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Your Homework Assignment For The Day:

In as many or as few words as you like, debate the accuracy of the following statement:

"Nobody in EMS is paid what they're worth. 25% are paid far less than what they're worth, and 75% are paid far more than what they're worth."

                                                                                                                                                                                                ~ Kelly Grayson

If you happen to agree with the statement, tell us what we as a profession should do about the 75%. If you disagree, tell us why.

Post your argument on your own blogs, and give us the link in comments so we can all read it.

Comments - Add Yours

  • Aaron

    I doubt there’s much you can do.  A lot of EMS systems are government and/or unionized.  We weren’t able to fire one of the losers that wrecked his vehicle a few hours before his shift because he was so hung over…  In a system where everyone is afraid of the unions and/or being sued, you’re out of luck.

    • Bobball

       I’m confused…he wrecked his personal vehicle off-duty? Yeah…I can’t see firing him either. Yes, I work in a union shop, but there’s also a limit to what we can discipline for…he walks in the door and I smell alcohol…even old stuff…no reason not to dismiss him (from there, it depends on one’s local policies, etc.).

      I’m not afraid of unions or of being sued necessarily…but neither would I invite problems that fall outside my scope of authority.

  • Mmorsepfd

    You can’t put a dollar value on a person’s worth.

    • Sabra Morse Onstott

       If you’re paying them to do a job, you damn well better.

      • Mmorsepfd

        I get Kelly’s point, 3/4’s of us drag down the other 25%, but even the best among us are worth far more than anybody is willing to pay, salary wise. A person would pay anything for that paramedic skill when their lives are on the line, but that is not how it all works.

        • cm366

          Mmorsepfd, as you say, that’s not how it all works.  Folks would pay anything for that skill when their lives are on the line, but the day before that incident they’ll pay you $15/hr and gripe about your need for health cover.  It’s all very well to say we’re worth far more than anybody is willing to pay, but isn’t one of our goals to quit acting like heroes and start acting like medical professionals?  I don’t know that I’d take Kelly’s numbers as gospel, but I definitely know more medics who shouldn’t be practicing than I do medics I’d trust with my family’s lives…

  • Samuel Kordik

    We might start by gaining a clear definition of who we as a profession are and what we do. There doesn’t seem to be a clear cohesive answer—and how the public perceives us (and values us) won’t change until there is. On one end we have colleagues who are “ambulance drivers” and nothing more: They pick up sick people and transport them to the ER. On the other end, you have knowledgeable, self-motivated clinicians who bring the ER to the patient. I’d say most of those are in the 25%.

    What do we in EMS really do? What should the public see us as?

    • Bobball

       Of course the reality is that we’re somewhere in the middle. I’ve seen many a medic who claims to be a knowledgeable clinician that fiddle-farts around on the scene discussing tertiary care suggestions when the patient (and agency) would be best served by beginning transport to the ED. On that same plane are those who bring the ED to the front of the patient’s house, but don’t bother to do thing one until the patient is in “a controlled environment” (read: ambulance), and still manage to sit on scene for 30-40 minutes…

      While the “ambulance drivers” often fail to do enough for a patient, the patient and family are often grateful because the patient went to the hospital.

      It’s all a matter of balance…and the people dragging us down fly under both the “ambulance driver” and “clinician” flags.

  • Fighter727

    In my opinion you have the %’s wrong 75% are paid too little and 25% are paid too much. All to often here in TX it seems EMS is running off the good ones because they are paid too little.

    • Anonymous

       I agree with this interpretation of the 80/20 rule. If the numbers were the other way around, EMS would stop to exist years ago.

  • Sigivald

    (Off topic: is everyone else always and only getting the “mobile” edition of ADF, despite being on a desktop computer running a normal browser [Firefox]?

    It is, needless to say, horrible to be stuck on the mobile edition that’s a glorified ToC; and even when I click “exit the Mobile Edition” it just goes back.


    • Ambulance_Driver

       Haven’t had that, Sigivald. Tell me what browser you’re using, and I’ll have the IT guys check into it.

      • Thehappymedic

         mobile version here as well AD, FF and IE.

      • mpatk

         Same here, the main page is normal but the post is the mobile version.

      • E.S.

