Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Way to stir the pot Dudley..... Just kidding. This thread takes a turn to Paramedic Initiated Refusals, a thread that has in the past brought up many good points, not the least of which is the need for training on the paramedics part. Many studies have shown that Paramedics are not the best in the world at defining what necessitates emergency room treatment, or hospital admission. That said, the training would have to improve to the point where field technicians could effectively evaluate which patients require the ER and which ones require their doctors office, and transport them accordingly. We spend a lot of time trying to figure out how to increase our reenue, which I will agree is imperative. But another thing to look at, is reduction of expenses. One of the ways to do this, is to reduce the number of unnecassary transports by MICU buses. Alternative transportation could be a med-assist van, or even a taxi. The expense is less on the service, and if the patient only needs trasnport to thier physicians office, it aides in reducing strain on the ER. We shouldn't have to do more with less, but we should have the opportunity to do more with what we have right now. Same revenue, lower expenses. Just my humble opinion, Mike > Danny, > > Not a bad can of worms to open...as our rates (on average-fully loaded) are higher than $600. This is another factor in my argument. If we could get everyone to pay the $600 (or even $450 in a lot of locations) we would be much better off...but M'care, M'caid, Tricare (notice the theme: All gov't provided healthcare) won't pay even close to the real cost so we shift the cost to all others. Some insurance will pay but it continues to be the non-insured and the ones with private insurance that only pays a portion that then subsidize our payments. > > Others have hit the nail on the head too...we pay for plumbers, AC repair, and electricians because if we don't...they don't provide the service. " EMS can't do this " is so very often quoted...BUT (To really open a can of worms)...I ask WHY NOT? > > Wait a second...let me finish. In the " Mother, Jugs, and Speed " days everyone paid or they didn't ride...that swung to the totally opposite end of the scale after that where we don't even talk about the payment end (let alone get a signature or insurance information) because " money shouldn't be a factor in it " . Neither of these extremes are appropriate...but like so many other issues in EMS, instead of having the pendulum at one extreme or the other...how about stopping it somewhere near the middle??? I know...I am speaking blasphemy here...but hear me out. > > We respond to all requests from 911 just like we do today. We evaluate and begin treatment of the patient. We recognize it as a medical emergency, we treat them, load'em up, and transport, gathering billing information when we can....BUT IF, after the evaluation, it truly appears as if the patient does not need EMERGENCY medical treatment, we then determine from them the method of payment. We should also have other means of transport (such as med-assist vans, wheelchair transport, taxi, etc) and we transport them according to their means of payment...again, only after we have determined that ambulance transport is not needed (by any stretch of the imagination)...We then, through credit card, check, cash, etc take payment for the trip from the patient (at a lower cost than having to bill it) and perform the transport. > > AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to us..... > > Now, we have that out of our system. Those who know me will think I have somehow suffered a head injury because this is not something I advocate right now...but as we move forward, the issue will continue to be how we get paid for it...not for the " suit's " profit margins....but so that you, joe & jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, 1.2 cats, etc..... > > Speak up...why not? What would it entail to make it happen (better trained medics again??? Seems that keeps coming up)...better oversight? More physician involvement? > > Just sharing on a blah Monday!!! > > Dudley > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Way to stir the pot Dudley..... Just kidding. This thread takes a turn to Paramedic Initiated Refusals, a thread that has in the past brought up many good points, not the least of which is the need for training on the paramedics part. Many studies have shown that Paramedics are not the best in the world at defining what necessitates emergency room treatment, or hospital admission. That said, the training would have to improve to the point where field technicians could effectively evaluate which patients require the ER and which ones require their doctors office, and transport them accordingly. We spend a lot of time trying to figure out how to increase our reenue, which I will agree is imperative. But another thing to look at, is reduction of expenses. One of the ways to do this, is to reduce the number of unnecassary transports by MICU buses. Alternative transportation could be a med-assist van, or even a taxi. The expense is less on the service, and if the patient only needs trasnport to thier physicians office, it aides in reducing strain on the ER. We shouldn't have to do more with less, but we should have the opportunity to do more with what we have right now. Same revenue, lower expenses. Just my humble opinion, Mike > Danny, > > Not a bad can of worms to open...as our rates (on average-fully loaded) are higher than $600. This is another factor in my argument. If we could get everyone to pay the $600 (or even $450 in a lot of locations) we would be much better off...but M'care, M'caid, Tricare (notice the theme: All gov't provided healthcare) won't pay even close to the real cost so we shift the cost to all others. Some insurance will pay but it continues to be the non-insured and the ones with private insurance that only pays a portion that then subsidize our payments. > > Others have hit the nail on the head too...we pay for plumbers, AC repair, and electricians because if we don't...they don't provide the service. " EMS can't do this " is so very often quoted...BUT (To really open a can of worms)...I ask WHY NOT? > > Wait a second...let me finish. In the " Mother, Jugs, and Speed " days everyone paid or they didn't ride...that swung to the totally opposite end of the scale after that where we don't even talk about the payment end (let alone get a signature or insurance information) because " money shouldn't be a factor in it " . Neither of these extremes are appropriate...but like so many other issues in EMS, instead of having the pendulum at one extreme or the other...how about stopping it somewhere near the middle??? I know...I am speaking blasphemy here...but hear me out. > > We respond to all requests from 911 just like we do today. We evaluate and begin treatment of the patient. We recognize it as a medical emergency, we treat them, load'em up, and transport, gathering billing information when we can....BUT IF, after the evaluation, it truly appears as if the patient does not need EMERGENCY medical treatment, we