Why does EMT job pay so little money?

What most in EMS do not understands is job or professional comparisons. Do we in EMS really justify having a decent salary? Do our so called technicians really deserve much more than a minimum wage?

If so.. justify it.


The only way things will ever change is not by ranting and raving. Rather it must be by proving the payers (such as Medicare, Insurance Corporations) that we our professionals and do deserve higher compensation in reimbursement. If the money does not come in; then it can't go out!

Now, let's listen in at the Medicare reimbursement and justification meeting.

EMS: You've got to help us! We need more money!!!!

Medicare: Okay why?

EMS: Well... uh, it costs more to operate the trucks, and our people get poor salaries.

Medicare: Okay, we acknowledge that fuel is higher. We will give you a higher mileage rate. Now, let's review your personal.
How long does take to be an EMT?

EMS: From 2 weeks to 16 weeks. Usually about 150 hr classroom and around 40 hours or so clinical time.

Medicare: Okay, so about or around < than 1 semester in length ? Do they perform any invasive or diagnostic skills that requires them to be a specialty.

EMS: Yes & No. Yes, about 1 semester and no; most states does not allow any special diagnostic capability.

Medicare: So what is it that you really do that is special to recieve additional payment?

EMS: We stabilize enough for transport, apply oxygen, take vital signs, control and banadage wounds, splint when necessary.

Medicare: No med's enroute, no special monitoring, no in-depth care, just basically transport?

EMS; Yes, of course those are for emergency responses. Many of our transports are non-emergency. The only care needed is moving and observation.

Medicare: Basiclly a taxi ride? Is there a high demand and shortage for EMT's to justify increased payments, so one needs to recruit?

EMS: Yes, unfortunately most of the work is only transport. Uh... well, actually we have an over abundance of EMT's. Usually there is up to 75-88% over saturation of EMT's every 16 weeks. In fact many can't even find places to volunteer.

Medicare: I'm sorry, I was not listening. I have 300 other agencies requesting increased payment structures as well. Oh, yeah they also have a shortage, degrees, and without their special skills that treatment cannnot be performed.

Uhh... Next....

I am all in favor of raising the wages. It would only benefit me, the system and patient care. Yet, to do so we do more than lip service.

Again, I ask how many are really involved in Lesigilation and Political changes for EMS? Even more, how many are supportive of EMS professional associations promoting higher reimbursement rates?

Have you really done anything or alike the other 98% or so.. just complained about things and wished they were different.

There is a reason other medical professions get paid more... they worked for it.

R/r 911
 
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What is a RT? Radiology Tech?

I wanted to say that I started out in the telecom industry making $12.96/hr. after 10 years experience I now make in the low $20,s/hr. It it possible for this kind of advancement being a Paramedic?
 
From my freimds that are medics from what they tell me they make about 28 to 32 an hour depending on their senority at their companies
 
When I first starting working as an EMT-B in the Detroit area, I made about $8.75 an hour. How did they get away with paying me and so many others so little?

We also need to put this in perspective. If an EMT-Basic works only five days a week, and works a typical 12 hour shift, then they make $2,450 a month before taxes.

1. Lets be honest, we're not exactly Doctors. We have anywhere between 100-300 hours of training, which is only twice that of a lifeguard. An EMT-Basic is an entry level position.
2. Lack of Investment - In order to get my BA degree I paid about $60,000+ in college loans and expenses. How much did your EMT-Basic program cost?
3. Endless Supply - There is no EMT-Basic shortage out there.
4. Step Above What? - You'll find that many of the big ambulance services run in-house EMT-Basic programs. Their attitude is that anyone can be trained as an EMT, as long as they provide minimal effort.
5. State of Healthcare - Lets be honest, no one makes it big running an ambulance service. Payments and reimbursements are horrible. Even in one of the wealthiest counties in the nation we could only expect 60% of our patients to pay.
6. Public Image - Firefighters make far more than we do, and for many years only had to deal with fires. Yeah, how many true fires does a busy unit see a week? I think that Cleveland Fire's busiest station sees one true fire a week, and the rest are medical calls or false alarms. They get away being paid so much more because their public image is far stronger than that of EMS.
7. Length of Service - EMS is relatively new compared to other professions.
8. Because it Works - When there is a massive shortage of available EMTs and Paramedics you'll see a sharp increase in pay and benefits.
 
rhan101277 said:
What is a RT? Radiology Tech?
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RT can be short for Respiratory Therapy or it can also be Radiology Technologist. My credential is RRT which is Registered Respiratory Therapist.

