Re: Where are the Paramedics?

August 28, 2000

I haven't ranted in a long time, so fair warning. Politically incorrect post

follows.

It is unrealistic to expect counties and communities with low tax bases to

fund paid EMS services at the same salaries that big cities pay.

Volunteers are, of course, very important, but they can't buy equipment and

trucks. Can't tell you how many fundraisers I've attended. Once raised

$17,000 in two days for a down payment on a new ambulance when ours broke

down. The bank lent the money at prime + nothing. We got a uniform and gas

allowance of, as I recall, $10.00 per call responded to, and most of us gave

it back to buy needed equipment. We bought our own pagers. Our wives baked

cakes and pies, and we stayed up all night burning briskets to sell the next

day and couldn't even get drunk because we were on call.

However, that is not the best way to approach this. We all pay exhorbitant

amounts in taxes. If you stop to think about it, we're taxed in every way a

greedy politician can think of. But how much of it goes back to the places

where it's needed for gut level services such as EMS and Fire and Law

enforcement? Not nearly enough. Recent grants for law enforcement resulted

in little towns going hog wild hiring police officers, only to have the grant

money run out and be faced with federal charges if they don't keep the

officers on. They didn't think it through, did they? They don't have the

money to keep them on, so all kinds of shady stuff is going on in these

cities to keep from having to pay it all back.

Instead of the federal government continuously cutting funding for EMS

reimbursements, we need a system of grants that would take up the slack and

fund these systems on a continuous basis. We also need state grants. Texas

sucks gas in the amount of money it spends on services. With surplusses

being touted by every politician, before we go cutting taxes for people with

6 figure incomes and corporations, we need to take care of our poor folks'

medical needs and that means paying some of those poor folks who have EMT and

Paramedic after their name a living wage to do what they love to do. BTW, if

you are mesmerized by thoughts of those great tax cuts both parties are

promising, take a cold shower. You won't see enough for a HappyMeal for your

family and a movie afterward. How many of you will retire with a 30 million

dollar pension granted you after just a few years work? Gee, he might just

have to pay too much in taxes. Won't it be peachy creamy for him to get a

tax cut? I'm sure he'll invest his savings in volunteer EMS services. BTW,

don't think I'm any more kindly toward the other politicians or the other

party. They're all pieces of doggie-doo as far as I'm concerned.

Now, I'm all for tax cuts, but let's start from the bottom, not the top. I

can't feel too sorry for somebody making a six figure salary. Let's hear it

for those making a LOW five figure salary first.

Tax cuts will in no way grow tax bases most of the rural communities of

Texas, unless they build a prison there. That seems to be the major growth

industry in Texas. What happens when we've got more people in jail than are

on the outside? Do y'all have any idea how much it takes to keep one

prisoner in maximum security? About twice and a half of the salary a

Correctional Officer makes. Who pays this? You, every time you buy

anything. Today we surpassed California in the number of people in prison.

Yet California has twice the population we do. And our crime rate is worse

than California. What's wrong here?

We also need to get out of the notion that EMTs and Paramedics are really not

medical care-givers but horizontal-taxi drivers. Some of our worst enemies

are those few but loud ER physicians who spout " evidence based medicine or

nothing " knowing full well that you can't do prospective double-blind studies

on people who are unconscious and emergent. I'm all for " evidence based

medicine " but let's get real about how it can be done. You'll never hear

Bledsoe or Bill knocking the value of EMS. It's only the very

elite nose-in-the-air six figure docs who practice in great trauma centers

who get patients 10 minutes after they're shot who tell the rest of us we

don't make a difference. We know we do, but so far we haven't done what we

need to do to prove it. Some evidence is empirical and perhaps will never be

proved statistically. But these doctors have the ear of politicians. They

can afford to buy $1,000 a plate dinner tickets, dress up in tuxedos and

mingle with the very rich and very politically powerful. And believe me they

do it. They promote their agendas in ways we can't even imagine. They never

promote gut-level EMS.

Rural paramedics could do basic clinic medicine and great home health care

with the education the new curriculum will give them if it's allowed to be

taught. But people are not going to go live and practice state of the art

prehospital medicine in West Barfington Falls (pop. 71 including today's

jackrabbits) for $21,000 a year when it takes half a tank of gas to get to

San Angelo to Walmart to buy groceries at a decent price.

Some paramedics don't want to do clinic medicine, give shots, and all the

stuff the nurses do because it's NOT ADRENALIN DRIVEN. Also, the nurses will

resist to the death the notion of paramedics treading on their turf, except

that none of them would be willing to live in WBF and work for $21,000

either. So it's not a matter of who, with what set of initials after their

name, does the work, it's a matter of paying whomever has the expertise a

reasonable and living wage to do it. The " whomever " happens to be Paramedics

with the National Standard Curriculum. We're the best qualified and equipped

to do this kind of medicine. We cannot do it under the old curriculum. But

we can if we adhere to the new curriculum. If you think it can't be done,

just visit Australia and see how they do it.

Now that leads me to the fact that we're largely our own worst enemy because

we (meaning EMTs and Paramedics) have failed and refused to band together for

our common good. Who belongs to an organization? Huh? Who? If you're not

a part of the solution, you're part of the problem. We happen to have an

organization called EMSAT, the stated purpose of which is to represent the

interests of the EMS community before legislative bodies and in every other

which way possible. It costs $35.00 a year. How many of you have taken the

trouble to join?

