USA Paramedic Shortage

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Salaries, Strong Recruitment Ease Area Paramedic Shortage

By McCaffrey, Washington Post Staff Writer

Friday, April 4, 2008; A01

To curb a critical shortage, fire departments across the Washington

region have pursued paramedics like star athletes in recent years,

enticing them with signing bonuses, handsome salaries and the promise

of fast-track career paths.

Montgomery County hired a marketing expert and launched a national

recruiting drive, reaching out in particular to women and minorities.

Fairfax County offered top starting salaries, now totaling about

$57,000 -- as much as 50 percent higher than some other local

jurisdictions, though Fairfax paramedics generally work longer hours.

The increasingly sophisticated recruiting tactics have worked, fire

officials say, turning around a shortage that gripped the region after

the 1990s. During that decade, the number of medical-related 911 calls

increased as the area's population grew by 16 percent and aged overall.

As a result of the efforts, response times to the most serious medical

emergencies have improved significantly in many jurisdictions,

according to data from the departments.

" We were getting worried, " said Lt. Col. Karl L. Granzow of the Prince

's County Fire and Emergency Medical Services Department. " We

were experiencing lot of attrition, and we were struggling with our

capability for service as the community grew. "

The department began offering new firefighters free paramedic training

through a program at a community college, an effort that has helped to

nearly double the number of paramedics and cut average response times

in medical emergencies requiring advanced life support, or ALS, by

more than a minute and a half. The initiative was successful enough

that the county abandoned its aggressive recruitment efforts.

" We got into bidding wars with neighboring jurisdictions, " Granzow

said. " And that's not healthy. "

Other departments targeted Pennsylvania and New York, areas with large

pools of volunteer firefighters looking to switch to paying jobs.

Loudoun County looked south and west after hearing that the Roanoke

area had more people training to be paramedics at a community college

than it had jobs.

In the past five years, the Fairfax County fire department has

increased the number of paramedics by about 85 percent, improving

response times slightly as its call volume has increased.

In roughly the same period, the D.C. fire department boosted its

number of paramedics by almost 19 percent, lowering the average

response time for ALS emergencies by 3 minutes, 21 seconds.

Montgomery nearly doubled its paramedic ranks during the past decade

and improved emergency care in growing rural areas, such as

Laytonsville, where the addition of a single paramedic cut the

response times for ALS emergencies by about three minutes.

Experts say those minutes can mean life or death for the most critical

patients: victims of heart attacks, car crashes and assaults.

Firefighters are typically certified emergency medical technicians,

capable of performing CPR, setting broken bones and stopping bleeding.

But paramedics -- EMTs who are certified after receiving intermediate

or advanced training -- can perform as field doctors, providing more

extensive treatment and diagnostic services, experts say.

The swelling number of local paramedics is due in part to the success

that fire departments have had in attracting diverse candidates to a

profession that historically had been the province of sons, grandsons,

and great-grandsons of European immigrants. Now, recruiters are

dispatched to ethnic festivals, county fairs and even a family reunion.

In recent years, Fairfax has run television ads featuring women and

minorities. In one, a woman reading to her children suddenly looks up

and says: " I'm a firefighter. "

" You're not going to see a recruiting poster with five white males on

it, " said Fairfax Deputy Fire Chief Kincaid.

Adam , a battalion chief in Montgomery, said he made sure to

enlist the department's women and minorities in the recruitment push.

He said, for example, that he might tell a firefighter: " You're a

22-year-old black female. You love this job. Tell your friends about

this. "

Maxam, a marketing expert with the department, said she has

found herself bridging another cultural divide: the one that has

separated firefighters and paramedics. One of her first moves was to

redesign the department's recruiting flier, removing what she

described as a " big ball of fire on the front. "

" I don't know if every paramedic wants to run into a burning

building, " she said.

Historically, firefighters rode on engines, and paramedics rode in

ambulances. Paramedics, their career paths limited, were often the

objects of playful scorn because they so rarely went to a fire.

" I kidded them that their fire days were annual events. . . . They

never got to ride the firetruck, " said Montgomery County Assistant

Fire Chief Mike Mc.

Now, in Montgomery and elsewhere, paramedics are an integral part of

the rescue service, often deployed on firetrucks and drawing larger

salaries than firefighters.

The District created an entry-level paramedic/firefighter position

that pays $48,731, plus a $7,000 hiring bonus, compared with the

$44,301 standard starting salary for a firefighter/EMT. Other

jurisdictions are offering bonuses that bring paramedics' salaries

close to that level.

Some have cleared the promotion path for paramedics, but Prince

's has gone one step further. Firefighter recruits who are not

certified as paramedics now face " limited " career prospects, said

Granzow, the fire department's deputy director: " You can't advance any

further. You can't be promoted. "

This represents a major change from the 1990s, when the department

required that newly hired firefighters obtain paramedic certification

within 48 months. Four years later, the department realized that only

25 of the 250 firefighters hired since that requirement took effect

had actually become paramedics.

" It wasn't realistic that the government was going to fire 225

employees, " Granzow said. " We used to offer the stick; now we offer

the carrot. "

In 2005, the county developed a paramedic training program at Prince

's Community College, where recruits get free tuition and, once

certified, a bonus. The county is on track to increase the number of

paramedics so that about 40 percent of the department will be

certified, Granzow said.

The demand for paramedics is expected to grow everywhere as the

population ages, the number of medical calls increases and local

jurisdictions continue to encounter recruiting barriers, including a

lack of affordable housing.

" I think we can keep our head above water some days, " said Loudoun

County Battalion Chief Corey . " On other days, we struggle. "

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