Either way, the progression of Radiology and Respiratory professionals have been similar. Both professions have national certification and require at least a 2 year college degree with Bachelors and Masters degrees available. For educators, a Masters or higher is usually required depending on the type of college.


rhan101277 said:
I wanted to say that I started out in the telecom industry making $12.96/hr. after 10 years experience I now make in the low $20,s/hr. It it possible for this kind of advancement being a Paramedic?
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Over 10 years, it could be possible depending on the service you work for. In Florida, several small ambulance service areas have been taken over by Fire Departments. If their employees are able to complete the requirements to be a FF, then their pay will probably be more than what they were making with the private company. If they don't meet the requirements, then they will have to find alternative employment.

There are county systems that do offer pay increases from both years with the company and with periodic cost of living increases.
 
MMiz said:
6. Public Image - Firefighters make far more than we do, and for many years only had to deal with fires. Yeah, how many true fires does a busy unit see a week? I think that Cleveland Fire's busiest station sees one true fire a week, and the rest are medical calls or false alarms. They get away being paid so much more because their public image is far stronger than that of EMS.
7. Length of Service - EMS is relatively new compared to other professions.
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There are areas such as in California during the Summer that you could not pay me enough to be a FF. But then, in San Francisco you have FFs making $150,000 easily and able to work 19 24-hour shifts. This recent news item have led comments as to the job being too easy that one can work all those days or if public safety is at risk from over tired FFs.

EMS is now over 40 years old. I've been an EMT(1978) and Paramedic(1979) for 30 years . Respiratory was just getting recognized in 1986 when I got my RRT license in Florida. This was actually the first time a license was offered for the profession in Florida. The same goes for many of the allied health professions. Some, including Respiratory and Radiology, were OJT (on the job trained). Radiation Therapy and Nuclear Med Technicians are also relatively new and have come about with advancing technology. They, too, are now requiring advanced education.
 
Not to get off topic, but the RT is everyone's hero during a code in the hospital. They can't page you fast enough. In my experience the RT is an extraordinarily highly trained and specialized field. You do a few things unbelievable well, and also have the comprehensive knowledge to back it up.

Where do you find that in EMS?

In teaching we always argue whether we should be briefly teaching 100 topics or doing a phenomenal job of covering 10 topics in-depth. The EMT and Paramedic seems to be knowledgeable of many things, but master of few.
 
I got into Respiratory Therapy after driving for specialty teams and also by watching them work in the ED. As an EMT or Paramedic, you soon realize there is just so much you can do with the equipment at hand. While those first few minutes you spend with a patient to keep them alive until you get to the ED are the first and one very important link, there is more to come. Even 30 years ago, I was amazed by what magic CPAP could do for CHF. Doing transport with a child and a relative large ventilator (SERVO 900), compared to transport models today, strapped to an adult back board just amazed me. The transport team also did flights to the islands and South America.

RRTs do now have knowledge of many aspects of medicine since the Cardiopulmary system affects everything as does the medications RRTs can give. But, yes, the airway is their specialty. I've always prided myself as being one of the best intubators in the field but I got a serious attitude adjustment in RT school even from the OJTs of the time. I also found that the techniques and caution factors to prevent injury that I learned as an RRT could be used in the field and not take any more time.

Those that also believe they have taken a college level A&P class with the little text books that are designed for Paramedic classes are fooling themselves. This includes the coloring book which is only an adjunct teaching tool in other professions.

I also got into Respiratory Therapy after an ambulance accident that separated my shoulder and my patient died at scene. I was only 23 y/o but I realized then what some of the old timers (those my age now - almost 48) were always concerned about...disability. I made a full recovery but still started expanding my education to have both more skills and knowledge as well as a backup plan. Those that believe they can go into some of the healthcare professions after an injury may find it is not that easy as there are lifting and standing requirements in almost all professions. However, if you already have the education, you may be able to get into some office or research. Even if you get a Bachelors degree in one of the sciences and not RN or RRT, you will still have something to work with. MMiz could probably give a long list of the advantages of higher education even if the jobs you find with it are not always well paying. You still have choices.

I've had a long career as a Paramedic because I realized the strengths and weaknesses of the profession early. I also left ground EMS for Specialty transport and Flight. I chose to do this after having many frustrating partners through the years fresh out of the 3 month medic mill. I knew most of them were just sold on the flashy TV commercial and not medicine. I see many of my former partners and graduates from the medic mills working for lawn services, which isn't bad income, and not in EMS.

I've been vested with a retirement plan so I'm now making the decision to leave EMS behind and see how far being an RRT can take me...traveling.
 
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I know of Flight Paramedics making < $12.00 hr and that is with all the titles and credentials. Even the RN's around here are only $18.00 hr for speciality. One has to be very aware of the location and costs of living.

R/r 911
 
Here is Mississippi you have to take real college level A&P I and II for paramedic. Are there states where that isn't required?
 
Ridryder911 said:
I know of Flight Paramedics making < $12.00 hr and that is with all the titles and credentials. Even the RN's around here are only $18.00 hr for speciality. One has to be very aware of the location and costs of living.

