Why are EMTs paid so low even when they have to do extreme tasks like intubating in a ditch, etc....?
Sox
Sox
Low salaries for EMTs?
- Thread starter soxman
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Well, EMTs don't intubate, medics do....but to answer your question, I have no idea. I'm interested to see some responses from people who may know, however, because I find it disgusting that people who save lives are paid less than entry-level office workers (hell even some fast food workers) who don't do crap in comparison.
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I would say it's probably the cumulative effect of two factors:
i) The training to become an EMT is rather quick. The ease of producing an EMT and the need for a lot of them combine economically to make it a rather low paying field.
ii) Like physicians, the folks in EMS generally do it, at least in part, out of a love for the job. Because of this, employers can get away with paying them less than it should take from a purely economic standpoint.
i) The training to become an EMT is rather quick. The ease of producing an EMT and the need for a lot of them combine economically to make it a rather low paying field.
ii) Like physicians, the folks in EMS generally do it, at least in part, out of a love for the job. Because of this, employers can get away with paying them less than it should take from a purely economic standpoint.
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Is there an overabundance of EMTs in the US or something? Paramedics are pretty well paid up in most areas of Canada.
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Medics still make crappy pay in most parts of this country. Everywhere I've worked (admittedly, only one part of the country), you'd need to be a paramedic with years in the company to make the same as an entry-level RN (or even LPN) at the hospital.
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It's partly just a matter of economics as mentioned previously. The existence of volunteer agencies (which I happen to support BTW) certainly does not help to elevate the pay scale.
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How much would you pay an 18 year old kid with minimal education and training past high school to drive around and actually have the possiblity (depending on service/are) to just sit around and watch TV? Plus, how often do you think we are actually intubating people in a ditch? (trust me, it's not often)
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Probably about as much as I made when I started ($7/hr). But I'd pay an ALS provider in a busy EMS and transport service about as much as an RN on a med-surg floor.
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Its such a cool job, people will do it for free. When that is the case, salaries will be low.
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Hmmm..maybe that's why. After clearing a call around here, you usually don't make it more than 2 or 3 blocks down the street before another call is dispatched to you. That is repeated for the entire 12 hour shift.
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Most paramedics where I come from are part of the fire service and make $100k or more. EMTs don't make a lot because it only requires a 120 hour course and there are a million of them.
Edit: when I say "where I come from" I mean Los Angeles, not Richmond...in Richmond the EMS situation is a bit different (read appalling).
Edit: when I say "where I come from" I mean Los Angeles, not Richmond...in Richmond the EMS situation is a bit different (read appalling).
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Yeah, I have some classmates from RAA. Out in my part of the state, things suck just as bad. In Roanoke, a starting FF/Paramedic makes about $34k before overtime, and at my old job in Carilion Patient Transport/Radford EMS, a Paramedic made about $25k before OT. At Carilion, though, it was fairly easy for the full-timers to rack up some serious OT with the way shifts worked.
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One thing that plays into it is how much money the ambulance service gets for the average transport and how much each ambulance "earns" a day. If Medicare is only going to pay $100 for a call, or you have to give a lot of free rides to people who can't pay, the company can't pay EMTs $30 an hour. That's why firefighter EMTs or people who work for municipalities often make more, because the department gets a certain amount of money per year so it's more an issue of how much tax the public is willing to pay rather than how much the department can collect in billing.
I'm not saying that this is right, I didn't enjoy making $8/hr. But most ambulance companies aren't making huge profits. And the reason that places like AMR can pay better is because they run so many transfers which are pre paid. 911 doesn't make money, but I'd rather be underpaid running interesting calls then make more doing transfers.
I agree with what people above say, the large number of people who want to work 911 and the fairly small amount of training needed to be an EMT certainly play a part
I'm not saying that this is right, I didn't enjoy making $8/hr. But most ambulance companies aren't making huge profits. And the reason that places like AMR can pay better is because they run so many transfers which are pre paid. 911 doesn't make money, but I'd rather be underpaid running interesting calls then make more doing transfers.
I agree with what people above say, the large number of people who want to work 911 and the fairly small amount of training needed to be an EMT certainly play a part
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I don't buy that ambulance companies cant afford to pay their employees well. This may be something of the case for a small one-town 911-only service or something like that, but a big company like AMR makes tons of profit. There is plenty of room for increased salaries in that budget if they were willing to slice off a bigger piece.
