The city of San Diego’s ambulance provider, Falck, is set to see fines again, after failing to meet response times and staffing goals. KPBS Reporter Matt Hoffman has more on changes that could be coming in the new year.
There's a nationwide shortage of emts and medics because 1. Lack of good pay 2. Lack of good benefits 3. Bunch of bs calls 4. The abuse of 911 from people that don't need an ambulance but want an ambulance 5. The homeless people 6. You're trained to do these badass skills and never use them. You're a taxi driver. I know medics who went MONTHS without starting an iv because the calls were so incredibly stupid and required no medic intervention 7. The burnout isn't because of "bad calls", it's because of frustration because of everything above I listed
100% on the nose. Not to mention the wear and tear on your body. I'm a paramedic and in February I had no choice but to leave, the constant pain and exhaustion just got overwhelming and honestly it effected my mental health to the point where I was suicidal. I worked four 24 hr shifts a week and still got guilt tripped when I wouldn't do more. I love EMS, spent most of the last 17 years in it, but I had to walk away for my own well-being
EMS is understaffed, underfunded, and underpaid. No one wants to work in this field for those reasons. It's not just Private Services. And also fining services for response times is ridiculous in and of itself.
i guess it depends on what the freshhold is finind someone for being 5-10 minutes on a 10 minute response time? probably a bit harsh but fining the service for being say a hour to a critical response well thats a different matter i guess it goes both ways
I think that all depends on how much money do they pay for the service. The city either Falck doesn't want to pay enough to have staff and so enough cars and so low response time. Also I'm wondering are there different response time criteria for different level of calls?
exactly, and the prior vendor AMR had same issue with response time hence why the City changed to Falck exactly one year ago. So what dividend of property taxes being paid go to City emergency services? I know large chunk goes to the over-bloated school system (which 1,000's of property tax payers don't or never utilized). With the change-over of multiple properties being sold has def made an increase of $ in the City coffers; apart from property taxes, many cities & counties collect unsecured personal property taxes on business property, boats, and aircraft. Sounds like the contract needs re-negotiation with the City to pay more and then in return that could filter down to the vendor offering better pay - likely too simplistic
Response fines are the entire structure of private ems. Companies like Falck and AMR are frequently paid exactly zero (0000) dollars to run the 911 service in a city. The reason they do it, is because it gives them more billable patients. They quite literally do it for free because they get the money elsewhere. Because of this, cities actually found they could GET PAID THEMSELVES by the ambulance provider for them to serve the city. It's definitely a backwards setup. It's also a massive barrier to integrated fire dept ran ems. Going from getting a payday to let falck or amr run your system, to actually having to fork out hundred million+ yourself.
This is a nationwide and system wide problem. Every EMT or medic I know is running their asses off right now. I'm averaging 60-70 hours a week doing emergencies and transports and so are many others. We're doing this often without food or breaks, no benefits, low pay, poor treatment, very heavy people, and equipment that barely works. I genuinely enjoy this job but no one can keep this up indefinitely. Patients, EMS personel, etc are gonna get hurt. Someone's gonna call 911 for a real emergency and no one is going to come. The system is holding on by a thread and I honestly don't think the average person has any idea. And the most frustrating thing is this is FIXABLE and it starts with better pay and benefits.
It also starts with EMS carrying for protection... and then setting the public straight spiritually and mentally so they're not calling for bogus reasons. if someone calls for a splinter or something, EMS should have the ability to decline to be able to go to a more serious call. And also so the public can treat first responders better. The whole community should be supporting and helping. Times are tough rn, end times
It’s the crappy business model. This is the only public safety branch that’s ran on a profit. This needs to change and make them a public entity with retirement.
You hit the nail on the head here. It's easy to point the finger at private EMS providers, but when you consider how much goes into the vehicles, equipment and personnel costs (even with the insulting wage they are paying) and the constantly fluctuating cost of medications and supplies, all of which expire and need replacement and most of which the service must carry to comply with state EMS protocols; no matter how high the price goes, it makes for a slim profit margin. Add to that the number of patients they haul from whom they will never see a single nickel of payment and it's clear. Our society's present use and reliance on EMS has rendered corporate EMS an inappropriate business venture. It's simply not viable without cutting some corners and municipalities should begin to accept and plan for the impending need to fund this critical service.
