is a union state, so VA fire/EMS employers strive to keep in the pay/benefits corridor with their competitors in MD.

 

[46Young]

My father-in-law is a union tradesman in one of the major metro areas in the north. Good, hardworking man. Been in Local XXX since he was 18 or 19, shortly after dropping out of high school. Makes well into the six figures most years, even when he takes takes several months off to live on unemployment because work is slow, or he doesn't like the commute to the jobs that are available then, or when he just feels like taking a vacation.

On several occasions we've had discussions that go something along these lines:

Dad: I'm glad that last job is over. I told Vinnie to tell the bosses not to bid on no more work like that right now, but you know, those guys down at the hall never stop lining up work. Right now they say we've got work scheduled to start as far out as 5 years from now.

Me: 5 years from now? What project manager can wait that long to start construction? Why don't they start it sooner?

Dad (proudly): They ain't got no choice but to wait. We and the other locals are just booked up.

Me: Why don't they hire a private firm?

Dad: Cuz they can't, cuz these are either public projects (which require the use of union labor,) or they involves some big tax deals or something for somebody and part of those deals is that they agree to use union labor.

Me: So the government is forcing the people doing these projects to use union labor, even though they are unable to start the project for several years?

Dad (proudly): Yep. We cost a lot more, too, but they gotta use us. Them bosses really take care of us. Make sure we got work and that we get paid what we are worth.

Me: Why do you cost so much more?

Dad (proudly): Cuz I get $54 per hour plus (recites a whole list of great benefits and ridiculous work rules), and double time for anything over 32 hours in a week - those private firms pay their guys like $25 bucks an hour and some crappy insurance and only 2 weeks vacation.

Me: Why do you make so much more than what the private guys do, though?

Dad: Cuz I'm in the union.

Me: I know.....but what makes your labor worth more than a private guy doing the same exact job?

Dad: Cuz the union takes care of us.

Me: Yeah, obviously they do. But how do they justify forcing others to pay you guys so much more than the market rate?

Dad: Cuz the laws say that they have to use us. So we can basically charge as much as we want.

Me: But why?

Dad: Cuz union.

Me: Dad, you realize you aren't answering my question at all. So you are saying that you are legitimately worth whatever the union bosses can convince the state and local governments to force others to pay you, even if it's far more than a private firm is able to charge?

Dad: Yeah. Whatever. Stop it with your philosophy mind tricks, you prick. And pour me another drink.

Me. No mind tricks, Dad, I just like to figure out how things work they way they do. Good talk.​

Sounds like my uncles, who were carpenters and electricians in NYC. You couldn't change a damn light bulb if it went out; a union member had to do it, whenever they got around to it.

They would similarly make north of $50/hr, work a fair amount of OT, collect unemployment part of the year, but meanwhile they would whine about entitlements, people on gov't assistance.

 

[46Young]

Back home in NYC EMS, the Jewish wouldn't work the Sabbath, and made sure that they got off way before sundown on Friday night. Meanwhile, the Christians needed off on Sunday to go to church, but did not receive the same courtesy as the Jewish on the Sabbath. Can't make this stuff up.

 

[Tigger]

I expect to be compensated at a figure appropriate for my job description. More skill sets, more pay.

I'll admit that I posted that after a crappy shift where I watched the fire medics do an absolutely terrible job on each patient contact that I was unfortunate enough to bear witness to. I agree, if you have more responsibility, you deserve to be compensated for it. That is of course why a city fire medic makes more than their AMR counterpart. It just sucks watching them, and to me if you have that extra responsibility, you need to take it seriously. More often than not it seems that is the case locally.

 

[terrible one]

It'd be nice if that extra responsibility and pay translated into better patient care, however, at least in CA it does not. I'd like to see some of the fire medics near me actually 'pretend' to care about EMS.

These are generalizations which of course does not mean every FD or every FF / PM does not care. There are some that are definitely excellent providers, but they are not in the majority.

 

[BEN52]

I'll admit that I posted that after a crappy shift where I watched the fire medics do an absolutely terrible job on each patient contact that I was unfortunate enough to bear witness to. I agree, if you have more responsibility, you deserve to be compensated for it. That is of course why a city fire medic makes more than their AMR counterpart. It just sucks watching them, and to me if you have that extra responsibility, you need to take it seriously. More often than not it seems that is the case locally.