then determine from them the method of payment. We should also have other means of transport (such as med-assist vans, wheelchair transport, taxi, etc) and we transport them according to their means of payment...again, only after we have determined that ambulance transport is not needed (by any stretch of the imagination)...We then, through credit card, check, cash, etc take payment for the trip from the patient (at a lower cost than having to bill it) and perform the transport. > > AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to us..... > > Now, we have that out of our system. Those who know me will think I have somehow suffered a head injury because this is not something I advocate right now...but as we move forward, the issue will continue to be how we get paid for it...not for the " suit's " profit margins....but so that you, joe & jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, 1.2 cats, etc..... > > Speak up...why not? What would it entail to make it happen (better trained medics again??? Seems that keeps coming up)...better oversight? More physician involvement? > > Just sharing on a blah Monday!!! > > Dudley > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Mike, you may have just reduced yourself out of a job. You may need those few calls (responses) to justify an additional truck. They could be the difference of having a second truck and not missing a call or having a extended response time while getting back in service to make the call. It must be a trend, I have noticed that Paramedics now days don't want to make calls or the call must be worthy of them. They need their down time for the rare 10% true emergency call. Even some of those troll calls that everyone is complaining about may sometimes pay their bill or part of it. Your already on the clock so just how much expense do you really have. Probably not as much as crews run up running personal errands or stopping for drinks at the local corner store with the unit running while inside. Work on those expenses and you would have more impact and still have the call volume you may need. Everyone out there has a magic number the bean counters throw out to them as the one that will take some of the stress off by putting on another truck. In the mean time the other 500 call you are running before you hit that number are the ones that are really putting a strain on the system. My thoughts on trolls are take the good with the bad, make them, be nice and get back in service as soon as possible. Who knows you may be that troll tomorrow. Remember texas is a at will state. Henry Hatfield wrote: > Way to stir the pot Dudley..... Just kidding. > > This thread takes a turn to Paramedic Initiated Refusals, a thread that has > in the past brought up many good points, not the least of which is the need > for training on the paramedics part. Many studies have shown that Paramedics > are not the best in the world at defining what necessitates emergency room > treatment, or hospital admission. That said, the training would have to > improve to the point where field technicians could effectively evaluate > which patients require the ER and which ones require their doctors office, > and transport them accordingly. > > We spend a lot of time trying to figure out how to increase our reenue, > which I will agree is imperative. But another thing to look at, is reduction > of expenses. One of the ways to do this, is to reduce the number of > unnecassary transports by MICU buses. Alternative transportation could be a > med-assist van, or even a taxi. The expense is less on the service, and if > the patient only needs trasnport to thier physicians office, it aides in > reducing strain on the ER. > > We shouldn't have to do more with less, but we should have the opportunity > to do more with what we have right now. Same revenue, lower expenses. > > Just my humble opinion, > > Mike > > > > > Danny, > > > > Not a bad can of worms to open...as our rates (on average-fully loaded) > are higher than $600. This is another factor in my argument. If we could > get everyone to pay the $600 (or even $450 in a lot of locations) we would > be much better off...but M'care, M'caid, Tricare (notice the theme: All > gov't provided healthcare) won't pay even close to the real cost so we shift > the cost to all others. Some insurance will pay but it continues to be the > non-insured and the ones with private insurance that only pays a portion > that then subsidize our payments. > > > > Others have hit the nail on the head too...we pay for plumbers, AC repair, > and electricians because if we don't...they don't provide the service. " EMS > can't do this " is so very often quoted...BUT (To really open a can of > worms)...I ask WHY NOT? > > > > Wait a second...let me finish. In the " Mother, Jugs, and Speed " days > everyone paid or they didn't ride...that swung to the totally opposite end > of the scale after that where we don't even talk about the payment end (let > alone get a signature or insurance information) because " money shouldn't be > a factor in it " . Neither of these extremes are appropriate...but like so > many other issues in EMS, instead of having the pendulum at one extreme or > the other...how about stopping it somewhere near the middle??? I know...I > am speaking blasphemy here...but hear me out. > > > > We respond to all requests from 911 just like we do today. We evaluate > and begin treatment of the patient. We recognize it as a medical emergency, > we treat them, load'em up, and transport, gathering billing information when > we can....BUT IF, after the evaluation, it truly appears as if the patient > does not need EMERGENCY medical treatment, we then determine from them the > method of payment. We should also have other means of transport (such as > med-assist vans, wheelchair transport, taxi, etc) and we transport them > according to their means of payment...again, only after we have determined > that ambulance transport is not needed (by any stretch of the > imagination)...We then, through credit card, check, cash, etc take payment > for the trip from the patient (at a lower cost than having to bill it) and > perform the transport. > > > > AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him > and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to > us..... > > > > Now, we have that out of our system. Those who know me will think I have > somehow suffered a head injury because this is not something I advocate > right now...but as we move forward, the issue will continue to be how we get > paid for it...not for the " suit's " profit margins....but so that you, joe & > jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, > 1.2 cats, etc..... > > > > Speak up...why not? What would it entail to make it happen (better > trained medics again??? Seems that keeps coming up)...better oversight? More > physician involvement? > > > > Just sharing on a blah Monday!!! > > > > Dudley > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > I > am curious to know how the new legislation on putting liens on those that owe > EMS bills is doing. The liens for EMS are in use in a few places that I am aware of, my service is one of them. Remember that the liens are only in place for third party type injuries/illnesses and only apply to prospective or expected settlements. We file the lien, and if they get a settlement, we get a check first before anyone else does. The cost to place a lien for us is 11.00, and to remove it is the same. It is without a doubt the best 22.00 one could spend. Jane Hill and her staff took a lien form that we had, updated it and made corrections to it, and if I recall, it is posted to this groups files section, you might wnat to download it and take a look at it. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > I > am curious to know how the new legislation on putting liens on those that owe > EMS bills is doing. The liens for EMS are in use in a few places that I am aware of, my service is one of them. Remember that the liens are only in place for third party type injuries/illnesses and only apply to prospective or expected settlements. We file the lien, and if they get a settlement, we get a check first before anyone else does. The cost to place a lien for us is 11.00, and to remove it is the same. It is without a doubt the best 22.00 one could spend. Jane Hill and her staff took a lien form that we had, updated it and made corrections to it, and if I recall, it is posted to this groups files section, you might wnat to download it and take a look at it. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > I > am curious to know how the new legislation on putting liens on those that owe > EMS bills is doing. The liens for EMS are in use in a few places that I am aware of, my service is one of them. Remember that the liens are only in place for third party type injuries/illnesses and only apply to prospective or expected settlements. We file the lien, and if they get a settlement, we get a check first before anyone else does. The cost to place a lien for us is 11.00, and to remove it is the same. It is without a doubt the best 22.00 one could spend. Jane Hill and her staff took a lien form that we had, updated it and made corrections to it, and if I recall, it is posted to this groups files section, you might wnat to download it and take a look at it. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Dudley, were you just talking base charge + mileage or what when you figured your pay scenarios here? Jane Hill -------------- Original message from petsardlj@...: -------------- In a message dated 9/11/04 11:16:56 AM Central Daylight Time, THEDUDMAN@... writes: $18 per hour on a 24/48 hour schedule # of employees needed for one truck 24-7 = 6 Cost of full-time benefits/taxes (35% of annual salary) Annual gross salary of one Paramedic: $59,904 (nothing extra added in...just 24/48) Annual cost of this one Paramedic: $80,870.40 Annual total cost of ONE ambulance staffed 24-7 $485,222.40 (assuming no time off; which is unrealistic) Average Bill for each transport: $600 Assumed Transport Percentage: 60% Assumed Gross Collection Percentage: 50% (including contractuals) Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 2,696 or 7.39 per day (this doesn't include cost of vehicle, supplies, fuel, station, uniforms, holidays, maintenance, equipment, dispatching, supervision/control, billing processing, computer support, etc) So why the charge so low? >>>>>>>Opening another can of worms>>>>>> I mean $600.00 for a call?? Tell me we are charging what we should for EMS. I understand what Medicare and Medicaid pay. But come on, most places will support a general fee of at least $850.00. So start throwing the tomatoes. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > Remember texas is a at will state. Not for those employees covered under civil service. In our field, though, that would be certain police and fire personnel who also act as medics. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > Remember texas is a at will state. Not for those employees covered under civil service. In our field, though, that would be certain police and fire personnel who also act as medics. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > Remember texas is a at will state. Not for those employees covered under civil service. In our field, though, that would be certain police and fire personnel who also act as medics. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 How many times have I heard this, after asking a " patient " to sign a billing form..... " What do you mean bill? What do I pay taxes for? " sigh.......... > Excellent point Barry. One way I heard it described before (potentially on this list) is that our taxes should provide for its availability...but the end user's should provide for its use. > > Such as a water department. The city taxes pay for the water mains, wells, treatment plants, etc. But if I water my yard once a month and you re-fill your 10,000 gallon swimming pool twice a week, why should I have to pay for your usage? The same really holds in this entitlement vs. service argument. > > Dudley > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Image is everything, and is a > sorely overlooked part of the equation. It is true that if you want to be > important, you had best look important. If you wouldn't go to a job > interview dressed as any of the above, then you shouldn't be working while > dressed as any of the above either. > > EMS needs a queer-eye makeover. In the words of a very intelligent lawyer friend of mine...... " Perception is reality. " How are we perceived? Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 ENOUGH WHINING! Do something besides sticking your head out the window and yelling, " I'm mad as hell and I'm not going to take it anymore. " Do not pass GO. Go directly to _www.emsatoftx.org_ (http://www.emsatoftx.org) and sign up today for EMSAT. Strength is in numbers. We at EMSAT have some exciting things in the works. We have legislators who are listening to us, who are committed to working for our cause, but they always want to know............you guessed it.........HOW MANY PEOPLE DO YOU REPRESENT? Now, I tell them, 51, 697, as of now, hoping that they won't ask how many PAYING members we have. Folks, we cannot carry out our mission to secure an independent EMS Commission for you, to watch your back for you and see what kind of legislative crocodile is about to bite you in the ass, advance your interests with GETAC and other agencies, unless we have the members and money to do it. Membership is a mere $35 per year, the cost of a movie, Cokes and popcorn for 4, or two giant pizzas with everything but anchovies. Visit the site to see what other bennies you get. You may be surprised. There's some insurance for you there and we keep you up to date on what's happening in the EMS world that affects you. EMSAT Board Members and Officers get NOTHING for their service except a tax deduction for the money we spend on hotels, meals, and gas in traveling to Austin and other places to represent you. And we WANT NOTHING. Except enough members to back us. And if you're a Fat Cat Owner and want to become a corporate sponsor, that's available, with prominent sponsorship displays. Show your support for our profession. EMSAT is the ONLY organization that looks out for the RANK AND FILE ECAs, EMTs and Paramedics. No other organization does that exclusively. Soooooo, JUST DO IT! We need 10 NEW MEMBERS TODAY! Who will be the first? Gene Gandy, JD, LP Vice-President EMSAT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 Well Rob I am only going to guess that you know nothing about firefighting or the profession. As a veteran I can tell you that we do not sit around all day. As for why Fire Departments are taking over EMS services you need to do some research and you might find out that it was the private providers going out of service and then the responsibility was handed down to the fire service. I truly believe if you do have the passion you say you do for EMS you should take Mr. advice and join EMSAT. There you will have a voice to help make the decisions of the future of EMS in Texas. And yes I am a member of EMSAT. FF/Lic-P Vernon College FIRE/EMS Training Program 4105 Maplewood Wichita Falls, Texas 76308 Office ext. 3233 Fax agarcia@... Re: EMS Pay > " nelson williams " <williamn@n...