I'm a firefighter/paramedic, but before getting on with the fire department, I worked for a private 911 EMS agency, and I can tell you the pay, work load, constant turnover, bad attitudes from co-workers, short staffing where because of which came a constant push from management to pick up extra shifts, having to put up with a "system status management" (where you sit in a parking lot somewhere) between calls in a crowded, cramped, uncomfortable ambulance front seat in all kinds of weather, and poor health insurance all made for wanting to leave to search for better opportunities. I have lots of friends that still work for private ambulance services as both paramedics, and EMTs and everyone of them are anxious to leave.
I never understood the split between EMS and FD. Grown up in an area where all but very few ambulances are operated by the FD and it's just normal to see them swapping roles and supporting each other.
I’ve worked in EMS for 6 years, 4 as a medic. There are number of reasons why the staffing is garbage and why there’s a high turnover rate: Pay is garbage. Benefits are garbage. Everyone and anyone can request an ambulance and we’re obligated to take them even if it’s BS. Especially during the colder weather, homeless folk have straight up told me they just want to go to the hospital so they have a place to stay and get a Turkey sandwich. You call, we haul. Then you have the people that for, let’s say chest pain, get transported to the ER, only to go against medical advice once at the ER; they just needed a free Uber. Long shifts (12’s, 24’s, 48’s) with no guaranteed breaks and no sleep, causing the crews to get burned out. A lot of people that leave EMS, myself included, do so to work at a hospital where pay/benefits/morale is higher.
One thing I’d like to add in addition to what others are saying is the lack of RESPECT ems workers get is very low. We are seen as inferior to most other medical staff. This deters people from entering in the field as well.
To be fair, most of the time our interventions don’t even improve patient outcomes. The doctors and nurses do the saving usually. The thing that improves outcomes the most is just driving. Like I wonder how many lives the cath lab saves daily? This month I’ve only saved one and he was mad at me for it
@@andynonymous6769 Can't sell yourself short man, the nurses and doctors might be doing some work but they aren't the ones running out in what is basically a microwave oven to bring them back to the hospital.
@@andynonymous6769 Give yourself some credit. Pre-hospital is and will always be extremely vital to our healthcare system. The ability to get someone to a hospital quickly is enough alone alot of times, as time is tissue. Not to mention, those doctors and nurses are in a mostly controlled environment and much less likely to walk into dangerous situations/households.
Don't know what the problem with AMR was.... But I bet all the strained first responder branches are experiencing the same thing since this shortage is on a national level, even the military is having a hard time making recruiting goals.
Don't know the specifics, but Falck likely submitted a lower bid than AMR. The city has a very strong incentive (and some times, legal obligation) to select the lowest bidder that says they can meet the requirements. Here they said they could meet the requirements in the contract, but they clearly aren't. They are paying the penalties set out in the contract for non-performance, and if things don't get better soon, the contract will likely be terminated.
It is not just a San Diego problem. The issue is nationwide. The solutions are there, but politicians simply do not want to hear or act on them. As a retired paramedic of over 30 years, these are the same issues we were seeing years ago when I was still on the job. They are just more pronounced today because they were not dealt with back when they first surfaced. Jurisdictions have got to increase the pay and perks for being a paramedic. They simply don't want to do so. Moreover, the continuing education program for medics has got to be looked at with a critical eye and made both realistic and affordable. Shift schedules, staffing, mandatory over time and mandatory call backs on off days have got to be reduced and revamped so that medics have some semblance of a life. Hospitals and jurisdictions have got to address the policies that allow the 911/EMS system to be so badly abused by the public. We eat up our ALS , burn out our medics and wear out our equipment on non-emergent calls that, for the most part, do NOT require EMS intervention or which, at the most, require treatment by Basic Life Support personnel....not highly trained medics. Medic units across the nation are being treated like medical taxi services instead of being reserved for serious, life threatening calls only. Not everyone who calls 911 needs ambulance transport to the ER. Many, if not most, can get to their family doctor, an urgent care clinic or even the ER on their own. Yet, medic units still pull up to homes with 4-5 cars in the driveway to treat and transport a minor boo-boo that it no way meets the criteria for a 911 call...much less tying up a scarce and overworked medic unit for an hour or two. Hospitals