        I’ve been having that off and on, here, as well. Not constantly, though, which makes it harder to figure out a cause. I’m on Chrome.

      • mr618

        I’ve been getting too, not just here but several og the other Fire/EMS blogs. Windows 7, IE 9. I get it on home page, individual posts look fine.

      • Dave

        Funny enough, I didn’t get it yesterday, but I do get the mobile version today, for both the main page and the post.

      • Bobball

         I’ve had that happen to me occasionally using Firefox, but it’s sporadic.

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  • Groundhog

    Wow, I guess I’ve never lived where the 75% hang out.  All the people I’ve ever dealt with have been top notch.

  • cmassie

    I say we all just continue to strive to be our best. Lead by example. If the 25% keep on keeping on, work diligently and hard, their partners will begin to see them. Sure it may be hard, but isn’t it better to restore a smile to a crying child’s face while they are in your care, than to wait until the ER? In the services I am involved with, the ones who are amazing show it, the ones who aren’t sit behind in the wayside, and I have seen both at work. Just keep being amazing, and soon the world will see.

    • LeeLee Byrne

      You sound like an idealist.  It’s refreshing!  I wish it were so simple, though.  I pray that you will alway view your job (your calling) this way.  Once you loose a child in your arms it becomes a lot less rosey.  Hang on, cmassie.  Hang on.

  • Aaron

    same as any profession, there are good and bad. the public often don’t care about the fire/ems personnel or police for that matter unless they really need us. pointing a finger to the bad is where I’m from in ohio definitely supports the safety services. but there are always haters for whatever reason. I know I always strive to give the best possible care that I can. I would hope everyone does that is a professional.

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  • SherriLajeunesse

    Well here in MA we’re in that 25% bracket and I don’t see anyone in the 75%…Anyone who works EMS, whatever the pay, we all know we don’t do it for the $$$ anyway!

    • Bobball

       I have to ask (and I’m truly sorry)…but what about those that were caught in the whole MA CE scandal last year? Were they part of the 25% or the 75%?

  • mpatk

    At the risk of opening up a can of worms…

    Take paramedics off fire engines.  If you want to be a paramedic, work on an ambulance.  If your fire department doesn’t have ambulances, choose between firefighter, paramedic, or a new department that transports patients.

  • medic268

    I don’t know any medics that get paid to much, but I have spent a career in the other side. The problem starts with public perception when I tell people how much a street medic makes they are all withour exception totally amazed becuase they think we get paid on a scale with nurses etc.

  • MiniEmTFD

    I know a lot of people in the fire and ems community. Haven’t run into any of the 75%.

  • LeeLee Byrne

    In my limited and humble opinion, I’m can not agree with the statement.  This is probably because I work with a small county community where those who became “burn-outs” were summarily “put out to pasture” while the others (younger, less jaded) were moved up in the hierarchy.  Many of my colleagues who burned-out went to work in small community health offices and/or joined their local volunteer fire departments (if they weren’t already members).  Many of us are members and use our talents accordingly.  None of us have ever been paid what we are worth, but we do the job regardless.  We don’t do it for the money.  We save lives because we give a damn.  It’d be nice to have financial recompense (recognition) for our talents and education (it ain’t cheap!), but we save lives because we CAN. 

    • Ambulance_Driver

      Then in this case, that would put you in the 25%, wouldn’t it?

    • Underpaidandoverworked

      it would be nice to have the financial comp? bro your kidding yourself…its a job not like anyother…dont sell yourself short…you deserve much more then what your getting paid

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  • Woodlawnmedic

    I think you should apply that same argument to EMS administrators. The good-ole-boy system of promotion is what has held back EMS for so long, in my humble opinion. We now have a chief that is pro-active, education based and not afraid to make his old buddies step up to the plate or step aside. Its amazing how our service has changed in 18 months. Hopefully in the new budget year we will see it rewarded. But politics is another battle.

  • Underpaidandoverworked

    we as a community wont be receiving the moeny we deserve for about another 20-30 years…based on the fact that if you look at FD PD and nursing. Those carrers have been around for soooo long that they have become such a staple in society they have gained the rec needed to get to the pay scale they are at. The Ems community has been around since 1972, i figure the job is still too young but alose a union would probally help out as well…just a thought

    • Bobball

       Doubtful we’ll ever see what you think we deserve. The nursing “bubble” is fit to burst…they’ve up-waged themselves to a point where the industry can’t support them any longer.