The real reason EMTs (and medics) are paid so low is because they are willing to accept those wages for the job. Too many people are okay with low salaries because the job seems "exciting" or because they want to "help people." This is taken advantage of by companies who have no worry about ever running out of employees. If someone leaves, no big deal, there are 10 EMS'ers waiting to take his place.
It is up to US to make this workforce valuable.
The real reason EMTs (and medics) are paid so low is because they are willing to accept those wages for the job. Too many people are okay with low salaries because the job seems "exciting" or because they want to "help people." This is taken advantage of by companies who have no worry about ever running out of employees. If someone leaves, no big deal, there are 10 EMS'ers waiting to take his place.
It is up to US to make this workforce valuable.
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Well, corporations exist to make money. That's not going to change. I personally think this is one reason why EMS is better performed by the government than the private sector, but I'd rather not get into that debate right now.
As stated above, the barrier to entry for the EMT workforce is so low that this will always be the case. Also, most people are using the EMT cert as a stepping stone to something else, usually fire, nursing, or medicine, so I don't see it as such a big deal that EMTs are not paid a lot.
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I've been wondering about this myself lately... There is definatley a need for EMTs around here, especially good ones. I had all my EMT training and ed payed for by a local program that is promoting health care careers. It amazes me that the rural EMS services have such competive salaries against the urban services. (counties) I rode along with both. For the more rural one, we had 3 calls in 12 hours on a Friday night. In the urban we had 8 on a Sunday night which is typically a slow day. Private Services are competitive too. From my research I've gathered:
Lexington county(more rural): ~$34,000 to start
Richland county(urban): ~$38,000 plus benefits to start
Private services avg: $13.75/hr
If anything... I can't figure out why paramedics are payed so close to emts. They work so hard for their education and ALS makes up all the difference in the world.
Anyways I think that EMTs and medics are payed so low because they don't fuss. From my understanding, Cops have gotten paid much better since they got unions. (like any job that has unions backing it) First day of school we were told if we were in this job for the money, then we should leave. I look forward to helping people when they are at their worse and saving lives.
-Cooper
Lexington county(more rural): ~$34,000 to start
Richland county(urban): ~$38,000 plus benefits to start
Private services avg: $13.75/hr
If anything... I can't figure out why paramedics are payed so close to emts. They work so hard for their education and ALS makes up all the difference in the world.
Anyways I think that EMTs and medics are payed so low because they don't fuss. From my understanding, Cops have gotten paid much better since they got unions. (like any job that has unions backing it) First day of school we were told if we were in this job for the money, then we should leave. I look forward to helping people when they are at their worse and saving lives.
-Cooper
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I don't want to give away the end of the story but you'll do more of the former than the latter.
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man was I bummed out when I found out that exactly same thing once I started working as an EMT...more like helping prolong people's miserable existence after they already ceased to be actually alive (IE veggie, dementia, etc.).- Joined
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I realize this. I know about frequent flyer's, fakers, and people who think they wont be triaged or have to wait if an ambulance takes them to the ER. At the same time the occasional "good call" is possible.
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That isn't quite what he was getting at...a lot of your calls will be legitimate complaints...for a primary care physician, not an ER. You'll get plenty of people with very benign complaints such as stubbed toe, someone who felt "sick" and got spooked, etc. etc. and you'll also get a lot of calls from SNFs to take people to the ER where you will see the greatest legacy of neglect known to man. It's not so much the lack of good calls; it's just that EMTs don't get to save too many lives because first you have to have a good call and then it has to specifically be a cardiac arrest that you zap back since that's about the only way you're really saving a life. Keeping someone alive until they get to the hospital, on the other hand, probably doesn't count since that's what usually happens anyway (the person staying alive). Regardless though, I like what I do, and hopefully you will like it too.
Although I wouldn't recommend working a 24 hour shift and then a 10 hour shift directly after that the weekend before finals week. I don't know why I elected to do this, so if someone could just quietly shoot me and dispose of the body so I don't have to take finals, that'd be great.
Paramedic is short for EMT-P (in MA, among other states) so in that regard, EMTs do intubate.
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But it's still an issue of supply
emand. We have volunteer agencies up here, as well, but they already have a hard enough time filling the paid positions.I agree, was just pointing out that paramedics are also EMTs. A fact that sometimes is overlooked.
Call a paramedic an EMT and see what your response is.
Seriously? I've worked in EMS as an EMT-B for 6 years now. The paramedics that I know don't care if you call them an emt or a paramedic; both are correct.
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Ask them to show you their state issued license. It should state Emergency Medical Technician. As well, look at their National Registry certification. That too should say Emergency Medical Technician - Paramedic. And if they happen to belong to the NAEMT, then gently point out that they belong to the National Association of Emergency Medical Technicians. Additionally, the four levels of licensure are MFR, EMT-B, EMT-I, EMT-P.