It'd be nice if that extra responsibility and pay translated into better patient care, however, at least in CA it does not. I'd like to see some of the fire medics near me actually 'pretend' to care about EMS.

These are generalizations which of course does not mean every FD or every FF / PM does not care. There are some that are definitely excellent providers, but they are not in the majority.

I will also say this for full disclosure. This site seems to have a lot of California based third service / private providers on the boards. The system you guys speak of seems quite strange to me to say the least, it is simply foreign to what I am accustomed to.

I previously worked for a very large, very high volume urban system that made EMS a priority. While there where bad apples and a generationally improving but still sometime poor attitude towards ems by some the EMS system as a whole was good. While I lived there I also worked PRN for a private service that provided 911 service to the remainder of the county with fire department first response. We responded as a "team". There was no FD medic is in charge and then passes care to the private ambulance. I now work in a suburban dual role system with FD transport. We have a low fire volume and EMS is our bread and butter. Quality care is a priority and EMS is not punishment work.

My point is that good fire based systems exist nor do I discount the beefs aired on this site about some fire based systems.

 

[46Young]

I'll admit that I posted that after a crappy shift where I watched the fire medics do an absolutely terrible job on each patient contact that I was unfortunate enough to bear witness to. I agree, if you have more responsibility, you deserve to be compensated for it. That is of course why a city fire medic makes more than their AMR counterpart. It just sucks watching them, and to me if you have that extra responsibility, you need to take it seriously. More often than not it seems that is the case locally.

Admittedly, when I first started here in 2008, medics were much less accountable than they are today. The quality of provider overall was much poorer. I'm talking about giving every patient every single diagnostic, nebs for any adventitious L/S, and if the pt is in extremis, hopefully one of the 2-4 medics on-scene will have a clue. If you run every test on every patient, even if you don't know why you're doing it, you can appear to be competent for the most part. As long as they run tests, get an IV, and give Oxygen, they would typically survive a poor pt. outcome and QA/QI.


Over the past few years, we've seen an influx of highly competent single role medic refugees, many of whom have EMS degrees. We dedicate the better part of a month in the fire academy to EMS specific training, and have a 4 month ALS internship, and we do dismiss people if they cannot get through it. Meanwhile, we're now seeing the benefit to our mass influx of medics from years ago, as medics have climbed high up the rank structure. Our Fire Chief also happens to be very pro-EMS.

 

[terrible one]

My point is that good fire based systems exist nor do I discount the beefs aired on this site about some fire based systems.

I'm sure there are great systems outside of CA. I can only speak of my experiences which soley reside in CA. I've been licensed in 5 different counties in CA and my fire counterparts attitudes didn't differ by much.
I'm hoping I've only got another year and a half before I leave this state.

 

[46Young]

I will also say this for full disclosure. This site seems to have a lot of California based third service / private providers on the boards. The system you guys speak of seems quite strange to me to say the least, it is simply foreign to what I am accustomed to.

I previously worked for a very large, very high volume urban system that made EMS a priority. While there where bad apples and a generationally improving but still sometime poor attitude towards ems by some the EMS system as a whole was good. While I lived there I also worked PRN for a private service that provided 911 service to the remainder of the county with fire department first response. We responded as a "team". There was no FD medic is in charge and then passes care to the private ambulance. I now work in a suburban dual role system with FD transport. We have a low fire volume and EMS is our bread and butter. Quality care is a priority and EMS is not punishment work.

My point is that good fire based systems exist nor do I discount the beefs aired on this site about some fire based systems.

The system that seems to be common in CA, FD ALS first response with private BLS txp seems to be a very poor decision. The reverse should be true, IMO, BLS first response with ALS txp, be it private or municipal. If it's a private txp. company, they absolutely need to have a sufficient number of in-service rigs to handle surges in call volume, 100% dedicated to 911 for the shift, not this nonsense where the ambo goes from IFT to 911 and back all throughout the shift. There's too much incentive to take a risk in taking an extra IFT call to make more $$$ at the expense of 911 coverage.

The txp crew should have 100% control once they receive the patient.

We get single role refugees from all over the country, particularly OH, FL, AZ, and CA (LA/San Diego typically).