crap all over medic units by going on "ER by-pass" and refusing to accept critical patients because they are either getting full or simply too busy and the staff orders the medic units to "shop around" for a less busy facility. This often involves bypassing multiple hospital ER's to find one that is not on by pass. This practices is often authorized by the hospitals and accepted meekly by the jurisdiction's senior fire/EMS staff because they don't want to buck the politicians or the highly connected senior hospital folks. Not only does the by pass system tie up medic units for extremely long periods of time, longer drives to find an "open" ER often proves to be detrimental to critically ill patients for whom rapid transport to a definitive care ER is essential if they are to survive. Politicians need to open their eyes to the grim reality that EMS is on the verge of being a failed system unless they become more amenable to looking at the real issues and become more open minded to solid, practical solutions. And hiring private EMS services to do the job is NOT the answer. Their pay, perks and personnel management practices are even worse than those of the various local governments, if that is possible. The final solution is also going to involve re-educating the public as to exactly what EMS is there to provide...emergency life threatening care only. We are not the local "boo-boo bus" or 'band aid wagon". When the $600,000 50,000 pound fire engine and the $300,000 medic unit roll out of the station, they should be rolling for a bonafide, life threatening medical emergency only. And the crews should not consist of low paid, over tired, stressed out disgruntled firefighter EMT's and paramedics who are pulling 36-48 hour mandatory overtime shifts and who, after 30 or 40 calls, are exhausted and running only on coffee and unhealthy snacks grabbed from the convenience store between runs.
wow. I pray for this country. It's only going to get worse. Repent and know Jesus. Believe and receive Him. It's the End times. Or end of "normal" before the start of the end times. Apocalypse is soon!! Get ready, learn survival skills.
Let’s see, take run, after run after run. You can’t eat, drunk, take a break or use the bathroom. Then you get paid shit, have little to no benefits and no future. For the same amount of time you can become an RN, or join the fire department, and have a career, not a job. Room for advancement, moves into specialties, move up to management. I started as a FF/PM, was on the hazmat team, tac medic, Lieutenant, Capt. Batt Chief, Fire Marshal and retired as Deputy Chief. Guys I knew in medic school in the 80’s are still in the back of an ambulance.
I worked for a fire department for many years until I moved to a new city. I started working for an emt company and quit after 3 weeks. Pay, working conditions, and abuse wasn't worth it. Went back to fire as soon as I could. You'll still be worked hard, but at least the pay is livable.
Everyone wonders, how do we fix this? What's going on? What solutions can we come up with? It's easy, just pay people what their jobs worth. You can't even afford to live in San Diego on EMT pay. The pay of EMT's, Nurses, and Aides has not caught up to the cost of living in San Diego. With EMT's pay being the most underpaid. Might as well go work in the hospital and be paid poorly than dealing with the back breaking work in the streets.
You know what wont fix it? Having firefighters do it because they are on shift anyways. Its the same problems in every city even small ones. When your a medic dealing with travel nurses making upwards of $5k a week for a few shifts and your up all night for table scraps, its unsustainable. I gave my medic up because the stress and responsibility wasnt worth an extra $50 a 24 shift.
San Diego County needs to change the definition of an emergency patient for starters. Just because you request field treatment and or transport and have a chief complaint of a butt itch. Doesn’t mean you are entitled to an ambulance transport to an ER. Urgent cares and Skilled Nursing Facilities abuse the 911 system as well. The city needs to start incorporating fines for these places that abuse the system.
It’s highly regrettable to see large cities contract out complete EMS coverage to private companies. Many companies do a poor job of caring for employees and making necessary changes to accommodate employee and community needs over profit. Further, a large metropolitan area like San Diego it makes absolutely no sense to attach a paramedic to a transport unit I would wager my salary that the overwhelming majority of their calls are appropriate for the BLS level of care and should not involve a paramedic responding to the scene at all. I can only hope that needed changes in the system are accounted for while the city examines this issue.
This company blows my mind. I'll admit getting out of the Navy I didn't fully prepare to do a skills interview for a position as a basic and that's on me but with a shortage not only do they do that they also put you on a year long probation period and you still have to do like 16 FTO shifts. If you're doing all that why do a skills interview If they're gonna get in the field anyways to reiterate that?