R/r 911
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Well I am just doing it for extra money, so I guess it isn't a big deal. Also the occassional call where I feel I made a difference. I know most of the runs are transport where I am but anyhow. I just get tired of working on cell sites, been doing it so long. Sometimes there are problems that are a bit difficult, but most of them I have seen before.
 
Ridryder911 said:
I know of Flight Paramedics making < $12.00 hr and that is with all the titles and credentials.
R/r 911
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I was lost really quick when everyone got it the drips and the physio behind it all. What medications and physio stuff should I read up on as a 911 guy trying to get into CCT? What are the most common medications that all of you carry?
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The above quote was just posted on another forum. Unfortunately, some that want to do "advanced" practice things are clueless when it comes to the prep work. Some Paramedic schools have taught "flash cards" as a way of learning pharmacology. The Paramedics that have taken 2 semesters of college pharmacology will have a basic concept for the physiology and will just need to apply this knowledge to whatever medications are required for the job. It is easier to build if you work from the foundation up and not trying to build from the roof down.

For a flight job, we may get 200 applications with more than half being easily eliminiated. The others are eliminated during the interview when you realize they are trying to picture their note cards and not rely on critical thinking for the answer. Thus, geographical location is not the only factor for low wages in this profession. The warm body mentality may still apply even for some flight companies.
 
rhan101277 said:
Here is Mississippi you have to take real college level A&P I and II for paramedic. Are there states where that isn't required?
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Yes, many states have programs that still promote the medic mill concept by teaching only the bare minimum of hours for the Paramedic program which for some states (like Florida), it is only 700 hours. There are also online programs that you can take in another state and fly in for "intense clinicals" or it may be contracted off site to a location closer to you. Either way, oversight of quality in a profession that does rely on good technical skills can be greatly skimped on.
 
rhan101277 said:
Here is Mississippi you have to take real college level A&P I and II for paramedic. Are there states where that isn't required?
Click to expand...

Yes, most of them.

R/r 911
 
Again, here in Canada, EMS pays well. It may be due to the subsidized health care. The ambulance service I work for is part of a regional network. We are part of Alberta Health Services/ Peace Country Health. We are affiliated with each hospital in each city/town that we work in. I primarily work out of Fairview, however, as I am typing this our second crew is covering another town approximately 40 minutes from here. Most of our calls are for transfers. And, most of those transfers are for pts 65 and over. And, those pts don't pay anything for ambulance service. It's covered by the province.

We just sent a query CVA out this morning. The town we responded to was 25 km away. STARS (Shock Trauma Air Rescue Society), our regional flight medical crew, flew them to Grande Prairie (25-30 minute flight time). They landed at the local school to pick up. Our pt was a female in her mid-80s. Because she is in the over 65 category, and STARS is Volunteer and not-for-profit, she won't pay for anything out of her own pocket.
 
wow, I don't even know where to start, but from the sounds of it the level of education / responsibilities is scattered all over the place in the U.S. And with a 3-6 week EMT-Basic course staffing from the sounds of it, a huge majority of ambulances in the states, I can see why this reflects poor wages.

Here in Alberta Canada, our EMT-Basic equivelant is an EMR, and it is basically viewed as a joke, if this was as far as you took your EMS education, you would be limited to working standby events, on oilrigs as an industrial first aider, and for VERY VERY rural services that basically need 1 more guy on the truck to drive. If you even want to CONSIDER working on an actual ambulance in alberta, having your EMT-A (EMT-I) is the industry standard. its about a 7000 dollar course, which enables you to ECG monitor / dfib, do blind airway maneuvers (king-LT, combitube etc.) give nebulized atrovent / salbutomol, epi, glucagon, ASA, Nitro, D50, nitrous oxide, and oral glucose, which really isn't much but its the basics.

The average starting wage for EMT-A's here in alberta is roughly 19.00$ and up. If you are working for Edmonton or Calgary, our 2 major urban cities, EMT starting wage is around 25$ an hour.

As for Paramedics, am I hearing this right, there are paramedics in the states with 3 month long courses? Tuition here in canada is around 20,000 and the course is 2 years long MINIMUM, and you have to already have your EMT-A and have been working for a year before schools even accept you, so that being said pretty well the FASTEST you could ever become a Paramedic in alberta is 4 years, and thats balls to the walls. At the end of it, our ALS paramedics are from what I am told are among the highest level of trained paramedics with one of the widest scopes of practise in the world.

Paramedics top out around 32$ an hour working in the city. But if they go work industrial they can easily net 700 bucks a day. 32$ an hour is still alot when you consider they work 12 and 14 hour shifts.

Paramedics, at least here is NOT an entry level health care job, they are highly skilled, trained, and specialized elements of the health care field. They are expected to be on top of their game, and have a vast understanding of emergency health care situations.


here in alberta, our wages are becoming competetive, and are poised to be even further on the rise, as the provincial health care system is beginning to utilize EMS personnel even in the hospital setting as their skills are useful in a variety of settings.