      Police and Fire? They’ve managed to slurp a great deal from the public teat over the last several decades. Now? Many areas you’re going to see wage freezes and staffing cuts.

      Unions can help, or they can hinder. One thing to keep in mind is that in unionspeak “Fair” actually means “equal”. That means that the laziest, sloppiest, doing the bare minimum to-not-get-fired person will make the same as the hardest working, nicest most caring person.

      That said, unionization can at least raise the floor up for those parts of the country where poor pay and conditions are the norm.

  • Underpaidandoverworked

    lemme say one more thing so i can my peace about this. (prob going to have spelling errors..heads up)
    listen i know its a job unlike any other and we do so much that others could not fathom. YES people get burrned out all the time. ITS PART OF THE JOB.. deal with it. All of the young people who come in here and say things about the older guys about who are burned out…get this kid…you couldnt hold that guys jock when it hits the fan keep your mouth shut and learn. I may be young (late 20’s but ive been doing this for about 10 years burned like the next guy.The other people who say but we save lives. your right we do…but go home and tell your kids you cant pay rent or you cant pay for food or you cant pay for bare essentials but hell you save a life…yeah that will put fodd in there stomach….get a clue and fast we are so under paid as a industry is stupid… WE ALL DESERVE MORE MONEY from the n00bs to the “burned out” everyone needs to stop seeling themsevles short….

    • Bobball

      I’m not really sure where to start…oh, heck, I’ll just go in order.

      “…a job unlike any other…”. Well, if I agree with that, then I can also say that waitress, truck driver, kindergarten teacher (I could go on) are also jobs unlike any other. Oil well roughnecks do things that others cannot fathom…so do commercial divers (heh, heh…divers…fathom, but I digress). Let’s face it, in reality, our job is like many others…except we forget that. 90% of the time, we are a cross between a taxi driver and a flight attendant. We take people to the hospital…and we’re supposed to try and make them comfortable and safe. Unfortunately, we get a lot of folks who think this is a “job unlike any other”, and when they realize (even if they won’t admit it) that it actually is like many others, they grow disillusioned and “burn out”.

      EMS is a service job, much like nursing is supposed to be (at least they keep trying to show the service part), or flight attendants, or wait staff, or even doctors (though surgeons are probably more like your local mechanic). We rarely save lives (and that’s coming from a department that has a >50% Utstein survival rate for cardiac arrests, an aggressive STEMI and Stroke Program, etc.). Mostly we help people. Most of that help is a) keeping them safe, b) making them as comfortable as possible and c) taking them to the hospital. If doing A, B and C repeatedly is not something that interests you, you’ll “burn out” and you’ll be part of Kelly’s 25%.

      There are many parts of the US that underpay their paramedics and EMTs (regardless of their value). There are others (my neck of the woods included) that pay reasonable wages (like you don’t have to have a second job to survive). So, it’s not a completely industry-wide issue…it also has to do with geography and the local market.

      I will say that the “burned out” are overpaid if they receive anything at all…the “burned out” should move on so that those of us who have matured beyond this concept of “job unlike any other”, lifesaver crap can stop being dragged down…

  • annoy cat

    Id like to know where this 75% is. I live on LI and I make $12 an hour as an EMT. I only survive because of my GI benefits cause the low pay has forced me back to college since I need to be able to take care of my new family.  Yea I’ve meet techs who weren’t worth their salt and I’d never let help me, but that’s about 25% of them not 75%. I’ve done this for 10 years now, and I love (to an extend) being a tech but I can’t wait till i graduate and get the hell out of EMS. I’m sick of how we are treated, from the nurses in the nursing homes to the people we serve in the community. I have a feeling that Kelly isn’t really in ems or she’s one of those who have been in dispatch her entire career and doesn’t know what it’s like out on the street or she wouldn’t be saying that.

    • Emtblair

      Kelly is a MAN. Kelly Grayson, NREMT-P, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 18 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the LA Association of Nationally Registered EMTs.
      He is a frequent EMS conference speaker and contributor to various EMS training texts, and is the author of the popular blog A Day In the Life of an Ambulance Driver. The paperback version of Kelly’s book is available at booksellers nationwide.

