One of your first questions when you start out in a new career likely is: “When and how much will I be paid?”

As you begin contemplating careers, you will hear many people group emergency medical services (EMS) with firefighters.

Although you may want to begin your career in EMS, when EMT pay comes into consideration you may be astonished by the low earning potential of the discipline.

EMS professionals need to create a dialogue for what we must do to collectively improve our earning potential to improve this situation.

According to the United States Department of Labor, a median salary for a paramedic in the U.S. is $34,320 or $16.50 an hour. The lower 10% make less than $22,750 versus the highest 10%, who earn more than $58,640.
To explore why these earnings are less than 40% of the average employed U.S. professional, we must consider several factors.

1 — EMS is a relatively new profession

Many identify the EMS White Paper, which researched auto crash deaths, as the first realization EMS needed to become its own profession.
In the 1970s, initial training programs arose; out of these programs the EMS Agenda for the Future developed in the 1980s.
We still employ that agenda in 2019 to develop further training.

2 — Public perception

We also have a low profile, which deprives our profession of the status of an essential public safety service.

At the beginning, what volunteer EMS providers proved willing to tolerate in time and financial commitment had a significant influence on training requirements.

This is not necessarily viewed as a bad thing because communities have access to emergent medical care they may not otherwise have. But the downside is we are not viewed as essential.

View any town’s budget and see where EMS funding is located, and you will get a sense of the hierarchy and why EMT pay is so low.
Former U.S. Labor Commissioner Robert V. Linn defended New York City Mayor Bill De Blasio’s explanation for noticeable salary differences between fire suppression members, EMTs and other first responders. They stated the work was different and not as dangerous. DeBlasio’s comments demonstrate how deeply rooted the disparity has become.
Countering this statement, Kevin Munjal, MD, chair of the New York Mobile Integrated Healthcare Association, said: “EMS should not be viewed as simply a transportation commodity nor merely a technical function,” in an article in The Chief.

Additional beliefs are EMS should pay for itself by billing individuals treated and transported. Insurance companies should be petitioned for more payment.

For example, we see the effect of Medicare and Medicaid reimbursement and how it has financially challenged healthcare institutions, including EMS. Communities that prove unwilling to pay for ambulance services like they do for other public safety, such as police and fire departments, exacerbate this issue.

3 — EMS education

EMS education requirements are relatively lenient when equated to comparable professions. One only needs to have a high school education. While department encourage completing a college degree, they do not require it.

Respiratory therapists require a two-year degree for entry level positions. Physical therapists need to obtain a master’s degree for entry. It is rare to find an allied health profession that does not require a minimum of a two-year degree.

There also is relatively little practical education through field and clinical internships. If one argues the trade aspect of the profession, we still fall short on the hours spent in training.
Hair and make-up artists require more than 2,000 hours of training and many other trades require years of supervised work to reach a status of full licensure or certification.

4 — Many are leaving the EMS profession

Many people use EMS to transition into higher paying positions such as firefighters or RNs, leading to a densely populated field of young licensed providers with little experience.

Because of the above situation, employers also face a large turnover of employees.

Research in The New England Journal of Medicine shows experience levels of less than three years affects the quality of care patients receive.

5 — What are we doing to earn more money?

Some suggest you can address EMT pay deficits in several different ways.

  • Consistently accrue overtime, which many already do.
  • Hold multiple jobs.
  • Change employment from the private sector to the public sector, which can be difficult because these positions are highly competitive.
  • Obtain additional education, which can add to financial reimbursement if your company acknowledges the education.

How we can address the EMT pay disparity

The factors explored above influence wages.

There is a large constituent of EMS professionals who are resistant to formal education. Other allied health professions have shown us that a lack of formal education has a negative impact on wages. We need higher educational standards to justify increases in earning potential.

We also need to produce a better product. Drop the “lifesaver” role and embrace a role of a professional healthcare provider.

Labor unions generate enthusiastic discussions, which will broadly demonstrate that unionized services generally have better wages and benefits. This isn’t to suggest non-union services can’t compensate equally well, but it should be cause for evaluation.

EMS must be recognized as essential and valued at the same level as other emergency services.

As a profession, we are at a crossroads. We must make our profession appealing to all, not just those who view it as transitional.
As a profession, we should raise our voices to educate the public and showcase our value.

Lesson 24 of our EMS Refresher course discusses EMT pay. Join us to express your thoughts.