> wrote: > > You cannot wear 2 hats and be respected for 1 Person. WEe either > > have to be Public Safety or WEe have to be health care. > > That is an excellent point, and one that seems to be constantly > overlooked. I once met a guy with the State Fire Marshal's office. I > told him I thought that must be a pretty cool job. He said, " Not > really. The cops don't respect you because they think you're just a > fireman. And the firemen resent you as just a cop. " That is exactly > what is happening to EMS. > > Let's face it, the only reason that EMS ended up as a part of the fire > service to begin with is because bean counters thought that > firefighters weren't doing enough to earn their money. " Hey, those > guys are sitting on their asses anyhow. Let's make them run the > ambulances! " Consequently, EMS is forever tagged as a sideshow, not > quite as worthy as the main event. > > Once you take away all the silly patches, badges, pins and epaulets, > what makes EMS a part of the public safety sector? No matter how long > I ponder this question, it still comes down to one thing: lights and > sirens. > > It's time to cut the umbilicus and grow. > > Rob > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 Mike, my comments were in general and not directed directly at you. Henry Hatfield wrote: > Henry, > > As always, you make valid, as well as interesting points. My comments are > inline. > > > > > Mike, you may have just reduced yourself out of a job. You may need those > few > > calls (responses) to justify an additional truck. > > For the record. I am in support of Paramedic Initiated Refusals after > thorough training, I do not, however refuse anyone transport at this time, > as neither service that I work for has PIR protocols. Until such time as > they do, I will continue to transport each and every patient that requests > it, and treat them well. I don't make anyone feel bad, or ignorant by > requesting transport, and if they request a facility that is out of town, > then I take them. I do not believe that this is something that will be in > effect anytime in the very near future, I do however believe it will become > a necessity if the current rate of reimbursement, and the current rate of > expenses continue their current respective trends. > > Now for the thread. > > Just for the sake of argument, you might not need the additional unit if > your call volume wasn't inflated by 'trolls' (for lack of a better term) > that do not require ambulance transport, and that you cannot collect from. > Does that mean that if a patient is indigent and does not need an ambulance, > that you would treat him/her any different that someone who could actually > pay the entire bill, but still did not require an ambulance? No not at all, > if neither needs ambulance transport, then neither gets it. Medical > neccesity is medical necessity, regardless of ability to pay. You need to > go, you get a ride, period. This thread, and my argument is based solely > upon 'medical neccessity', nothing more and nothing less. > > If we know that the reimbursement rate isn't going to go up at the same rate > that our expenses are, then we need to move toward the middle proactively. > > So what's the answer? > > > They could be the difference > > of having a second truck and not missing a call or having a extended > response > > time while getting back in service to make the call. It must be a trend, I > have > > noticed that Paramedics now days don't want to make calls or the call must > be > > worthy of them. They need their down time for the rare 10% true emergency > call. > > Hmmmm, I don't think I said anywhere in my post that I don't want to make > calls, or that the call must be 'worthy' of me. What I have said, and the > point that I will continue to make, is that in a day and age where revenues > and reimbursements are down, and costs are increasing, we must find a way to > make ends meet. We even discussed taking credit cards on the scene from a > patient who did not medically require and ambulance. Any number of ideas > need to be presented, take any one of them to heart that you like and will > fit the needs of your service and community and make it happen. The > difference would majorly affect those services that do not have a medical > facility in their own town. Those services are the ones with a single unit, > and a 2 hour turn around time. All the extra calls in the world will most > likely not convince a financially strapped city council to authorize an > additional 200K to staff a second unit. So what then? > > > Even some of those troll calls that everyone is complaining about may > sometimes > > pay their bill or part of it. Your already on the clock so just how much > expense > > do you really have. Probably not as much as crews run up running personal > > errands or stopping for drinks at the local corner store with the unit > running > > while inside. Work on those expenses and you would have more impact and > still > > have the call volume you may need. > > There are a number of places that any given service could trim expenses. And > you're right, the amount of diesel used while leaving a unit running at a > corner store is one of them, then again, if it was a call that was not > medically necessary, they could have saved the fuel making the trip to the > hospital as well, and never would have been near the corner store in the > first place. > > > Everyone out there has a magic number the > > bean counters throw out to them as the one that will take some of the > stress off > > by putting on another truck. > > I disagree, I work part time for a service that just " cut " our annual > wages....... so that they could make ends meet across the board with the > entire city. We could double our call volume tomorrow, and still never > receive the necessary funding to staff another unit. > > > In the mean time the other 500 call you are running > > before you hit that number are the ones that are really putting a strain > on the > > system. My thoughts on trolls are take the good with the bad, make them, > be nice > > and get back in service as soon as