Is It All About the Money?

EMS is currently at a major crossroads as an industry.  Across the country requirements to become a paramedic are becoming loftier, and rightfully so.  In order to properly care for each patient we encounter, we need to be at our best, and the route to that is through training and that bar is being raised.  More education eventually should mean more pay, and some in the private sector are starting to realize that.

This is evident from the recent well publicized labor dispute in Buffalo, New York and their eventual 10 hour work stoppage followed by a contract settlement.  From the publicity I have seen regarding those negotiations and others I have more intimate knowledge of, it leaves little to the imagination as to what is most important to EMS professionals: pay and benefits.  I know, that seems like a slam dunk, no brainer, but it also seems clear that at least in the private sector, purse strings are becoming tighter, and benefit packages are less and less appealing.  It’s quite the conundrum, actually.  Increasing educational requirements are driving paramedicine towards being a career, yet employers are still far too often looking at employees with the expectation that they have a job, and there is a divide the size of the Grand Canyon between the two.

Now, the jury is still out for me on work actions such as strikes.  I do not really know if they truly follow the “spirit” of our profession and seem to do more of a disservice to the community than they do benefit the worker, but that is a debate for another time.  The fact remains that they happen, and there is certainly reason behind them, as evident by the Buffalo, NY Rural Metro incident.

While the private sector is just one of a number of EMS models, it is quite often the quickest path of entry into the industry and employs more EMTs and paramedics than any other model, so discussing the big kid on the block is extremely important.  With health care taking on a huge for profit presence in the economic world, everyone wants their piece and if some of the bigger players want to maintain their hold of the market share, a reevaluation of how they employ and who they employ might be vital for their survival.

The workforce has their own challenges to overcome as well.  They need to care about their future.  I remember back almost twelve years ago, I was a union steward attending a vote on a collective bargaining agreement.  The majority of people walked in the door, opened the negotiated contract straight to the page that outlined their wages, looked at it, were satisfied with it, voted “YES” and walked out the door, ignoring many of the other important pieces of the contract that would impact their job for the next three years.  While those who did read those other parts of the contracts were satisfied with what was proposed, one must not overlook the disregard of it by much of the workforce.  In their defense though, at that time raises were long overdue, and while we were the largest ambulance service in the area, we were also grossly underpaid.  A major battle was won at the negotiating table.

While it might not always come down to the all mighty dollar for everyone, what is clear is that many organizations could put a little more value in the people that they put on the streets.  If people are going to go through additional training to become a paramedic, and ultimately, as many would would be best for the industry, obtain enough college level credits to grant them a degree then employers need to invest in their paramedics for the long haul and not just for the next five years in hopes that a new, younger crop of field providers will be ready to go at that point.

As a few friends put during a recent Facebook discussion, a lot of how much a paramedic should be paid has to do with loyalty.  While a brand new paramedic does exactly the same job as a seasoned 20 year veteran something happened over the course of their career that made that 20 year veteran sick around, and that deserves to be recognized and rewarded.

It is time for the private sector to embrace those 20 year employees just as much as they do those first year employees.  They are going to need to create an environment that will encourage people to invest the education they have obtained in their organization because in the near future, a college degree is not going to be worth wasting on a job with crappy benefits and substandard pay.  People are going to want a career, and they are going to have to demand a career, and they are going to have to refuse to settle for a job.