EMS wages and salaries in most areas of the country are below where they need to be. Why would anyone want to be an EMT and work odd hours and weird shifts? Frequently the work involves unscheduled overtime and flexing shifts due to personnel shortages and higher call demands.

Wages and Careers Competing For EMTs

Recently I was invited to attend an advisory board meeting for a phlebotomy department in one of our local trade schools. Recent graduates were getting decent jobs with great hours, at great locations with wages ABOVE what an EMT makes. Life isn’t fair – and in this scenario, it sure as heck isn’t!  EMTs have a lot of responsibility and ongoing training, working on a variety of conditions and situations, yes some are dangerous, that no person in their right mind would sign on to do – especially at wages less than a phlebotomist gets with cushy hours and a comfortable work environment.

Where do our values set amongst the healthcare professionals we serve?

Medical Taxi – EMS in a Nutshell?

Where does the public see EMS? Do both they and the insurance industry see ambulance services as merely the medical taxi service? As much as EMS is involved with public safety and public health, it is not a part of either. Emergency Medical Services is synonymous with ambulance services for a reason. EMTs and Paramedics were born of the 1966 whitepaper addressing unnecessary death and disability due to the lack of training and skill of those responding to the sick and dying. 

Ambulance services are part of the healthcare industry. We work routinely with physicians, nurses, home health, hospitals, nursing homes, dialysis centers, and more – and remember what we treat and transports? Patients.  EMS providers treat and/or transport patients. What we don’t do is enforce the laws, fire or building codes. We have nothing to do with code or law enforcement. Ambulance Service provide emergency and non-emergency care AND transportation.

How can less skilled allied health personnel get paid a higher salary? Obviously, they are held in higher regard. Why else would anyone not work to hire and retain the best and the brightest people to make sudden life and death decisions out in the streets with only a few semesters of medical training under their belt, working in all kinds of weather and traffic conditions?

Is EMS Valued?

One can only assume that EMS is not valued. Face it. The pay and benefits are generally less than our public safety and allied health brethren. EMS providers are more than twice as likely to suffer injuries requiring time off work than workers in other industries, and more than three times as likely to be injured or killed in a transportation accident.

Once Upon a Time

Volunteers used to be the main body of EMS providers. The requirements involved with licensing and the liabilities inherent in the system have gave way to paid EMS professionals in most of the populated areas of the country. Life and society itself have changed over the last 20-30 years. The time constraints most people have to offer volunteer time has dwindled dramatically. The time commitments to become trained and licensed as an EMS professional remain significant compared to volunteering in other areas of the community. This too has drawn down the appeal of the volunteer ranks. As such volunteers dwindle, so have the pools from which larger paid services drawn from to fill their ranks of full-time personnel.

The Solution to Our Financial Inequity

Where do we find the solution to the salary inequities that we face? If we knew this with any certainty we’d all be in a better place. While public and quasi-public EMS agencies fill a void in many jurisdictions, along with fire-based and private EMS, the pay and support are generally inadequate to make real headway without subsidizing the agencies providing service.

Personally, I’m of the mindset that we need to rethink our operational model and begin thinking of inefficiencies and how to streamline our operations and frankly, services may have to be scaled back. Just how many times does a person really need to run lights and siren?  The facts tell us that the risks involved do not outway the benefits. In less than 1% of emergency responses or transports, it would only help a little and in the others – it made no difference.

Our mindset needs to change. Our attitudes and priorities need to change along with our operational model within the ambulance service realm. We need to curtail our risks to reduce insurance costs and reduce waste and other expenses to be able to provide the training and licensed providers at a living wage they deserve. We do not need two paramedics on every call, we need a team of trained providers who can work together. – Just as we don’t see the infectious disease specialist every time we have a cold.

In Summary, EMS Wages Rely on Refocus

We must refocus our operational methods and priorities. Failure to do so only keep the risk and expenses at the high levels they are today, if not higher. It is imperative that we rethink our operational models and reduce the number of risky behaviors (red lights and siren transports) that have been ingrained in our traditions without the research to back them up. Cost savings will take us only so far. Restructuring our operational models to allow us to pay higher qualified people decent wages and work decent hours is paramount to attracting and keeping talent. Insurance providers and the public have to realize the true cost of our ambulance service transport and emergency services operations and pay them. 

It’s time for everyone to know the cost of providing Emergency Medical Services and ambulance transportation.