possible. > > I do that now. > > > Who knows you may be that troll tomorrow. > > I hope not.... > > Mike > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 The grocery store gets $2.00 for a gallon of milk. You walk in, and because milk is REALLY good for you, and you REALLY like it, you decide to pay $5.00 for it? NOT. The prevailing wage is what nearly everyone will pay. No more. Maybe less. Good, bad, or indifferent, that's it. Another more extreme example: We teach CPR. It's a VERY valuable skill, lifesaving, VERY worthwhile, maybe more so than most other things you can learn. The going rate is about $50 for an all-day class. We also teach Database Design. Not NEARLY so beneficial to society, not nearly so important. The going rate? $500 for an All day class. Do I charge $50 for the Database Design class? Of course not. It will bring $500, people expect to pay $500, we charge $500. Would I like to charge a living wage for the CPR class? Of course. If I charge even $200, I could pay my instructors a living wage. But, I can't, cause no one would come. The point is that, regardless of how much or how little the service makes, it will likely pay the prevailing rate, or thereabouts. It's just how that works. We have to raise the prevailing rate. If someone wanted to pay me $20 for the CPR class, I'd say no. But will someone in EMS work for 1/2 what the prevailing rate is? Yes. Will someone pay them that? Yes. If it makes anyone feel better, the average full-time musician makes about $8000/yr, about what they made 30 years ago. So some are worse off. =Steve= -- Steve , LP Director of Training AlertCPR Emergency Training 2300 Highland Village Rd, Suite 340 Highland Village, TX 75077 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 The grocery store gets $2.00 for a gallon of milk. You walk in, and because milk is REALLY good for you, and you REALLY like it, you decide to pay $5.00 for it? NOT. The prevailing wage is what nearly everyone will pay. No more. Maybe less. Good, bad, or indifferent, that's it. Another more extreme example: We teach CPR. It's a VERY valuable skill, lifesaving, VERY worthwhile, maybe more so than most other things you can learn. The going rate is about $50 for an all-day class. We also teach Database Design. Not NEARLY so beneficial to society, not nearly so important. The going rate? $500 for an All day class. Do I charge $50 for the Database Design class? Of course not. It will bring $500, people expect to pay $500, we charge $500. Would I like to charge a living wage for the CPR class? Of course. If I charge even $200, I could pay my instructors a living wage. But, I can't, cause no one would come. The point is that, regardless of how much or how little the service makes, it will likely pay the prevailing rate, or thereabouts. It's just how that works. We have to raise the prevailing rate. If someone wanted to pay me $20 for the CPR class, I'd say no. But will someone in EMS work for 1/2 what the prevailing rate is? Yes. Will someone pay them that? Yes. If it makes anyone feel better, the average full-time musician makes about $8000/yr, about what they made 30 years ago. So some are worse off. =Steve= -- Steve , LP Director of Training AlertCPR Emergency Training 2300 Highland Village Rd, Suite 340 Highland Village, TX 75077 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 The grocery store gets $2.00 for a gallon of milk. You walk in, and because milk is REALLY good for you, and you REALLY like it, you decide to pay $5.00 for it? NOT. The prevailing wage is what nearly everyone will pay. No more. Maybe less. Good, bad, or indifferent, that's it. Another more extreme example: We teach CPR. It's a VERY valuable skill, lifesaving, VERY worthwhile, maybe more so than most other things you can learn. The going rate is about $50 for an all-day class. We also teach Database Design. Not NEARLY so beneficial to society, not nearly so important. The going rate? $500 for an All day class. Do I charge $50 for the Database Design class? Of course not. It will bring $500, people expect to pay $500, we charge $500. Would I like to charge a living wage for the CPR class? Of course. If I charge even $200, I could pay my instructors a living wage. But, I can't, cause no one would come. The point is that, regardless of how much or how little the service makes, it will likely pay the prevailing rate, or thereabouts. It's just how that works. We have to raise the prevailing rate. If someone wanted to pay me $20 for the CPR class, I'd say no. But will someone in EMS work for 1/2 what the prevailing rate is? Yes. Will someone pay them that? Yes. If it makes anyone feel better, the average full-time musician makes about $8000/yr, about what they made 30 years ago. So some are worse off. =Steve= -- Steve , LP Director of Training AlertCPR Emergency Training 2300 Highland Village Rd, Suite 340 Highland Village, TX 75077 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 Gene, I agree Eddioe Childs never did anything except to let everyone know that he was mad. Well I'm mad too eddie, but I choose to do something about It. Re: Re: EMS Pay > ENOUGH WHINING! Do something besides sticking your head out the window and > yelling, " I'm mad as hell and I'm not going to take it anymore. " > > Do not pass GO. Go directly to _www.emsatoftx.org_ > (http://www.emsatoftx.org) and sign up today for EMSAT. Strength is in numbers. > > We at EMSAT have some exciting things in the works. We have legislators who > are listening to us, who are committed to working for our cause, but they > always want to know............you guessed it.........HOW MANY PEOPLE DO YOU > REPRESENT? > > Now, I tell them, 51, 697, as of now, hoping that they won't ask how many > PAYING members we have. > > Folks, we cannot carry out our mission to secure an independent EMS > Commission for you, to watch your back for you and see what kind of legislative > crocodile is about to bite you in the ass, advance your interests with GETAC and > other agencies, unless we have the members and money to do it. > > Membership is a mere $35 per year, the cost of a movie, Cokes and popcorn > for 4, or two giant pizzas with everything but anchovies. Visit the site to > see what other bennies you get. You may be surprised. There's some insurance > for you there and we keep you up to date on what's happening in the EMS world > that affects you. > > EMSAT Board Members and Officers get NOTHING for their service except a tax > deduction for the money we spend on hotels, meals, and gas in traveling to > Austin and other places to represent you. And we WANT NOTHING. Except enough > members to back us. > > > And if you're a Fat Cat Owner and want to become a corporate sponsor, > that's available, with prominent sponsorship displays. Show your support for our > profession. > > EMSAT is the ONLY organization that looks out for the RANK AND FILE ECAs, > EMTs and Paramedics. No other organization does that exclusively. > > > Soooooo, JUST DO IT! We need 10 NEW MEMBERS TODAY! Who will be the first? > > > Gene Gandy, JD, LP > Vice-President > EMSAT > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 Gene, I agree Eddioe Childs never did