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Is EMS REALLY a calling?

How do WE get engaged?

This video shows how a population was motivated to participate in their first free elections.

The Return of Ben Ali. On January 14th 2011, we chased former Dictator President Ben Ali out of Tunisia. Since then many had lost interest in politics.

After many uneffective attempts to push Tunisian people to go out and vote for the upcoming elections, a new campaign was set up in La Goulette, to the shock of residents.

Their reaction was filmed. Results: On October 23rd, there was 88% turnout when 55% were expected.

EMS: More than a job (??)

This year's theme selected by the American College of Emergency Physicians is: EMS: More than a Job, a Calling

If you have been following the posts by National EMS Management Association President Skip Kirkwood, you may have a different observation. He is not a snarky pundit, but someone who has been doing heavy lifting for EMS. I would say he is a little frustrated.

Working conditions for many paramedics are grim, near minimum wage.

The US Department of Labor identified 2010 median pay for 226,500 "paramedics and emts" at $30,360 per year ($14.60 per hour).

As a contrast, the 310,600 firefighters 2010 median pay is $45,250 per year ($21.76 per hour). Police and detectives make more than firefighters.  Registered nurses even more than police and detective, at $64,690 per year ($31.10/hour).

I appreciate that this year's theme is:

… reflecting the idea that EMS practicioners don't choose this field for big salaries, comfortable working conditions, or 9-to-5 hours; they have a true calling to help and care for others in their hour of need.

Over the same 38 years, physicians dedicated to the practice of emergency medicine have significantly improved their compensation and professional status within the universe of medicine.  Nurses have transformed their profession.

Why are medics still near minimum wage? Why are some single-role ems providers engaged in 9-1-1 service without the same worker compensation presumptions that fire and police have?

Celebrating working for free does not pay the rent

My three passions; teaching, writing and emergency service, are not known as wealth builders.

I went to work full-time as a community college fire science program director with a master's degree and a dozen year's experience as a part-time faculty member. I was making less money than the rookie firefighters in the classroom.

At the beginning of every academic year, one of the college leaders would celebrate that a retired federal worker was teaching for free. After four years I left the college because of poor pay and threadbare resources.

This week we are going to look at issues affecting the profession of out-of-hospital care that will probably make you annoyed or uncomfortable.

Mike "FossilMedic" Ward

Comments - Add Yours

  • Skip Kirkwood

    You’re right, Mike – I am a little frustrated.

    First, I have to make clear that when I talk, I’m talking about EMS in general – not my own agency.  I am blessed to work in a place where entry-level medics, firefighters, and law enforcement officers make pretty much the same.  Although the LEOs scale goes higher, it is because they have successfully diversified their business to include many options beyond the “core” of patrol, while EMS remains a one trick pony.  Career, professional paramedics work here, some for a full career, with a deep commitment to quality care of patients based on whatever the medical evidence may bring.

    My frustration comes from the failure of, or the unwillingness of, so many EMSers to “engage,” to spend even a few minutes or a few dollars to advance their profession.  MANY are willing to speak, but a willingness to speak without the willingness to WORK on what you are speaking about is just whining.  And as a kid I learned (whap!) that there are few things worse than a whiner.

    My second source of frustration comes from the “What’s in it, or what’s easy, for me” focus.  Improving the stature of EMS in our communities, and improving the lot of EMTs and paramedics, is not rocket science.  It involves improving educational standards, becoming active in political regulator affairs, and stepping up to take control of our profession and our work environment.  Unfortunately, the response seems to be “If they’re not going to pay me more, up front, I’m not going to make any additional effort in this arena.”

    Folks, you make the investment first, then you get the dividend.  It works that way in the stock market, and it works that way in the economic, political, and academic environments.

    In our Canadian colleagues’ press, there is a great article called “Why are we number two?”  The issues that it raises for paramedicine in Canada can be multiplied by dozens in the U.S.

    When are we going to wake up, grab ahold, and fix this situation?

    • Mike “FossilMedic” Ward


      Thanks SO much for your response. 


  • Bob Sullivan

    Mike, I like how your metaphor about free elections in Tunisia put the challenges of advocating for EMS in perspective.  I’m glad some other people I respect have reservations about this year’s EMS week theme.  We make it easy to make EMS the only thing in people’s lives, from open shifts that need filled to volunteer ambulances that need to get out.  Skip writes about EMS being a one trick pony, and over time that calling becomes a job with a narrow career path. 

    I wrote more about this on my blog:

    • Mike “FossilMedic” Ward

       Thanks Bob.  Just read your post “EMS: Calling, Job, or Prison Sentence?”  Strong. Love the Thom Dick quote.