Don't whine about loss of jobs and diminishing services if you ain't

politically active. And don't think that somebody else will solve the

problems we're going to have within the next year. Services that serve rural

areas are going to drop like sheep pills because of the new HCFA rules

enacted by our dear friends in Congress.

Where will the volunteers be to take up the slack? I venture to say that

there won't be any increase in volunteers because those laid off from paid

services are not just going down the street to Rosie's Hide-a-Way and flip

hamburgers while still volunteering their services. Nope. Rosie's already

has Lester Eugene and PatsyMarie Ann flippin them burgers, fryin them

frizzen steaks, and warshin them dishes. Nope, the thrown-out medics will

make a sudden career change and either relocate or get serious about their

education and get into something that pays. A fork-lift operator at the

local Target warehouse makes a helluva lot more than a Licenced Paramedic

does in some systems. And has better benefits.

By the time people react to the crash of EMS, systems will have been

destroyed and services will have disappeared. I can name a county that gave

away a well-functioning system to an unproven but highly touted private

provider because of misplaced greed, only to find that the provider dumped

them when the goin got rough and they had to pick up the pieces and put it

all back together. NOW is the time to write, call, email and fax your local,

state, and national politicians to let them know you're MAD AS HELL AND

YOU'RE NOT GOING TO TAKE THIS. Do you even know who they are? Find out.

Also let them know that you're not going to allow some bean-counter making

$500,000 a year to tell you what doctor you can go to, what hospital you can

go to, that you can't call ems, and what prescription drugs you can have.

And that your EMS service has to be destroyed because they won't pay honest

reimbursements for services. And that you're not going to vote to re-elect

county commissioners who don't support EMS and you'll get out and work

against them. Maybe even some of you'd run for election on an EMS platform.

Personal note: I take Zestril (lisinopril) for hypertension. Now my HMO's

prescription plan has been taken over by Merck, and they've written me that

if I want to continue getting the best price for my prescriptions I must take

Prinivil (also lisinopril) instead. Guess who makes Prinivil?

Cousins, we're in for hell with a bob-war tail in EMS if we don't wake up and

make the politicians take notice of us. There's better than 40,000 of us in

the state of Texas, and we can make them notice us if we will. Yes, they're

bought and paid for, but the president of EXXON still has only one vote. As

one successful politician, Tip O'Neal, former Speaker of the House of

Representatives in Warshington said, " All politics is local. " We need to let

each and every single politician who " serves " us know each and every one of

us by name and that we'll vote on ONE ISSUE: EMS funding and the survival of

EMS in America.

One final thought. Our enemies in emergency medicine will always win until

we as gut-level providers have at least the educational credentials to prove

that we're reasonably safe to be cut loose on the poor unsuspecting public.

This means getting college degrees. The nurses did it. So can we.

My opinions are my own.

Gene Gandy

August 28, 2000

Please, Please, Please....do not take this wrong, but a salary like $21,000

to $23,600 is not good. I can see why you are having trouble finding

paramedics. Paramedic saleries within the Houston area are between $35,000

to $50,000 with some folks making up to $70,000(putting in a lot of hours).

I just personally fell that Paramedics should not work for less than $32,000

per year. Have you ever wondered why a plumber or mechanic change so much

for the little bit of work they do. Well, we pay them...for not what they

did but, for what they know. This needs to be our standards and nothing less

and..........STOP VOLUNTEERING.

You know, I was at the EMS conference one year and saw a cool t-shirt on

this guy. The front of the shirt read " what if they were no volunteers? "

This message was cute and moreso carried a follow-up to the front. This guy

had put the following on the back of this shirt which read " then they would

be paid " Funny yes.........

I come in peace and leave in peace

>XXXXXXXXXXXXXXXXX EMS in XXXXXXXXXXXXXX is looking for at least 1 Full-Time

>Paramedic and maybe a couple of on-call medics. We work 24 on/48 off Full

>time salary is around $21,000 to 23,600. Insurance, Holidays, yada yada

>yada....

>

>Thanks for listening,

>XXXXXXXXXXX

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August 28, 2000

Wow. I work for a small EMS in hire. Our budget hasn't had an

increase in 8 years, even though our call volume has increased 400%. If it

were not for our Volunteers, we'd pretty well grind to a halt. Do I wish I

got paid? You bet. Could I justify in my head, " I'm sorry ma'am I can't

come to the aid of your 2yr old daughter because we can't afford staff. "

Exaggeration, yes. But not by much. Thanks for reading..

Joe

August 28, 2000

So what do these counties do that have a population of 15,000 or less? They

can barely pay their Sheriff's deputies. They wouldn't have a fire

department if it wasn't for their vollies. I know this will probably start

a fire storm but we got to realize that there are some poor counties out

there, who wouldn't have an EMS system without their volunteers. Some of

these big city systems got to realize that when you get out away from these

large metropolitian areas, reality sets in. We got some dirt poor

communities out there and their Volunteers have got some of the biggest

hearts in the business, because they are not in it for a pay check but to

actually serve their fellow citizen. They don't go looking for a paycheck

but how they can help out the old lady down the road on their own free time

with equipment they probably purchased out of their own pocket. Not to

mention their EMS system can barely buy uniforms.

I guess I am to new in this business to be caught up in all the politics. I

seem to want to be a paramedic for my own self enrichment, personal growth

and to give back to my community. What is it JFK said " Ask not what your

country can do for you but what you can do for your country. "

As our fellow brother pointed out, this is all said in love and respect.

Let the flames begin.

Sloan

- Re: [texasems-L] Where are the Paramedics?