anything except to let everyone know that he was mad. Well I'm mad too eddie, but I choose to do something about It. Re: Re: EMS Pay > ENOUGH WHINING! Do something besides sticking your head out the window and > yelling, " I'm mad as hell and I'm not going to take it anymore. " > > Do not pass GO. Go directly to _www.emsatoftx.org_ > (http://www.emsatoftx.org) and sign up today for EMSAT. Strength is in numbers. > > We at EMSAT have some exciting things in the works. We have legislators who > are listening to us, who are committed to working for our cause, but they > always want to know............you guessed it.........HOW MANY PEOPLE DO YOU > REPRESENT? > > Now, I tell them, 51, 697, as of now, hoping that they won't ask how many > PAYING members we have. > > Folks, we cannot carry out our mission to secure an independent EMS > Commission for you, to watch your back for you and see what kind of legislative > crocodile is about to bite you in the ass, advance your interests with GETAC and > other agencies, unless we have the members and money to do it. > > Membership is a mere $35 per year, the cost of a movie, Cokes and popcorn > for 4, or two giant pizzas with everything but anchovies. Visit the site to > see what other bennies you get. You may be surprised. There's some insurance > for you there and we keep you up to date on what's happening in the EMS world > that affects you. > > EMSAT Board Members and Officers get NOTHING for their service except a tax > deduction for the money we spend on hotels, meals, and gas in traveling to > Austin and other places to represent you. And we WANT NOTHING. Except enough > members to back us. > > > And if you're a Fat Cat Owner and want to become a corporate sponsor, > that's available, with prominent sponsorship displays. Show your support for our > profession. > > EMSAT is the ONLY organization that looks out for the RANK AND FILE ECAs, > EMTs and Paramedics. No other organization does that exclusively. > > > Soooooo, JUST DO IT! We need 10 NEW MEMBERS TODAY! Who will be the first? > > > Gene Gandy, JD, LP > Vice-President > EMSAT > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 Gene, I agree Eddioe Childs never did anything except to let everyone know that he was mad. Well I'm mad too eddie, but I choose to do something about It. Re: Re: EMS Pay > ENOUGH WHINING! Do something besides sticking your head out the window and > yelling, " I'm mad as hell and I'm not going to take it anymore. " > > Do not pass GO. Go directly to _www.emsatoftx.org_ > (http://www.emsatoftx.org) and sign up today for EMSAT. Strength is in numbers. > > We at EMSAT have some exciting things in the works. We have legislators who > are listening to us, who are committed to working for our cause, but they > always want to know............you guessed it.........HOW MANY PEOPLE DO YOU > REPRESENT? > > Now, I tell them, 51, 697, as of now, hoping that they won't ask how many > PAYING members we have. > > Folks, we cannot carry out our mission to secure an independent EMS > Commission for you, to watch your back for you and see what kind of legislative > crocodile is about to bite you in the ass, advance your interests with GETAC and > other agencies, unless we have the members and money to do it. > > Membership is a mere $35 per year, the cost of a movie, Cokes and popcorn > for 4, or two giant pizzas with everything but anchovies. Visit the site to > see what other bennies you get. You may be surprised. There's some insurance > for you there and we keep you up to date on what's happening in the EMS world > that affects you. > > EMSAT Board Members and Officers get NOTHING for their service except a tax > deduction for the money we spend on hotels, meals, and gas in traveling to > Austin and other places to represent you. And we WANT NOTHING. Except enough > members to back us. > > > And if you're a Fat Cat Owner and want to become a corporate sponsor, > that's available, with prominent sponsorship displays. Show your support for our > profession. > > EMSAT is the ONLY organization that looks out for the RANK AND FILE ECAs, > EMTs and Paramedics. No other organization does that exclusively. > > > Soooooo, JUST DO IT! We need 10 NEW MEMBERS TODAY! Who will be the first? > > > Gene Gandy, JD, LP > Vice-President > EMSAT > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 Ahhh, Henry, I am nearly as thick skinned as you are, mind you I said 'nearly'. I don't take anything personal, and I kinda figured that they were not directed at me, but the thread in general. But I do like the exchange of strong opinions. Mike 'Tater Salad' Hatfield EMT-P " Si hoc legere scis nimium eruditiones habes. " EMStock 2005, it's never to early to plan!!! www.emstock.com www.temsf.org Re: EMS Pay Mike, my comments were in general and not directed directly at you. Henry Hatfield wrote: > Henry, > > As always, you make valid, as well as interesting points. My comments are > inline. > > > > > Mike, you may have just reduced yourself out of a job. You may need those > few > > calls (responses) to justify an additional truck. > > For the record. I am in support of Paramedic Initiated Refusals after > thorough training, I do not, however refuse anyone transport at this time, > as neither service that I work for has PIR protocols. Until such time as > they do, I will continue to transport each and every patient that requests > it, and treat them well. I don't make anyone feel bad, or ignorant by > requesting transport, and if they request a facility that is out of town, > then I take them. I do not believe that this is something that will be in > effect anytime in the very near future, I do however believe it will become > a necessity if the current rate of reimbursement, and the current rate of > expenses continue their current respective trends. > > Now for the thread. > > Just for the sake of argument, you might not need the additional unit if > your call volume wasn't inflated by 'trolls' (for lack of a better term) > that do not require ambulance transport, and that you cannot collect from. > Does that mean that if a patient is indigent and does not need an ambulance, > that you would treat him/her any different that someone who could actually > pay the entire bill, but still did not require an ambulance? No not at all, > if neither needs ambulance transport, then neither gets it. Medical > neccesity is medical necessity, regardless of ability to pay. You need to > go, you get a ride, period. This thread, and my argument is based solely > upon 'medical neccessity', nothing more and nothing less. > > If we know that the reimbursement rate isn't going to go up at the same rate > that our expenses are, then we need to move toward the middle proactively. > > So what's the answer? > > > They could be the difference > > of having a second truck and not missing a call or having a extended > response > > time while getting back in service to make the call. It must be a trend, I > have > > noticed that Paramedics now days don't want to make calls or the call must > be > > worthy of them. They need their down time for the rare 10% true emergency > call. > > Hmmmm, I don't think I said anywhere in my