As far as the poor attitude of the fire department provider against having to do EMS, I think a large part of that is due to most of the calls being for minor issues, that don't need an ambulance or an emergency room. Speaking for myself, I've been positioning myself here to have as many ways and opportunities to get off of the ambulance as possible. I truly enjoyed EMS and got a lot out of it when I worked in the tiered system of NYC. We were never dispatched to normal drunks, most injuries or falls, EDP's, most MVA's, sick calls, abd. pain, or conscious diabetics. Now, those calls are 90% of my call volume. I hardly ever use my skills anymore, and my day and nights are spent mostly transporting people that don't have a true need for an ambulance or a hospital at that moment.

So yes, I do find myself resenting the ambulance somewhat. I still genuinely enjoy a good medical call, that interest hasn't left me, but over the past 13 years in EMS I've grown quite tired of responding from the shower, the gym, from lunch and dinner, from training, and from bed several times a night to run BLS patients with very minor issues. I hate having to go back to sleep when I get home. Since I'm running mostly BLS, I find the fire side way more interesting and stimulating. Nowadays, I'm positioning to be on a fire apparatus on my regular shift, and then do EMS txp. for OT. Keep in mind that the average burnout time of the typical single role EMS provider is 7-10 years, and I'm well past that. Even though I've been fire based for the last seven years, I've done more than FT hours in txp. Even back in NYC, if I had never left for a FD, I would have been a PA or RN by now. Sitting on street corners gets old after a while.

A lot of firemedics I talk to share similar thoughts. Any busy "all-ALS" system, where every ambulance in the fleet has a medic on it, where the medics have to run every BLS as well as ALS call, slowly but surely crushes a medic's soul.

 

[46Young]

Adding to my last post, the norm in my FD is to keep the personnel assigned to the shift on the suppression apparatus, and have details and OT personnel staff the ambulance if it's vacant. What happens is that in busy stations, that ambulance vacancy is typically passed over as an OT opportunity, so if you're "stuck" on the ambulance, you're the one being held over for 12 hours, or worse, recalled for the p.m. half. This happens A LOT. If I work Friday/Sunday, I have to do OT on Thu. night just so that I can go home on Saturday, or OT Friday night so that I can go home on Sunday (36 hour limit). Even if the ambo is staffed, more often than not it's an OT person coming in from another station, and they may be waiting on someone else as well. So, on a typical ambo tour, I show up a little before 0600 for a 0700 start, but can't get out because of late relief until 0730-0830. Meanwhile, the suppression shifts do not generally have this problem, since they are the first to get filled.

Just another reason to dislike the ambulance. I wonder how many other departments have a similar problem to this one.

 

[46Young]

I'm sure there are great systems outside of CA. I can only speak of my experiences which soley reside in CA. I've been licensed in 5 different counties in CA and my fire counterparts attitudes didn't differ by much.
I'm hoping I've only got another year and a half before I leave this state.

It seems like the majority of complaints about EMS ops and employers comes from our CA members. Same for those that have been abused by fire departments. I would think that members of the fire service that are making $100k/yr or so would have a much better attitude towards private EMT's, who are basically making welfare wages when you consider the cost of living in CA.

As much as I resent running nonsense BLS (stuff that I wouldn't even dignify by calling it BLS), I never show it outwardly on a call. I simply try to turn the call over as quickly as humanly possible so long as the pt. gets all that they need, while not giving the vibe of being in a hurry to the pt if possible. I write my report on the way back to the station, and go in-service when I'm in my first-due, so that I don't run 2nd/3rd due nursing home calls. I just want to get the call out of my life at this point. First response is good for that, since I can shave 5-15 minutes off of each call with my suppression crew.

 

[sweetpete]

Some of these responses are dead on. if you want to be paid more, maybe try going to fire school and get hired on a fire department. That's what I did because I knew I didn't want to work IFT the rest of my life. Otherwise, if you're not happy or feel undervalued in this line of work....maybe it's time to switch careers (if you're able?)

 

[46Young]

Someone on this thread mentioned that we run less fires nowadays. I responded by showing how modern house fires burn much hotter and much more rapidly than those in the past, which necessitates an even more rapid response, if anything, not less resources based on call volume. Here's a house fire that developed very quickly, and got away from the crews, in my backyard, Arlington VA:

http://www.statter911.com/2015/04/16/pre-arrival-video-from-arlington-va-house-fire/