  • Ed Woods

    Mike, I agree. BUT, Is this our own Fault? I’m a Firefighter/EMT by Choice, not a Medic, but I see the same situation across all Public Safety Fields. Unusual thing is that I’m now retired, and my retirement is higher than my Salary was when I was working. Wages for those working have not kept up with the Cost of Living, Employee share of Benefits continues up as employers share decreases or stays flat. Many Public Safety Organizations are “Union Labor” (IAFF, FoP, etc.) but unlike all other unions, Public Safety cannot go on Strike, so a “Forceful” High Profile attempt at getting our point across is denied to us from the start. Then there’s my all-time favorite  in the “Public Preception” department. “Sure, you don’t make much, but you get to sleep on the job” My response has always been “Ride with us for a night and see how much sleep you get”……..  Anyway, all of the Classic, time tested, Public Relations methods have failed us, the very people who never fail the Taxpayers. We need new direction, but which way??…..

    • Unreal

       Nobody should get paid more to not work than they did to work.  Pensions like that are killing my state.  6% compounding COLAs for guys that retired in their 40’s?  Seriously?

      Sorry, I’m sure you’re a good guy, but it’s the truth.  It’s unsustainable. 

  • Vamedic4

     There are many reasons to get and stay involved in EMS, but if you know your chosen path isn’t going to pay the bills then you have to find something else to either supplement or completely replace it.  I had to do just that.
    I don’t mind blood, urine, stinky people, vomit or dangerous or complicated situations, but I absolutely DO mind being paid bottom dollar to work in such conditions.  I’m not the only one.   And it all starts with your first boss.

    See, your first boss is the one who is probably going to set the tone for you based on either his impression of you or his love of the almighty dollar.  If he values the level of care and dedication you can bring to his organization, he will pay you more.  If not, you will be paid less.  When I went to work as a CCT paramedic at the same organization as my college roommate, I was paid $1.30 less per hour despite the fact that I was a paramedic and when he began working with them was a Shock Trauma Technician (EMT-I now…showing my age here) in Virginia.  There’s no excuse for that, but it happens every day.  We’re not seen as people with lives, families and responsibilities, we’re seen as a means by which to make someone else more money while we work ourselves to death just to pay the bills.  That’s not whining, that was reality.  I made $.50 per hour less as a EMT B than I did as a degreed paramedic – and there’s no excuse for that at all.  That will quickly set the tone for your future in EMS.  You hope that better is out there but are you willing to chance it?  Or should you just move on?

    Another problem is that many places, here in Texas included, hire people to be cross trained and perform a dual role – firefighter AND paramedic or ff/emt.  And they’ll only hire you if you’re a firefighter first.  That puts EMS providers at a distinct disadvantage despite the fact that medical calls outnumber fire calls by a good margin.  I don’t want to knock firefighters at all, this is more an administrative problem (you’ve always had Fire Chiefs, who advocate for their firefighters. We only recently have the level of EMS Chief.)

    What I see as perhaps the biggest problem is that of perception.  No matter where you go, people value property over life – that’s one reason firefighters are held in high regard.  “Oh, they saved my home” seems more important than “grandma’s going to be just fine.”  We carry insurance in case of destroyed homes because of the risk, but we don’t carry insurance on our own bodies despite all the dangers of living every day.  Sorry, but my house can burn to the ground as long as my son makes it out of the hospital.  And he makes it out because of the work of paramedics and EMTs- the prehospital professionals whose job it is to stabilize him and get him to the highest level of care as quickly as possible.  There are far more instances where EMS is needed but not the full services of the fire department, but EMS gets lost in the shuffle because they work under the blanket of the fire department.  Combining services may save money, but our contribution as EMS providers gets forgotten and lost in the shuffle.

    • Mike “FossilMedic” Ward


      Thanks for the response.

      In the Washington DC area, you need to be a paramedic BEFORE getting hired as a firefighter (the opposite of Texas).

      Appreciate your perspective, not sure that everyone values property over lives.


      • Vamedic4

         Mike you are correct of course, and I doubt anyone would admit to valuing property over life but evidence is hard to deny.  When I see a brand new 3/4 million dollar piece of fire apparatus on a scene with a 2005 Wheeled Coach Ambulance it becomes clear where some departments put their priorities.    Any time there is a fire of any kind, the FD is thrust into the spotlight.  EMS can’t compete with that kind of PR.  Medical emergencies, because of patient privacy laws and a lack of interest unless it’s something truly awful, aren’t as noteworthy unless you are somehow personally affected.   And it is nice that there are cities across the country that hire medics and train them as firefighters.  Guess I moved to the wrong state.  Thanks for a great column, Mike.