post that I don't want to make > calls, or that the call must be 'worthy' of me. What I have said, and the > point that I will continue to make, is that in a day and age where revenues > and reimbursements are down, and costs are increasing, we must find a way to > make ends meet. We even discussed taking credit cards on the scene from a > patient who did not medically require and ambulance. Any number of ideas > need to be presented, take any one of them to heart that you like and will > fit the needs of your service and community and make it happen. The > difference would majorly affect those services that do not have a medical > facility in their own town. Those services are the ones with a single unit, > and a 2 hour turn around time. All the extra calls in the world will most > likely not convince a financially strapped city council to authorize an > additional 200K to staff a second unit. So what then? > > > Even some of those troll calls that everyone is complaining about may > sometimes > > pay their bill or part of it. Your already on the clock so just how much > expense > > do you really have. Probably not as much as crews run up running personal > > errands or stopping for drinks at the local corner store with the unit > running > > while inside. Work on those expenses and you would have more impact and > still > > have the call volume you may need. > > There are a number of places that any given service could trim expenses. And > you're right, the amount of diesel used while leaving a unit running at a > corner store is one of them, then again, if it was a call that was not > medically necessary, they could have saved the fuel making the trip to the > hospital as well, and never would have been near the corner store in the > first place. > > > Everyone out there has a magic number the > > bean counters throw out to them as the one that will take some of the > stress off > > by putting on another truck. > > I disagree, I work part time for a service that just " cut " our annual > wages....... so that they could make ends meet across the board with the > entire city. We could double our call volume tomorrow, and still never > receive the necessary funding to staff another unit. > > > In the mean time the other 500 call you are running > > before you hit that number are the ones that are really putting a strain > on the > > system. My thoughts on trolls are take the good with the bad, make them, > be nice > > and get back in service as soon as possible. > > I do that now. > > > Who knows you may be that troll tomorrow. > > I hope not.... > > Mike > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 Ahhh, Henry, I am nearly as thick skinned as you are, mind you I said 'nearly'. I don't take anything personal, and I kinda figured that they were not directed at me, but the thread in general. But I do like the exchange of strong opinions. Mike 'Tater Salad' Hatfield EMT-P " Si hoc legere scis nimium eruditiones habes. " EMStock 2005, it's never to early to plan!!! www.emstock.com www.temsf.org Re: EMS Pay Mike, my comments were in general and not directed directly at you. Henry Hatfield wrote: > Henry, > > As always, you make valid, as well as interesting points. My comments are > inline. > > > > > Mike, you may have just reduced yourself out of a job. You may need those > few > > calls (responses) to justify an additional truck. > > For the record. I am in support of Paramedic Initiated Refusals after > thorough training, I do not, however refuse anyone transport at this time, > as neither service that I work for has PIR protocols. Until such time as > they do, I will continue to transport each and every patient that requests > it, and treat them well. I don't make anyone feel bad, or ignorant by > requesting transport, and if they request a facility that is out of town, > then I take them. I do not believe that this is something that will be in > effect anytime in the very near future, I do however believe it will become > a necessity if the current rate of reimbursement, and the current rate of > expenses continue their current respective trends. > > Now for the thread. > > Just for the sake of argument, you might not need the additional unit if > your call volume wasn't inflated by 'trolls' (for lack of a better term) > that do not require ambulance transport, and that you cannot collect from. > Does that mean that if a patient is indigent and does not need an ambulance, > that you would treat him/her any different that someone who could actually > pay the entire bill, but still did not require an ambulance? No not at all, > if neither needs ambulance transport, then neither gets it. Medical > neccesity is medical necessity, regardless of ability to pay. You need to > go, you get a ride, period. This thread, and my argument is based solely > upon 'medical neccessity', nothing more and nothing less. > > If we know that the reimbursement rate isn't going to go up at the same rate > that our expenses are, then we need to move toward the middle proactively. > > So what's the answer? > > > They could be the difference > > of having a second truck and not missing a call or having a extended > response > > time while getting back in service to make the call. It must be a trend, I > have > > noticed that Paramedics now days don't want to make calls or the call must > be > > worthy of them. They need their down time for the rare 10% true emergency > call. > > Hmmmm, I don't think I said anywhere in my post that I don't want to make > calls, or that the call must be 'worthy' of me. What I have said, and the > point that I will continue to make, is that in a day and age where revenues > and reimbursements are down, and costs are increasing, we must find a way to > make ends meet. We even discussed taking credit cards on the scene from a > patient who did not medically require and ambulance. Any number of ideas > need to be presented, take any one of them to heart that you like and will > fit the needs of your service and community and make it happen. The > difference would majorly affect those services that do not have a medical > facility in their own town. Those services are the ones with a single unit, > and a 2 hour turn around time. All the extra calls in the world will most > likely not convince a financially strapped city council to authorize an > additional 200K to staff a second unit. So what then? > > > Even some of those troll calls that everyone is complaining about may > sometimes > > pay their bill or part of it. Your already on the clock so just how much > expense > > do you really have. Probably not as much as crews run up running personal > > errands or stopping for drinks at the local corner store with the unit > running > > while inside. Work on those expenses and you would have more impact and > still > > have the call volume you may need. > > There are a number of places that any given service could trim expenses. And > you're right, the amount of diesel used while leaving a unit running at a > corner store is one of them, then again, if it was a call that was not > medically necessary, they could have saved the fuel making the trip to the > hospital as well, and