Supply and Demand is at an employees advantage in alberta, as the majority of services are understaffed, and beginning to pay even more to attract highly trained EMS providers into their service. If you want to make a life working as a paramedic, maybe its time for you Americans to start looking north of the border, to your often overlooked neighbours :)
 
:excl::excl:
John E said:
if the "rules" about supply and demand held true, the high demand would mean higher wages and better working conditions. The reverse is true in SoCal. The demand is high and the supply is even higher with schools churning out thousands of EMT grads who are willing to work for artificially low wages in order to either fill some sort of personal need or to gain experience, etc.

What's actually happening is a devaluation of employees. The demand is high because after a few months of working for sub-standard wages, people leave to go work at In and Out or elsewhere. Those that stay with it either accept that they are at the bottom of the wage chain and convince themselves that they're doing it for the good of humanity or they figure out how to make more money by becoming an FTO or a supervisor before they finally get so burned out and pissed off about their low wages that they leave the field all together.

If the standards for EMT education and certification were raised and the private ambulance companies were actually held to some better standards, the wages would increase, patient care would improve and ambulance based EMS work could become an actual career. That ain't gonna happen and no amount of *****ing on a web forum with noble ideas about abolishing slavery is gonna change it.

John E
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:excl::excl::excl:
 
$32.00 hr, I'd like that. But I don't want the cost of living that a large part of Alberta has, or the -30 & -40 deg winters. $500.00 a month for a room in an industrial trailer up north in Ft McMoney(Murray). Maybe if I was young and single for a few months for some quick cash. I'll stick to the east coast. We only have a couple of weeks of -20C and usually not much snow. We haven't even had a really good blizzard in 3 or 4 years. Once every 20 or 30 years we actually have a hurricane come ashore. Even then it's only a cat 1 or 2. Not the big 3,4,or 5 ones. The ocean can top 20C in summer, so not bad. I guess I'll live with my $20.00 - $25.00 hr. Mind you I'll still grumble about the price of gas, groceries, beer, politicians, taxes ...........
 
bled12345 said:
wow, I don't even know where to start, but from the sounds of it the level of education / responsibilities is scattered all over the place in the U.S. And with a 3-6 week EMT-Basic course staffing from the sounds of it, a huge majority of ambulances in the states, I can see why this reflects poor wages.

Here in Alberta Canada, our EMT-Basic equivelant is an EMR, and it is basically viewed as a joke, if this was as far as you took your EMS education, you would be limited to working standby events, on oilrigs as an industrial first aider, and for VERY VERY rural services that basically need 1 more guy on the truck to drive. If you even want to CONSIDER working on an actual ambulance in alberta, having your EMT-A (EMT-I) is the industry standard. its about a 7000 dollar course, which enables you to ECG monitor / dfib, do blind airway maneuvers (king-LT, combitube etc.) give nebulized atrovent / salbutomol, epi, glucagon, ASA, Nitro, D50, nitrous oxide, and oral glucose, which really isn't much but its the basics.

The average starting wage for EMT-A's here in alberta is roughly 19.00$ and up. If you are working for Edmonton or Calgary, our 2 major urban cities, EMT starting wage is around 25$ an hour.

As for Paramedics, am I hearing this right, there are paramedics in the states with 3 month long courses? Tuition here in canada is around 20,000 and the course is 2 years long MINIMUM, and you have to already have your EMT-A and have been working for a year before schools even accept you, so that being said pretty well the FASTEST you could ever become a Paramedic in alberta is 4 years, and thats balls to the walls. At the end of it, our ALS paramedics are from what I am told are among the highest level of trained paramedics with one of the widest scopes of practise in the world.

Paramedics top out around 32$ an hour working in the city. But if they go work industrial they can easily net 700 bucks a day. 32$ an hour is still alot when you consider they work 12 and 14 hour shifts.

Paramedics, at least here is NOT an entry level health care job, they are highly skilled, trained, and specialized elements of the health care field. They are expected to be on top of their game, and have a vast understanding of emergency health care situations.


here in alberta, our wages are becoming competetive, and are poised to be even further on the rise, as the provincial health care system is beginning to utilize EMS personnel even in the hospital setting as their skills are useful in a variety of settings.


Supply and Demand is at an employees advantage in alberta, as the majority of services are understaffed, and beginning to pay even more to attract highly trained EMS providers into their service. If you want to make a life working as a paramedic, maybe its time for you Americans to start looking north of the border, to your often overlooked neighbours :)
Click to expand...

Canada is doing something right. Way right. And it's utterly pathetic that their neighbors to the south aren't even attempting to mimic them. I feel awful about American EMS after reading :censored::censored::censored::censored: like this.
 
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