Wednesday, October 29, 2008

Why Don't I Get Paid What I'm Worth?

I wanted to get started with a question that plagues EMS folk all across the country. Why don't we get paid what we are worth? It's an easy answer, but a complicated fix. If your employer is anything like mine, they will tell you tales of Medicare reimbursements and inability for people to pay for the services, but the answer is much less complex than that. I will agree that Medicare keeps tightening the noose around reimbursements and there is no good way to ensure payments from people when they cannot afford, but need an ambulance, and I could argue those points. The real reason Paramedics/EMTs don't get paid what they are worth is pure and simple, education.

If most Medics are like me they obtained their education from a technical school. Technical school education is one of the main reasons why our profession is lacking in monetary compensation. I have nothing against technical schools, I believe they serve a valuable purpose with professional trade training. My problem is that I view a Paramedic's profession as collegiate, not technical. In my state all you need to be a medic is to be 18 years old and have a high school diploma or GED. That is it, no college foundation courses or anything. Granted I believe it's changing a little to where anatomy and physiology are now a pre-requisite, but in my opinion, that is not enough. We think we are on the same level or better than nurses, but we aren't required to have the same education as they? How can we be better or even comparable? We cannot! Granted, nurses have a choice of just an RN or BSN, but I think you would find that most are BSN or attempting to get their BSN. Paramedics do not have anything like that. If we are to be taken serious about wages, or even professional, we need to up the ante on our education. Not only would it start to secure better wages for our brothers and sisters, but we would start to see better quality medics out in the field, instead of the cookie-cutter, get them out as fast as you can medics.

There is a problem with the idea of better wages for higher education. No employer in their right mind would hire a medic with a BS at $30-40k a year (starting) when they can get a technical school medic for only $20k a year. The only way to bypass that obstacle would be to make it mandatory for all medics to have a BS. Only then would employers find that they can no longer hire medics at ridiculously low wages, there would be a shortage, and wages would increase to lure people into the field. I know it is more complex than that, but it's a start. Educational requirements could be similar to nursing requirements, but with emphasis on Emergency Medicine and Triage. With this kind of educational background, medics can start taking over the ERs like we need to be doing, instead of leaving it to the nurses. I am not anti-nurse, but I do believe that Medics belong in the ER, not nurses.

Hopefully in the coming years as the need for more medics increase so will the educational requirements at obtaining a Paramedic license. Only by increasing educational requirements will our pay be increased as well. We need to take control of our profession and make it clear that minimal pay is not acceptable anymore. I have left a lot of my arguments out because of the length of this blog already. There is so much more reasoning and many more complex issues that need to be ironed out, I just want to start people thinking about it. Have any questions or criticisms please feel free to ask.

Be Safe,


Michael Morse said...

If you did get a BS, wouldn't the education be similar to or identical to that of an RN? What else could be covered to accumulate the necessary credits?

Just wondering, my guess is you have pretty good answers. I agree the pay for paramedics in the private sector is pathetic and an insult to the proffession

Zumstin said...

Yes the educational requirements would be similar to a nurse, obviously not exactly though. There wouldn't be an emphasis on a care plan, for example. Baccalaureate of Sciences in Paramedicine would be the degree name. Basic biological and physical sciences with an ethics class would be required. Then some classes on Incident Command and other specific classes that would need to be laid out and decided on. A nursing curriculum would be the model, but not a carbon copy.

Bernice said...

There are so many more factors to consider when approaching the wage subject. While I may not be as qualified to speak on the subject since I am nothing more than a volunteer, I would love nothing more than to be able to go full time.

While I agree, that more education never hurt anyone, tech school medics should not be getting the short end of the stick. Tech schools do not automatically qualify someone as a cookie cutter, factory made medic. Could they be even better with more education, no doubt? Should they be compensated more as a tech medic based on other factors, absolutely.

I'm not totally disagreeing with you. Unfortunately, I am not quite sure how to say what I want. I guess, just be careful not to discredit tech medics and lower their value just because their education came from a tech school. A BS doesn't automatically mean you are going to get a rockstar medic out of the deal. Somehow the slugs still find a way to sneak their slimy asses through.

brendan said...

Our profession will never advance until we in EMS wake up to and resolve to DO something about the fact that the people who cut our hair spend more time in school than we do. It's pathetic.

Is a BS the answer? Long term, probably. The Jefferson College of Health Sciences is starting what looks like a good program.

Shorter term, I think we need to push for a CoAEMSP/CAAHEP-accredited Associates requirement at the Paramedic level.

Zumstin said...

I am not discrediting "Tech School" Medics, I am a "Tech School" Medic, and I know plenty that are good medics. A BS will not make you a good medic, I agree with that, but a BS will put you on better ground to start demanding better pay. I believe that Tech Schools lead to "cookie cutter" medics. I see it all the time. The programs around here are more interested in outputting as many medics as possible to meet the demands of the services that hire here. When you require something like a BS it slows down the "cookie cutter" process and leads to better medics. The whole point to the argument is to obtain grounds to make better wages and that won't happen until we up our educational requirements. I love being a medic, but I am not willing to live in poverty just to be a medic. Granted differing services may pay better than others, but for some people, travel is not an option. If we want to make change we have to be willing to put in the effort to make change.

Anonymous said...

i am an e.r nurse in pediatrics and a former e.m.t . i am offended at your comment that nurses dont belong in triage. how can you say a comment like that? emergency room nurses are highly specialized and trained to perform at all levels in the e.r so please dont make comments that demise nurses who work hard and train hard to be great at what they do.

Zumstin said...

I didn't say that there aren't nurses that aren't great at EMS or running the ER, I said that I believed that Paramedics belonged running the ER. Of course there are good nurses in the ER, but lets look at what nurses are and what Paramedics are. Nurses, as described by the definition of their title are trained for long term care. Paramedics were created for short term care. The ER is designed for short term care. Nurses are trained to create and execute care plans, Paramedics are not. Yeah, nurses are qualified to take courses like an Incident Command or other courses that would make them good at Emergency Medicine, but those courses are designed for Paramedics. The funniest thing I ever heard a nurse state was that, "Paramedics don't belong in triage." Bah ha ha ha ha ha. That is what we do! There are good ER nurses, just like there are Paramedics that would do good at long term care, my point is that Paramedics are trained for Emergency Care from the start, I believe they would be better suited for the ER. Nurses can have the floor for long term care. Now will that ever happen? Probably not. Nursing Unions are too powerful anymore, and Paramedics are still rather new. Although, I bet you will start to see more and more Paramedics entering the ER for care, and taking more of the role that the nurses are taking, instead of the subservient role they take now, under the nurse. How many times does an average nurse get to intubate? Run a code by themselves? Needle chest decompress? The list goes on and on. I will blog more about this subject later, there is too much to discuss for a reply. Hopefully I have made my point a little more clear. Sorry if I offended you. Wasn't personal.

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