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A deeper look at an EMS provider strike

Remember that you are not only gambling with your own livelihood, you may be gambling with the very lives you are supposed to protect

You went to school. You studied. You trained. You tested and you passed. You are either certified as an EMT or licensed as a paramedic. And you paid for it all by yourself — or are continuing to make payments all by yourself.

You have worked very hard to put yourself in a position to announce to the world: “We have never met, but I will be there for you when no one else can. I will be there for you when no one else will. I will risk my own life and safety to protect yours. And if I can do nothing else, I will try to make you a little more comfortable.”

That is what you will see when you break it down to its simplest terms and really take a close look at what it means to be in EMS.

Of course, not every provider actually feels that way, but you should. And in my humble opinion, if you don’t feel that way, you should get out of the business and out of the way of those who do. But, that’s just me.

For the context of this column, I will assume that you are reading because you agree; I will say to those of you who presently work for a private provider, your willingness to do it for barely minimum wage makes you a real-world superhero.

I get it. I truly do. My EMS career was spent working for a private provider and, after a decade, I don’t think I broke the $12.50 per hour threshold. (Secretly, I would have done it for free.)

I also get that at some point, enough is enough and it’s time to take a stand for what’s right and fair and proper. Sometimes you have to take it to the streets. Sometimes, you have to take it to the people who depend on you for the very protection and comfort you are willing and able to provide.

Sometimes, striking is all you can do.

However, that sword has two very sharp edges. Sure, one side cuts to the quick of the issues: private EMS providers rarely earn a living wage in comparison with what they actually do or are willing to do. 

The second side, though, cuts away the emotion of that issue to expose the reality of low reimbursements and high operating costs — as well as multiple layers of regulation compliance (always moving target). All of this creates an operational environment that prevents employers from offering and paying more to the employees who clearly deserve better.

The X-Factor
If the issues were as simple and clear as those painted above, resolution without striking would be easy. Unfortunately, there is an X-factor: All too often the message is irreparably distorted by the messenger.

In far too many circumstances, the very providers who are decrying the unfair labor practices of their employers at the greatest volume are the same employees who interfere the most with the delivery of service. Think about it — through delayed responses, incomplete documentation, destruction of equipment, and trash talking to facility and other ancillary personnel, they are aggressively creating the environment they detest.

Before the hate mail comes, let’s be clear. I know the percentage of providers who fit that description is relatively small, but they are disproportionately mighty. Think of it like this: Ebola is microscopic and sharks can be very large, nevertheless more people die from Ebola every year than from shark attacks.

Thanks to the folks who engage in this or similar counter-productive activity, Basic EMT's are essentially fungible and paramedics are only slightly less so. This remains true, because so many providers lack the maturity expected (and required) of a patient care provider . That is, many do not behave like professionals.

As a result, those who do lack the maturity are preventing companies from generating higher revenues and the industry as a whole from becoming a profession. And, as a result, the current pay scale reflects that.

Now look at a strike. When the employee body is represented by those who have higher volume levels than maturity levels, the message gets muddled. If there is evidence of unprofessional conduct, equipment tampering, or any other intentional deficiencies, who is going to take any of you seriously?

The Answer
In general, private EMS providers do not typically earn a wage commensurate with their responsibilities. Anyone who disagrees is either uninformed or unrealistic. Ironically, the power to change that fact rests almost entirely in their own hands.

When an employee body is sharp, professional, well-trained, self-regulating, and committed to excellence in all aspects of EMS, they will develop the leverage necessary to demand and receive higher wages. This is because they will have created the financial resources to accommodate it.

On the other hand, employees who engage in the kind of nefarious conduct discussed above forfeit the right to complain about the abysmal environment to which they have so recklessly contributed. Likewise, the other employees who stand as silent observers have earned their place in the muck.

By the same token, it is incumbent upon the employer to set a professional and consistent example; to reward good performance and behavior; to better compensate those who afford you the ability to do so.

On the other hand, employers who operate detached from reality and fail or refuse to do what’s right…well, you don’t get to complain when morale and profits tank.

​Sometimes, after all of the “T’s” have been crossed and the “I’s” have been dotted, employees must resort to that last option and strike.

Before that time comes, however, I hope you will take a very close and extra-objective look at how you got there.

Remember that you are not only gambling with your own livelihood, you may be gambling with the very lives you are supposed to protect.

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