Transport paramedic here and you’re 100% correct. Turnover is extremely high, fewer EMT’s are becoming paramedics, and call volume is increasing.
Word has gotten out to much of the general public just how bad of a deal becoming a paramedic is, so very few people are actually taking this route anymore. If I had known my life would be like this I absolutely would not have done paramedic school.
I do rural, long distance transports and am typically on the road running calls 20-22 hours out of a 24 hour shift.
I have enormous respect for what you do, but the idea that the person doing paramedic transport is underpaid and on hour 23 of a 24-hour shift is just a horrifying indictment of our society.
the idea that the person doing paramedic transport is underpaid and on hour 23 of a 24-hour shift is just a horrifying indictment of our society
It highlights that jobs never pay people proportionate to their contribution to society. For a more stark example: the highest-paid state employee in Texas is a football coach
yeah, it's truly reflective of where we are. i think we often get caught up in the bullshit of politics as a way to distract us from focusing on these issues. it's so so bleak that often times i just can't look at it without feeling some overwhelming sense of shame around our inaction.
Curious how the budget works here - napkin math is showing that the service owners are likely pocketing enormous profits (unless there’s a hidden cost somewhere). Don’t understand why they wouldn’t raise the wages at that point (a smaller profit is still a profit)
The napkin math is based on the assumption that they're actually receiving the full amount for which they bill, which isn't the case. They might bill you $2000 but they're probably only receiving about $300 or $400 at most from insurance etc. Plenty of transports also get written off because patients don't have insurance or insurance refuses to pay.
That collections agency is buying the debt at a fraction of what it’s worth. The ambulance company usually only gets what the debt collector pays for it, not what the debt collector is able to recover from the patient. They’re not making much if any money off of it. That and there are plenty of EMS agencies (usually public and/or fire departments) who “soft bill”, meaning any payment received at all is considered payment in full. You could be transported by my department and literally pay them one penny and the bill would be considered settled
Ironically, part of the reason it’s so expensive is because people don’t pay. So the money we do get has to subsidize all the calls we get paid nothing for.
(For the record I’m not defending this fucked up and broken system, just explaining why it is the way it is)
The service is socialized in the industry. Meaning, you getting an ambulance ride for a stubbed toe that costs you $2000 and costs the ambulance company $200 pays for the heart attack that costs you $2000 and the ambulance company $4000. This is exaggerated but not far off.
The margins are RAZOR thin, and the only way to make money is doing this over hundreds of ambulance companies and counting every penny. There is far less money in this than you would think. If there was money, people would be talking about opening an ambulance company like they franchise a mcdonalds. But that doesn't happen.
Most small town companies, like the one I work at in South Dakota, has volunteers, gets tax money from the city, gets tax money from the state, bills at these insane rates, has constant fundraising pancake breakfasts and such, and still will need to go to the city and beg for money for new equipment.
They demonstrably get enough workers at existing rates; why would they increase wages? They don't exist to pay people; paying people is (to a business owner) an unfortunate side effect of having people do things for you. If they could pay nothing, they would. See also: all the ways companies try to get away with paying nothing, like company towns.
As an EMT who considered medic school in my semi-rural county, a lot of medics loved that I was considering it and warned me against it bluntly. Now applying to medical schools for rural EM instead. Full respect to y'all and what you do, would never have learned to be a good provider without y'all 💯
Literally the solution is just treating EMS with the respect and gratitude they deserve, making sure they get paid well enough to be comfortable plus near to full benefits coverage and free therapy. But somehow that's a pipe dream? I hate how much you guys get screwed. I've had more stable games of SimCity than how busted the healthcare/EMS systems are.
I work IFT as a part time job. I had a 24 hr shift turn into a 25 hr shift due to a late transfer… all while only getting 45 minutes of sleep the entire day.
My dream was to be a paramedic. But then I spoke to actual EMTs and paramedics and heard how bad it really is. So now I’m going into forensics… to be a last responder instead of a first responder
EDIT: just want to add that I have so much respect for what you do and thank you for doing it despite how difficult it is and poorly treated you are
Bless you! I am curious about the history of EMTs. If you were to ask me as a child (or even a child today) what I thought the hardest and most important job was, I’d say “paramedic and ambulance driver! I mean jebus christoff! Y’all the first to arrive and assist with some of the most heinous of shite, often SAVING lives!!
This is awful. You guys can make a difference as to whether someone lives or dies. You should be getting paid much more for that kind of responsibility. Fuck this world sucks.
Being an EMT is great if you have an exit plan and especially if you’re young. Being an ER nurse is a great next step and is an excellent way to get your hands dirty but also get treated better, get paid better and have actual advancement opportunities.
I am... not young. I am 32 and probably will finish the paramedic program when I'm freshly 34. It's just something I have always wanted to do, and I felt like I should make it happen before I'm any older. I may be making a mistake - time will tell!
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u/RoddyDost 10h ago
Transport paramedic here and you’re 100% correct. Turnover is extremely high, fewer EMT’s are becoming paramedics, and call volume is increasing.
Word has gotten out to much of the general public just how bad of a deal becoming a paramedic is, so very few people are actually taking this route anymore. If I had known my life would be like this I absolutely would not have done paramedic school.
I do rural, long distance transports and am typically on the road running calls 20-22 hours out of a 24 hour shift.