Occupy EMS

A few months back, I engaged in a bit of trollery on Facebook and here on the blog when I asked readers to defend or refute 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."

The statement was in response to one of those pointless Facebook threads wherein EMT's bitch about how little they make. As usual, every argument once again made the rounds.

"If we increase educational requirements, better pay will follow."

Actually, I happen to agree with this one.

"Why should I strive for better education? Going to college doesn't make you a good paramedic. I've been a medic for [insert number of years] and my class only lasted [insert number of months], and I've done just fine!"

Maybe so. Then again, maybe he's one of those medics with one year of experience, repeated twenty times.

"If you got into this for the money, you're in the wrong profession."

Ah, a dose of realism. Then again, why should we have to choose between rent and job satisfaction?

"Making more money is simple. Go to work for the fire department. We make great pay!"

Yep. Then again, more and more cities are questioning whether they're getting any value for all that pay, expecially with dwindling tax revenues making budget shortfalls commonplace. And while your unions might get you better wages and benefits, they also make you a big target for some politicians.

"If I wanted to run into burning buildings, I'd have joined the fire department long ago. I just want to be paid a fair wage for being a paramedic. Besides, fire departments provide really shoddy care."

Two fair sentiments, followed by a gratuitous slap at others in our profession. Not exactly constructive.

"How can I go to school for more education, when I already work for three private ambulance companies just to pay the bills?"

Brother, do I feel your pain. Then again, if you saw how paltry the reimbursement is for ambulance transport, the low pay starts to make more sense.

"See, that's why I won't work for private EMS. They're all just a bunch of mercenaries, getting rich off sick people while paying their employees chump change. I VOLUNTEER my services, because that's just the kind of altruistic sonofagun I am."

Except, of course, that those wages come from a finite revenue pool of Medicare and Medicaid reimbursement that runs about 30% less than the actual cost of providing the service. And that reimbursement was derived from some arcane formula calculating the average cost of providing EMS services across the country… including the volunteers who provide the service for free. So, thanks for doing your part to keep EMS wage levels in the toilet, Mr. Noble Volunteer.


I used to engage in these discussions. But after you've seen the same ignorant statements a thousand times, maybe dropped a few ignorant statements of your own, you grow weary of such things. The signal to noise ratio in such threads makes it tiresome. So instead, I skim it, maybe drop a verbal grenade, and move on.

Some of you took up my challenge. Happy Medic proclaimed himself a member of the 75% of us who are overpaid, and told us of the choices he had to make to get there. If you don't understand what he's saying there, I can 'splain… no, ees too much. Let me sum up: Challenge yourself, seek professional growth, and get out of your comfort zone. It pays off.

TOTWTYTR chimed in with a sentiment I've heard him express for years:

"There is no shortage of paramedics. What there is, is a shortage of paramedics who are willing to work for the low pay, high call volume, crappy or non existent benefits, sitting in an ambulance for 8-10-12 or more hours, not able to even go to the bathroom without asking for permission, lowest common denominator medicine, that is EMS in much of the country."

He's right, but he misses my point. So did Happy Medic.

Silicon Valley Redneck hit closest to the mark, when he correctly interpreted my statement to be a variation on Sturgeon's Revelation, which states, "Ninety percent of everything is crap."

Change the professions around and the percentages might change, but the law holds true. Mediocrity reigns.


That fact is sometimes easy to forget, especially here in this insular little world of the Internet. My EMS readers here are passionate about their profession. The EMS blogs I read are written by people who are passionate about their profession. I can look around and see great medics and EMTs, people who are a credit to their profession. They're easy to find because, by and large, we surround ourselves with those kinds of people.

I don't teach nearly so many EMS classes as I used to. It's been over seven years since I had a paramedic student, four years since I taught anything longer than a refresher. And the vast majority of my students have been talented and dedicated kids who are passionate about their chosen profession.

But the reason I see so many of them is because they sought ME to teach their classes.

For every student I get who takes the education I provide and runs with it, there are a dozen more who sought their education elsewhere, because I demanded too much, or charged too much, or graded too hard, or required them to think and not memorize. A dozen more who didn't want an EMT education, just an EMT card.

And if you look hard enough, you can see beyond your circle of like-minded people and realize that you're outnumbered by the turds of our profession, the ones who are satisfied with good enough. They're all around you. They outnumber you at least three to one.

For a variety of reasons, this post was back-burnered until I could find the time to give the subject its due. And yesterday, I discovered that now I don't have to, because Tracy Loscar wrote it for me. For me, the money quote was:

"In short, you are required to metabolize, but nowhere does it say you must evolve."

You need to read the whole thing, but that one sentence, to me, sums up what is wrong with EMS.

So no, Happy Medic isn't one of the overpaid 75% he claims to be. He's just the opposite. He's the underpaid 25%, because you can't put a salary value on what he does for the profession. Ditto for TOTWTYTR, Rogue Medic, Steve Whitehead and others.

The good news is, even though we're outnumbered 3:1 by the turds of our profession, those are not overwhelming odds. The 75% aren't doing anything to actively advance our profession, but then again, they're too apathetic to do it much harm, either. Less than 3% of the American colonists actually took up arms in the American Revolution. Less than 10% actively aided them with arms, shelter or materiel. Perhaps only another 20% were favorable to their cause.

And yet, they were able to throw off the yoke of the most powerful nation on the face of the Earth.

Imagine how we can transform EMS if we manage to shift the ratio even a few points in our favor.