5 Reasons EMS DOES Deserve Higher Pay

In a guest ‘rebuttal’ yesterday to a recent article by Sean Eddy on EMS wages, I apparently succeeded in generating “more heat than light” on the conversation. While I regret the author’s tone in that post, my desire to open a dialog with interested parties remains. I discussed the topic with up-coming EMS author and blogger Caitlyn Armistead who agreed to submit the following post in an attempt to re-establish a civil discussion on the topic with specific and focused talking points.

Sean Eddy wrote an article entitled, ‘5 Reasons Why EMS Doesn’t Deserve Higher Pay.’ I appreciate his point of view, and I agree with many of his points. We must grow up, take responsibility for ourselves, avoid stereotypes, encourage education, and see the big picture. Who wouldn’t want those things? However, I would like to propose five reasons why EMS workers do deserve higher pay:

1) The effects of EMS work on mental health are only now being formally recognized, let alone compensated for.

The Code Green Campaign is a non-profit organization whose mission is, ‘to bring awareness to the high rates of mental health issues in first responders and reduce them.’ These mental health issues include PTSD, depression, and suicide. This organization is doing great work, and I encourage everyone to support their efforts. Suicide rates among emergency workers are increasing, and EMS agencies are often at a loss as to when and how to help their employees.  Is CISD effective? Was the PTSD due to the job? Was the depression a pre-existing condition? How do we know? An organization cannot compensate for what it cannot define. Until policies are created to confront, define, and address these issues, it is impossible to ensure an employee is properly compensated. However, higher pay would allow an employee to devote funds toward whatever stress management techniques, therapies, and medications she and her doctor decide are appropriate.

2) EMS agencies tend to cut salaries before other expenditures.

A ribbon cutting for a new fire station. A ‘Your Tax Dollars at Work’ sign at a construction site for a new dispatch center. A shiny new ambulance. All of these can be great things. And all of them are great marketing tools to the public. These things are fun. People ‘oooh!’ and ‘aaah!’ It’s easy for management to want to keep up appearances, give the people what they want, and allocate funds toward exciting new ideas. But in these hard economic times (and what time is not hard economically?), budgets must stretch and sometimes strain to keep the shiny newness coming, so managers go in search of funds. Cut a building project, and the town roars. Omit a few medics’ 1% cost-of-living raises, and no one hears anything. It’s simply wrong to cut salaries or omit raises while overspending building and equipment funds. Take care of your employees first. They will take you further than any state-of-art dispatch center ever will.

3) Pay structures often do not recognize experience

No one denies that educational standards are in transition. Few advocate the current card-based system. The EMS profession is changing and maturing out of necessity, and this is a good thing. However, in the awkward meantime, it is difficult to prove that someone has the ability, skills, knowledge, and experience necessary to demand appropriate payment. A paramedic may have every alphabetic-combination card in the deck and decades of experience, but if he has needed to change departments for whatever reason, he’s now making the same as any other paramedic. Why? Because he could not prove objectively that he was worth more. Next year, he’ll have to recertify again just like the new guy. Ongoing training is critical, but in our current system, it is not cumulative for the purpose of compensation. As such, experienced medics are undercompensated for their contributions to an agency.

4) Poor wages destroy organizational culture

I’ve heard it said, “In EMS, you don’t live off the job. You live off the overtime.�? This statement was not referring to mandatory overtime or even to time and a half. It means we assume an EMS job will pay so poorly that an employee must bounce from service to service in order to scrape together enough hours to pay the bills. For the individual, this leads to fatigue, error, and burnout; however, it is also detrimental to the agencies involved.

When employees bounce from service to service simply to make decent wages, any devotion is short lived and dependent upon who will assign the necessary hours. It matters little what the core values, mission statements, and the nature of care are when you are rushing to yet another job or desperately trying to find someone to stay over and cover the time discrepancy between the two shifts.

Well-paid employees are stable employees. They can devote their time and energy to not just being present but focusing on the job, contributing in a positive way, and growing the organization. Most employees want this to be the case; they want to do their jobs, not just adequately, but with excellence. But they will only do this when their own needs are cared for. It bears repeating, take care of your employees first.

5) Inflation affects everyone

There has been quite an uproar over the move to pay fast-food workers $15/hour. EMS personnel look at their own meager pay rates and cry foul. But it has nothing to do with competency. It has nothing to do with college. It has nothing to do with pickles, onions, or rapid trauma assessments. It has nothing to do with the required skills of the job.

If prices rise and wages do not keep pace with inflation, then the first people to feel the discrepancy are minimum wage workers, those at the bottom with the least wiggle room. When the discrepancy becomes uncomfortable enough, they begin to push for higher wages. When they receive those higher wages, it does not mean that others, such as EMS personnel, get waged out—it means that all wages shift upwards. It takes time, and it is not an even, across the board shift, but all wages do shift upwards eventually. Wages must keep up with inflation. If the upper-level workers want higher wages, the lower-wage workers have to shift first. This is not a threat. It is not about the value of the job or the skills. It is simple economics, a symptom of inflation.

Inflation is caused by the debasement of the currency. The US Mint prints money, which lowers the value of the dollar, so it takes more dollars to equal the same value. When they stop printing, inflation stops, and there is a recession/depression. When people protest the economic correction, they start printing again and inflate some more.

Resisting wage increases does not stop prices from rising or stop inflation, and if we are going to inflate the money supply, we need to own the consequences completely. Our only option is to raise minimum wage, match inflation, and understand that in time our own wages must increase as well—just in time for prices to rise again. To not increase wages is unfair to those who have lost the most value due to inflation, and this includes for EMS workers.

– Caitlyn Armistead