We are all Emergency Medical Technicians. I cannot do my job without at least an EMT-B at my side, and truthfully I prefer an EMT-B over an EMT-P as a partner. In part because my Basic's are experts at their chosen level of practice, and because my Basic will concentrate on the basics, ensuring I do not overlook anything while trying to perform the other aspect of my job.
A Paramedic that allows himself to get "up-in-arms" over what he is referred to should take that energy and place it into continued education and training. If he/she get's hung up on being a Technician, then they should be working to change the outlook of our profession through their own and their peers training, proficiency, and relations with other longer standing healthcare professions.
As to why we are a low paid profession. I believe it is largely due to the current state of reimbursement for our services by insurance companies. Mainly medicare and medicaid. Secondary to that, the services we work for will of course pay us the minimum necessary to attract an individual to perform the job's we choose to do. And they will not think twice about it, since EMS is a revolving door and there are always people willing to take low pay while they work for a higher education.
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Here is another question, does the UPS guy get payed a lot? The answer is no. EMT-B's are just a glorified UPS guy. All they do is make sure the patient is adequately ventilated, plug any holes, and package and ship (just like the UPS guy). BTW I am a EMT-B for any of you planning to flame me for ignorance or something.
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UPS guys are paid A LOT better than EMT's here in FL UPS drivers start at about 45-50k a year....My neighbor has been with them 12 years and makes over 100k so bad example...
D
deleted6669
there was a recent article comparing lifetime earning potential for ups drivers vs fresidency trained er docs. guess what? the ups guys do really well in the comparison. they start earlier, peak salary higher, have no debt and can work longer. I will try to find a link to the article.
here it is:
http://www.er-doctor.com/doctor_income.html
here it is:
http://www.er-doctor.com/doctor_income.html
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I will say this though, four years of college and the first two of med school have sure been more fun than hauling boxes 5 days a week for six years. Also money aside, I think I'll be happier at the end of a career as a doc than as a driver. The article makes a good point about what our society values, which is why it is unfortunate that physicians have to pay for their own schooling. The government should pay for all or most of med school, and then say "okay, if you want to be board certified you have to see this percentage of medicaid/medicare patients." Docs would be more likely to see patients they aren't going to get paid back for if they either don't have crippling debt or the feeling that "hey, I paid $200K for my MD, it'd my right to maximize my profits.
I'm sure the finances are going to matter more to me once I have kids and a house, but
I went to a good undergrad and if I just wanted to make bucks I could have been a gun for hire consultant and pulled in a lot more than a UPS driver out of college. So I went into medicine knowing I was turning that down for a lot less, so I don't have regrets about being able to make more doing something else. Though the finances are driving the way the system works which is depriving a lot of people of good quality care.
I'm sure the finances are going to matter more to me once I have kids and a house, but
I went to a good undergrad and if I just wanted to make bucks I could have been a gun for hire consultant and pulled in a lot more than a UPS driver out of college. So I went into medicine knowing I was turning that down for a lot less, so I don't have regrets about being able to make more doing something else. Though the finances are driving the way the system works which is depriving a lot of people of good quality care.
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Most Advanced Life Support guys here make over $100k with overtime pay. We also have a small group of specially trained paramedics called the Infant Transport Team. A few of those guys are making over $200k with all the overtime they do.
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Be careful what you wish for. I know it sounds unlikely but in 10 years your med school debt won't be the overwhelming thing in your life that it is right now. If you trade the debt for letting the government get its hooks into you as you describe you will be paying it off forever. Remember that if having free med school paid off with mandatory service as a doc were such a great deal the military med programs would not be recruiting.
BTW mixing the govt in with board certification would also be a nightmare. They are not the certifying entity for board cert. You'd do better, although it still wouldn't be a good idea, to argue that for participation in CMS you have to do stuff for free. That's already how it is but you could push for more.
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Hmm I wonder how much that will change in the US with the Barack/Clinton duo. One misunderstanding many people have is that Cdn physicians are public doctors. They're not. They are for-profit fee-for-service physicians who simply bill the government for payment, instead of insurance companies. The licensing/governing bodies of physicians are also independent of the government. Physicians who work in hospitals sometimes receive salary, and the hospital in turn receives its funding from public (government) and often private sources. I think a lot of positions such as anaesthesiologists still bill on a procedural basis, because they make around 350-400K/year with the number of procedures they can bill for.