never would have been near the corner store in the > first place. > > > Everyone out there has a magic number the > > bean counters throw out to them as the one that will take some of the > stress off > > by putting on another truck. > > I disagree, I work part time for a service that just " cut " our annual > wages....... so that they could make ends meet across the board with the > entire city. We could double our call volume tomorrow, and still never > receive the necessary funding to staff another unit. > > > In the mean time the other 500 call you are running > > before you hit that number are the ones that are really putting a strain > on the > > system. My thoughts on trolls are take the good with the bad, make them, > be nice > > and get back in service as soon as possible. > > I do that now. > > > Who knows you may be that troll tomorrow. > > I hope not.... > > Mike > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 Ahhh, Henry, I am nearly as thick skinned as you are, mind you I said 'nearly'. I don't take anything personal, and I kinda figured that they were not directed at me, but the thread in general. But I do like the exchange of strong opinions. Mike 'Tater Salad' Hatfield EMT-P " Si hoc legere scis nimium eruditiones habes. " EMStock 2005, it's never to early to plan!!! www.emstock.com www.temsf.org Re: EMS Pay Mike, my comments were in general and not directed directly at you. Henry Hatfield wrote: > Henry, > > As always, you make valid, as well as interesting points. My comments are > inline. > > > > > Mike, you may have just reduced yourself out of a job. You may need those > few > > calls (responses) to justify an additional truck. > > For the record. I am in support of Paramedic Initiated Refusals after > thorough training, I do not, however refuse anyone transport at this time, > as neither service that I work for has PIR protocols. Until such time as > they do, I will continue to transport each and every patient that requests > it, and treat them well. I don't make anyone feel bad, or ignorant by > requesting transport, and if they request a facility that is out of town, > then I take them. I do not believe that this is something that will be in > effect anytime in the very near future, I do however believe it will become > a necessity if the current rate of reimbursement, and the current rate of > expenses continue their current respective trends. > > Now for the thread. > > Just for the sake of argument, you might not need the additional unit if > your call volume wasn't inflated by 'trolls' (for lack of a better term) > that do not require ambulance transport, and that you cannot collect from. > Does that mean that if a patient is indigent and does not need an ambulance, > that you would treat him/her any different that someone who could actually > pay the entire bill, but still did not require an ambulance? No not at all, > if neither needs ambulance transport, then neither gets it. Medical > neccesity is medical necessity, regardless of ability to pay. You need to > go, you get a ride, period. This thread, and my argument is based solely > upon 'medical neccessity', nothing more and nothing less. > > If we know that the reimbursement rate isn't going to go up at the same rate > that our expenses are, then we need to move toward the middle proactively. > > So what's the answer? > > > They could be the difference > > of having a second truck and not missing a call or having a extended > response > > time while getting back in service to make the call. It must be a trend, I > have > > noticed that Paramedics now days don't want to make calls or the call must > be > > worthy of them. They need their down time for the rare 10% true emergency > call. > > Hmmmm, I don't think I said anywhere in my post that I don't want to make > calls, or that the call must be 'worthy' of me. What I have said, and the > point that I will continue to make, is that in a day and age where revenues > and reimbursements are down, and costs are increasing, we must find a way to > make ends meet. We even discussed taking credit cards on the scene from a > patient who did not medically require and ambulance. Any number of ideas > need to be presented, take any one of them to heart that you like and will > fit the needs of your service and community and make it happen. The > difference would majorly affect those services that do not have a medical > facility in their own town. Those services are the ones with a single unit, > and a 2 hour turn around time. All the extra calls in the world will most > likely not convince a financially strapped city council to authorize an > additional 200K to staff a second unit. So what then? > > > Even some of those troll calls that everyone is complaining about may > sometimes > > pay their bill or part of it. Your already on the clock so just how much > expense > > do you really have. Probably not as much as crews run up running personal > > errands or stopping for drinks at the local corner store with the unit > running > > while inside. Work on those expenses and you would have more impact and > still > > have the call volume you may need. > > There are a number of places that any given service could trim expenses. And > you're right, the amount of diesel used while leaving a unit running at a > corner store is one of them, then again, if it was a call that was not > medically necessary, they could have saved the fuel making the trip to the > hospital as well, and never would have been near the corner store in the > first place. > > > Everyone out there has a magic number the > > bean counters throw out to them as the one that will take some of the > stress off > > by putting on another truck. > > I disagree, I work part time for a service that just " cut " our annual > wages....... so that they could make ends meet across the board with the > entire city. We could double our call volume tomorrow, and still never > receive the necessary funding to staff another unit. > > > In the mean time the other 500 call you are running > > before you hit that number are the ones that are really putting a strain > on the > > system. My thoughts on trolls are take the good with the bad, make them, > be nice > > and get back in service as soon as possible. > > I do that now. > > > Who knows you may be that troll tomorrow. > > I hope not.... > > Mike > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 > Gene, > I agree Eddioe Childs never did anything except to let everyone know that he > was mad. Well I'm mad too > eddie, but I choose to do something about It. , that's a blatant lie. In his first (and ONLY) post on this thread, he asked questions. No whining, no complaining - this thread was a question, and ONLY a question. " Eddie to More options Sep 10 (4 days ago) We were all discussing how little we are paid in this field a while ago and I'm curious. How much do you think EMS personnel should be paid? How much per hour? Or yearly? With what kind of benefits? Free CEs? What do y'all think? " I suggest you apologize to Mr. Childs. Mike Quote Link to comment Share on other sites More sharing options...
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