I had a friend who finished EMT cert like 15 years ago. He made like 12.50/hr and quit within the year. That was pre pandemic, pre hyper inflation. Pays a joke, mental trauma is a joke. EMT are treated like 💩
I work as a Medic. The private ambulance providers suck. They are only concerned with profit and routinely run their employees into the ground. Medic Ambulance (near me) cut their empty shifts in order to give the illusion of full staffing in Sonoma. This is how to fix the problem. Pay more. Treat your employees as assets and not expendable.
Why you would sign a contract for one company is stupid. Where I live, there is an ambulance in every fire station, and all firemen are trained EMT's. Plus we have multiple services in the area. When you call 911, you get an immediate response with an ambulance and a fire truck. Within a few minutes they can have you loaded and on your way to the hospital. Some situations one of the private services is on scene for paramedic issues, but even some of the fire departments have those now. If you can't respond within minutes, you need change!! 😳😳
I was in EMS for nearly 20 years. The last 15+ as a medic. I went to something completely different for all the reasons you see in the comments. benefits were non existent. Pay sucked. Hours were awful. Most of us had to hold at least 2 jobs to make ends meet. You're constantly exhausted. People crap all over you.... patients, family, hospital staff, your own dispatchers and supervisors.... You're literally out there non stop seeing the worst humanity has to offer and getting kicked in the teeth while it happens. The county can take it over, but they're going to have the same issues. I've told ANYONE who has ever asked me about it to avoid going into EMS. At this point avoid going into Healthcare at all. It's just not worth it. The abuse is constant. It's hard on your body (My knees are shot). No part of it is worth it any more.
I work EMS in Flint, MI(Genesee County). The comment about the turn-a-round times at the hospitals being normal, I feel that is a lie. We are being held hostage sometimes with patients waiting for a bed. The longest that I waited was 3 hours. I have seen and heard of other crews waiting much longer. I have had to become a crazy "b" with some patients because they wanted the person go to triage and the person would have died if they had. As for not enough personnel. That is EVERYWHERE!! Not just California. We have some nights where there are only 3 ambulances on for our company. So, how do we solve this issue??
In Canada our paramedic services are provided at a regional level or municipal NOT private business, in the uk it’s run by the NHS (national health service) the government pays for it. Time to join the first world socialist countries of the world
How is giving them a fine going to help staff the contract? Seems like it would take away from the pool of money alloted to the paychecks for the staff, wouldn't it?
The best part of this is even if the city took over and integrated it into the fire department the city would still be facing employee shortages. Welcome to the future of employment after the pandemic
Mental anguish is right. I do not mind running calls if it paid better, But driving 20+ miles for a full arrest and ETA of 20 min is so painful to my morale. AMR,Falk, CARE or any other for profit organization is not there for the public. They are there for the money.
It would help if EMS was officially made an essential service. That would open certain funds to help increase wages for EMS. EMS is clearly a young man's life style and you mostly see only people in their 20s and 30s in those roles. When you have to work 60 hours a week to make ends meet and because the job demands you to work overtime, it's not health from a both physical and mental standpoint. Being perpetually exhausted and never having time to decompress means that most of the industry is at some level of burnout. When I can as a 10 year paramedic go work at a post office or shipping company and barely take a pay cut, most people would get a very nice pay raise for a job with better hours, consistency, and less stress. And that's after I got a huge raise because of a nearly catastrophic shortage of medics. Also, most EMS, especially in cities and private business, so don't think we get some of the perks that fire depts offer, which is why a lot of EMTs and paramedics leave EMS to work for the fire services, since they ARE an essential service and are mostly municipal services with good retirement after 20 years with pensions or tmrs. It's "so nice" to hear how disappointed they are while not wanting to put their money where their mouth is. Expect things to get worse before they get better.
How the American public sits back and allows cities and municipalities to engage in exclusive contracts thinking that you're going to get better service that way is beyond me wake up America every one of the exclusive contracts you have in your city is the Main reasons that you will never get the best service.