      • Bobball

         Annoy cat must’ve been confused with the whole Kilted to Kick Cancer thing…

  • 25%er

    Kelly, If you’re talking commercial EMS, I couldn’t agree with you more. At least 75% punch in, walk past the overflowing trash can, on the unmopped floor, plop down in front of the TV set that is never turned off, and begin the bitch session that is also never turned off. They only go to their unwashed ambulance when sent to a call, deliver rushed care in an effort to get back to the couch and continue the bitching. Meanwhile, the 25% is picking up their slack.

    • mpatk

       Hmm, different parts of the country must have different conditions.

      Most ambulance crews out here don’t have a TV or couch; when they’re not running calls, they’re sitting in their ambulance at a post.  Of two 911 ambulance companies in this area, 76% and 83% of their crews spend their entire 12-hour shift posted or on calls.

  • Medic_jojo

    Sounds like the numbers are crossed. Would agree with them the other way around. Crenditling employees on their skills from patient assessment to drug calculations would point those Medics out and give them an opportunity to move to the other side of the precentile.

  • Bobball

    Kelly…I don’t have solid data, but I’d disagree. I think the breakdown goes more like this (at least in my neck of the woods where a paramedic can make a decent living wage):

    10% are underpaid
    20% are overpaid
    70% are making pretty much what they deserve (yes, I think we have people…about this percentage in my department, that do get paid what they deserve).

    Of course, the 20% that are overpaid also cause 80% of the trouble…for their partners and the organization. These I’d prefer to push away with the tip of my umbrella. Instead, I work on dotting ‘i’s and crossing ‘t’s. I try to coach those with a chance toward success…and the others I try to manage into oblivion.

  • Adrienne Nobles Hill

    I have been a Paramedic since 2005 an was an EMT for six years before that in all my experience I have worked for private an public (government) EMS agencies. I have learned several things…..1.) Often you are only as good as your last call. 2.) People will either remember you for doing your job an being nice or being an asshole an noy doing your job (though) their interpretation of what your job is might be wrong so bare that in mind 3.) We were all new at some point so you can either teach an make a difference or sit an bitch knowing nothing will change. 4.) Most managers are not worth their salt an got into their position for having a willingness to screw over the little guy. If you see someone is struggling an having problems gap in there knowledge or practice help them if they are willing to learn or fire them an move on but dont invest the raise you could give the 25% you have that are putting their all into a job……which I really hope that is not an accurate number 25% sounds pretty low generally its the 10% that make us all look bad.

    • Bobball

       Perhaps it’s because I’m running in the right circles but I would take exception at your #4, “Most managers are not worth their salt an got into their position for having a willingness to screw over the little guy”. I’ve been in EMS for almost 30 years, and the last 6 in management. Being willing to “screw over the little guy” is not how I got into this position (nor did my bosses).

      My job is to help insure that my staff have the tools they need to successfully complete the mission. Since I give them the tools and opportunity, I also have to hold them accountable for both their success or failure. Failure…well, retraining is the ideal thing; but for some people, the best thing for everyone is for them to move on.

      • Adrienne Nobles Hill

        Perhaps so. In most situations I have found there is a great deal of who you know and who you are willing to know in the biblical sense. There are certainly good managers out there just as there are good EMS attendants however I have found a vast majority of those who are at the top got there because they were politically connected or willing to strategically place a knife. It is good to find good managers who are great communicators and listeners. Sorry if my view offends it was simply my observation. Perhaps I am not in the right circle.

  • Ahynes77

    I work as an EMT-B in greater Boston. I make ~$13 an hour.

    Now in some places that may be OK but here milk is $4 a gallon and so is gas. Average rents for a 1 bedroom apt. $1100
    Oh yeah and I’m not some Young kid,I’m a 35 y/o mom.

    *typed on a tiny touch screen phone… apologies for typos *

  • Ruth West

    No medical person: Emt, Doc, Nurse, Pa,Pn or police office is paid  what they are

  • Ruth West

    In my big city, have more fire trucks than amulances.
    How much would you pay somebody to save the life of your child, parent, spouse,
    sibling of even your self.

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