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Pay paramedics a thriving wage to end the retention crisis

Paramedics: don’t settle for a living wage. Instead, be audacious and demand a thriving wage for your lifesaving career of community service


“A thriving wage is one that is attainable and earnable through a single job’s regular work hours. It is nearly impossible to thrive by working excessive amounts of overtime or multiple jobs,” Friese writes.

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EMS is several years into a retention and recruitment crisis that pre-dates the COVID-19 pandemic. Several factors have contributed to the crisis, such as inadequate reimbursement, low community support and poor leadership. One of the rallying cries to move our industry forward has been that paramedics need to be paid a living wage.

A living wage, according to the MIT Living Wage Calculator, is the “local wage rate that allows residents to meet minimum standards of living.” The calculator adjusts for regional cost of living differences and can be searched by state and county. The living wage in my Wisconsin county for a single adult with no children is $14.19/hour. To meet the minimum standards of living in my rural location, two adults (one of whom is working) with two children would need to make $30.44/hour.

This Fast Company article, “6 ways to better compete for talent in 2022,” introduced me to the thriving wage. The article explores priorities for companies seeking to retain and hire personnel during the great resignation. The article explores the importance of streamlining the hiring process, showcasing diversity, equity and inclusion successes, and building a healthy work culture.

Recent paramedic job listings on the EMS1 careers page range from $15 to $40 per hour. But, depending on location, is that pay just enough to live? Or is it enough pay to thrive?

What is a thriving wage?

A thriving wage is the combination of compensation and benefits that increases retention and reduces the risk of top performers chasing signing bonuses and higher hourly pay, in and out of EMS. A thriving wage in EMS is the minimum annual salary that allows a paramedic to:

  • Pay for daily expenses of shelter, food, utilities, transportation and child care

  • Build up an emergency fund of at least $1,000 for unexpected financial emergencies

  • Contribute enough to a retirement account or pension fund to at least get the full employer match

  • Save for a big purchase, such as a house

  • Have enough left over to have some fun on their time off

As compensation is more than take home pay, a true thriving wage for paramedics should also include these benefits:

  • Health insurance with affordable premiums and deductibles

  • Paid time for in-station or online training, as well as in-person attendance at professional development events

  • Tuition reimbursement towards higher education

  • Paid time off and sick leave

  • Maternal and paternal time off for the birth or adoption of a child

  • Financial planning and career coaching

A thriving wage is one that is attainable and earnable through a single job’s regular work hours. It is nearly impossible to thrive by working excessive amounts of overtime or multiple jobs.

Greg, are you really this out of touch?

Many of you might think these criteria for a thriving wage are pie in the sky wishful thinking and won’t come true any sooner than unicorns skipping across rainbows. Your critique is fair, but I don’t want you to settle for a living wage, the minimum pay needed to survive. Instead, have an audacious goal that you and all paramedics are paid a thriving wage. You’ll never get where you are going until you decide where you want to go. Be audacious and thrive.

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Readers respond

  • It’s not so much a question as a comment, but as someone studying a paramedical degree, and working in an “almost paramedic” role in Australia, reading your “pay paramedics a thriving wage” really put into perspective how good we have it here. So many of the things paras should ask for (paid time off, sick leave, parental leave) are basic entitlements for anyone on a contract in almost any job in Aus. It also blows my mind reading comments on all the EMS/EMT pages I have joined (with the idea of maybe coming to work in the US for experience) when I see people talk of being paid $14 an hour?! That’s what I was earning at 17 working in a grocery store. For anyone who says it can’t be done, it absolutely can, keep pushing for a thriving wage!
Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.