What should be looked at is creating a legit city run EMS agency and then the city council needs to ask themselves what they were willing to pay a firefighter to become a paramedic and make that the salary for EMS. Why try and turn firefighters into paramedics and pay them 6 figure salaries when all they have to do is stop pimping out the current paramedic pool to a low paying private company. The idiot politicians would rather spend the money on ambulances to be a part of the fire department and pay the cost to train firefighters to become paramedics instead of buying those same ambulances to be operated by the current paramedics who only work at Falck because it's the only game in town!
*YOU GET WHAT YOU PAY FOR PEOPLE!* How much do all these bureaucrats and politicians make? Do you think they would keep doing their job if they were underpaid and forced to work overtime shift several times a week in addition to coming in for unscheduled mandatory shifts? Do you think they'd go find another job if they were told no, you can't stop and eat, you can't go home, and don't complain because you know it's the nature of the job! Well guess what? You don't give people a chance to grab food that didn't come from the gas station, on top of no sleep and reports backing up because you don't have time to write them because you've got another call pending and they go find something to do where they don't get treated like… I'll leave it to your imagination. People are willing to pay stupid amount of money to watch over grown men and children chase a ball. What makes a football, basketball or baseball player worth millions of dollars a year but medics, firefighters, law-enforcement and teachers? There are only worth $40,000 or $50,000 a year. That's just wrong!
This is a result of lack of funding and embarrassingly low reimbursement rates from Medi-Cal and Medicare. It doesn't matter which company they contract with, the problem will be the same because the funding all comes from the same place. Until they raise reimbursement rates, nothing will change.
I am currently in paramedic school, looking to make a lifelong career out of fire & ems. Yesterday i worked my first code, we did not get ROSC but so far I feel fine. It was not on me, it was not our fault he died, there simply was not anything we could do unfortunately but watching my paramedic partners do their work was pretty awesome and I am glad to live in a place where firefighter paramedics are paid a livable wage upwards of 80k but if you go 1 hours west or east of my town, medics are making JUST over minimum wage. These enormous corporations are so money hungry that they CANT see past the fact that they are ruining people's lives that simply want to help people and do good for their community. I have had my EMT license for 2+ years now and I am finally managing to do something with it given the opportunity that has presented itself to me recently and it does NOT involve strictly being in EMS. I refuse to work solely in EMS until it pays a TRUELY FAIR wage and can provide resources to help each and every emt/paramedic. Working horrible hours with zero sleep is not something im interested in. Fuck AMR, Fuck falck, fuck any other EMS service that can't wrap its head around paying their employees a fair wage. The fact that I made more money working as a bicycle mechanic than most paramedics do is beyond me. Paramedics are expected to do borderline surgical procedures wherever the patient may be and that fact alone is worth $30-$40 an hour.
@@michaelsnyder4642 im sure it'll happen one day but in the area im in, everyone tries really really hard to lend a helping hand when possible. also on my shifts, we have 5-6 paramedics and usually not all of them are caught up doing more important things when a code tones out
Been a medic for 7 years in large major city, very busy system. Seen it all. Do not stay in EMS. You’re better off going Nursing, PA/NP, or MD. You can retain an EMS license to run calls if you desire, but fire/EMS is underpaid and overworked and you’re sacrificing you’re body for nothing.
@@Ryan-co7on fire/ems in my area is not underpaid by a huge margin. minimum salary for firefighter paramedics is about 85k in my state and thats a salary for someone with MINIMUM requirements and will likely only go up from there if you get more certs.
@@dash0173 85k is nothing, I know new grad nurses clearing 100k, and with more options to increase income apart from becoming engineer/captain. I know a CRNA who makes 230k and works less than 30 hours a week, and is not working 48 hour shifts being woke up nonstop. Im not saying it’s unliveable, im just saying there’s MUCH better options out there and I wish I had realized sooner.
This is starting to be a broken record where a private ambulance company promises what they can't deliver. They low ball to get the contract and then pay the Medics and EMT's peanuts and work them into the ground to make a profit.
Didn't San Diego Fire at one point have their own ALS ambulances? Are they not allowed to have that anymore because of the FALCK contract? They should allow San Diego fire to operate ALS ambulances, along with FALCK. That's what they do here in Las Vegas, just with AMR as the private ambulance contractors.