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There seems to be a common misconception on SDN that if a Democrat is elected they will assume the office of emperor and have limitless power to enact sweeping changes. In fact any legislation will have to get through both the Senate and Congress, neither of which have been into radical reforms of late. The insurance and hospital lobbies are also quite powerful and will fight to the death against anything that will hurt their bottom line. It's very unlikely that even the mild reforms proposed by either candidate will pass, let alone anything resembling a single payer system.
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I hear the FDNY pays starting EMT-B's 20-25$/hr
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Edited to sound less offensive..
http://www.payscale.com/research/CA/Job=Family_Physician_%2F_Doctor/Salary
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25 an hour based on a 40 hour work week is 50,000 that in NY city isnt that great of money. I make a bit more than that a year in FL and I still don't do that great with school and all my bills..
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They're probably working twice as many hours as family physicians, and yes they are making much more.
If you want to verify it, the information is out there somewhere on the Internet, as well. As a public job, the salary of paramedics making over $125k (I think) is on the Internet due to disclosure laws.
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I think you may want to tone it down a bit. Lots of people make more money than physicians, especially primary care docs.
It is very common for firefighter/paramedic salaries in California to exceed $100,000 with overtime, and not infrequently get close to $200k. The LA Times annually publishes a list of the highest paid city employees, with firefighters and a handful of cops making up the top tier.
http://www.caltax.org/documents/2003/McGreevy-OvertimeLAFireDepartment10-25-03.pdf
http://www.surfsantamonica.com/ssm_...3/02_06_03_The_Rising_Price_of_Protection.htm
http://www.dailynews.com/ci_9220386
http://www.allbusiness.com/government/1037076-1.html
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The other thing to take into account is that these public employee jobs tend to have really great benefit packages. Compare a firefighter making $125K+ with a doc making $150K with no benefits (which is more common than you'd think) and it's easy to see those jobs better better in overall compensation than docs.
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No I realize that Docs aren't the highest paid profession. But Canada with its healthcare system as it is,it just didnt seem right that a medic would make more than a doc when rt's were only make $25,000 in that posting. I do understand public workers can do well. Before I went part-time to go back school I worked a bunch of overtime and made a tad over a 100k as a medic/FF but I was working OT every week. I didn't mean to come off as disrespectful in anyway and if you took it that way sorry.
Yea, but why would anyone interested in medicine want to be a paramedic in LA or OC? There's a reason (cough too many really bad fire medics cough) that those two counties are strongly "mother may I" with required full radio reports for anything more serious than a sniffle and restrictive scopes of practice. There's a reason that neither two counties require their medics to read 12 leads (machine interpretation FTL) and Orange County doesn't even stock ASA on their medic units (as in not even in the protocol). Great if you want to be a fire fighter, terrible if you want to practice prehospital medical care.
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Nah, not really true. Obviously EMS and medicine are pretty different career paths and I doubt many people are trying to decide between LAFD and med school* but not all agencies in LA require base contact for everything. All the medics I worked with certainly did know how to interpret the 12 leads.
The thing is that the transport times are so short that there really is no need to do crazy stuff in the ambulance there.
* if you are, don't pick med school...
By "practicing medicine" I mean the provision of medical care to treat diseases. This is not strictly limited to physicians. There are people who actually want to be paramedics and would like to do more than treat patients based off of cook books. Similarly, the skills and attributes required to be a good fire fighter and a good paramedic are vastly different.
As far as 12 leads,
http://www.jems.com/news_and_articles/articles/Paramedics_Activate_Cath_Lab_STEMI_Patients.html
http://www.ochealthinfo.com/docs/medical/ems/treatment_guidelines/c15.pdf
Just because a some of the paramedics can do it doesn't mean that their systems trust them any further than they can throw their ECG.
Since when are things like ASA (side note: Apparently OC finally got around to adding it to their treatment protocols this year.) or relying on a human 12 lead interpretation "crazy stuff?". It's not like I'm talking about RSI or surgical airways here.
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Back to the FDNY EMT salary, I found this site
http://www.nyc.gov/html/fdny/html/community/ems_salary_benefits_042607.shtml
Says that they start at 27,300 a year. At 40hrs a week, 52 weeks that's 13/hr.
Medics start at 37,350.
Not very much if you are living in the city.
http://www.nyc.gov/html/fdny/html/community/ems_salary_benefits_042607.shtml
Says that they start at 27,300 a year. At 40hrs a week, 52 weeks that's 13/hr.
Medics start at 37,350.
Not very much if you are living in the city.
