We Don't Pay Them Like Heroes

"Northern Dutchess Paramedics is a wonderful company and family-oriented," Ann says. "They care about their employees and their well-being, and that is what keeps me going." When asked whether she really likes EMS, Ann says, "You know what, I'm not sure. It is very frustrating. I have enough college hours to apply to nursing school, but I can't find the time or the money to make the change."

Southern California

Things are better for EMS providers in Southern California, even when the increased cost of living is factored in. Justin Weems, EMT-P, has been a paramedic with a private company in Riverside County, Southern California, for over 10 years. Justin works 84 hours every two weeks and earns $16.64 an hour-approximately $40,073 annually.

"I work in a great place," he says.

Justin and his fellow field employees work a 4/3 schedule-four 12-hour shifts followed by four off, and then three shifts followed by three off. This equals 84 hours a pay period. The company also offers a 401K plan.

Despite Justin's satisfaction with his employer, the grass remains greener at some of the fire departments in Los Angeles County. Justin recently completed the fire academy and is interviewing for firefighter/paramedic jobs. One town he is considering is Manhattan Beach-a small beachside community in Los Angeles County that operates a paramedic engine and a paramedic rescue ambulance.

The annual salary for a firefighter/paramedic in Manhattan Beach ranges from $60,072 to $73,020. The city offers an employee benefits package far superior to that of most private ambulance services. In Manhattan Beach, through their collective bargaining agreement, firefighter/paramedics receive health insurance, retirement, a uniform allowance, tuition reimbursement of up to $2,000 a year, and seniority credit. Paid vacation accrues at 15 hours per month for employees with fewer than 10 years of service. Employees are provided 12 hours of sick leave a month. Firefighter/paramedics in Manhattan Beach work 48 hours on duty followed by 96 hours off duty.

The disparity in pay between nursing and EMS seen elsewhere in the United States does not exist in Southern California. It is not uncommon for nurses to leave nursing for an EMS career. Likewise, it is not uncommon for fire department paramedics to attend nursing school and moonlight as ED nurses during their off-duty hours. Justin says he will continue to work for his current employer on his days off, either in Riverside or Los Angeles County.

Other Countries

Many countries have EMS systems similar to the United States, yet these countries seem to put a greater value on EMS than does the United States. This is reflected by salaries competitive with similar medical and public safety professions.

Canada

Although EMS delivery varies significantly throughout Canada, each provincial Ministry of Health recognizes EMS as a part of the healthcare team and sees EMS personnel as healthcare professionals. A 10-year paramedic with Toronto EMS earns approximately CAD$68,000 (about US$53,553) annually. Paramedics receive six weeks of annual paid vacation, free training, free uniforms, dry cleaning, retirement and 10 months parental leave. Most paramedics retire at age 65, although earlier retirement is possible. Several unions represent EMS providers in Toronto EMS.

Unlike the United States, Canadian EMS education is generally much longer and more comprehensive. In Toronto, two years of education are required to become an entry-level primary care paramedic. Advanced care paramedics (ACPs) require at least a year of experience and another year of formal education. Paramedics in Toronto who want to be critical care paramedics must take a fourth year of education before becoming certified. This course is much more comprehensive and more difficult than the typical two-week critical care paramedic course offered in the United States. In Toronto, enhanced education and a strong union have led to pay and benefits that are among the best in Canada.

In the western province of Alberta, the City of Calgary operates a state-of-the-art EMS system. Functionally a third municipal service, Calgary EMS operates 37 ALS response vehicles and responds to over 80,000 calls a year. There are three levels of EMS providers in Calgary: Emergency Medical Responder (EMR), Emergency Medical Technician (EMT) and Emergency Medical Technologist-Paramedic (EMT-P). The EMT is the entry-level position and requires six months of education. EMTs may go on to seek paramedic certification by completing a full-time two-year paramedic program (although some one-year programs still exist).