For me, being a paramedic pays about the same as a nurse, so the pay is good. My reason for not wanting to be a nurse is because I want to work in an environment where everything can change from one moment to the next, one where you can spend a lot of time outside (I hate that working in a hospital, sometimes you can go an entire shift without seeing the sky), one where I get to see human life in every permutation from someone living under a bridge to a billionaire in a mansion. It’s cliche but I also like how intimate the job is: people invite you into their house when every safety net has failed them and they have no idea what to do- they trust you to. And my favourite thing is just how bizarre it can be: like talking to a drunk gang member who’s bragging to you about how many people he’s beaten up, and then a teeny little kitten trots in and he’s like “yeah thats Mittens.” Then finishing my assessment while petting a kitty. I’m not making that up, that happened once. Can’t get that working in a dentist office There’s definitely drawbacks though. The lows are very low, and I’m still making my mind up about if it’s worth it or not
We had them here in Michigan for a bit, lots of promises, zero follow thru. They took over a private agency here, gave out huge raises and then left, leaving that small company to try to afford to pay their people, without the financial backing that had been promised. Messed up.
Ive seen several cities in Orange County, CA (Anaheim, City of Orange, Laguna Beach) recently bring their ambulance service in house (part of fire department). Cities of Newport Beach and Huntington Beach have been doing their own transport for several years. Have to wonder if there was something changed in the state budget or Medicaid laws that they now see a financial benefit to providing this service. All these cities do have a contract with a private service for back up ambulance. City of Placentia recently took back their fire service from the County of Orange and hired a private paramedic service for their BLS/ALS and ambulance service
As a city government agency, they have a higher reimbursement rate than a private company from MediCal and Medicare. A private gets between $185 to $215 per transport while a government agency (City Fire/EMS) can recieve between $700 to $850 per transport. This is why private companies pay so much less than City/County Fire/EMS.
Newport, Huntington, and Laguna have ambulance operator programs that pay minimum wage or less for EMTs. The appeal of the ambulance operator position is that the fire departments typically hires out of the operator pool to fire fighter positions.
This is what happens when politicians get in the fire service. Private ambulance providers are horrible. Here professional union fire department paramedics
Flight mechanic 70 hr box truck delivery driver 35 hr lineman for the city 38hr toped out critical care paramedic with years of experience 30$ an hour in a few states that are hurting enough to pay that yeah I wonder why you have a shortage
@@shsuususjssnjsus8239 they are in our areas. Lineman easily make 30-40 an hour with a badass Union. CSX railway 20-35 an hour, basic weekend CDL course driving box trucks 35-45 an hour. Neither of the jobs above requires a 1-2yr college degree or certification. Lineman school is about 3-6 months and then paid apprenticeship usually. Heck even basic Amazon van drivers are making 3-5 dollars more an hour then EMT’s and only 2-4 dollars less then a starting out Paramedic in our area.
I worked for Falck this year in LA and Orange County. It was awful. 24 hour shifts with many nights ZERO sleep. Lifting people 300lb+, watching people die from stabbings, gunshots, car crashes, all just to do it all over 20 mins after. Our union took 2 years to negotiate a pitiful $1.25 raise making our hourly $16.25. Most of us worked 3-5 24 hour shits a week to earn OT to make ends meet. I quit in October with no backup plan. Couldn't do it anymore. I was physically and mentally toast. The serious depression the union rep from San Diego talks about is real. I work in a hospital now, pay is $19.25 an hour and I'm much happier. DONT MAKE A CAREER OUT OF STRICTLY EMS. You'll only find yourself years later looking in a mirror, like I did, asking what the hell happened?
Making a career in private EMS isn't possible if you're only an EMT. You'll never make enough without OT. Being a medic is better because it provides more career opportunities. Overall though, working in private EMS usually doesn't work out as a career no matter your certification level. Source: 16 years of EMS experience in private and government systems
@@shsuususjssnjsus8239 some EMS companies allow 24 hour shifts especially if they're based out of a station and not only on a truck. Also, you can be In it for the right reasons and still be burnt out with ptsd regardless.
I make $4 less than a starting medic (what I would make off the bat). I am an EMT for the City and County of Denver, 3 years experience. While we are paid much better than Falck, who has the 911 coverage of Aurora here in CO, becoming a medic is by no means a cure all.
This is what happens when the public abuses the system and calls 911 for horseshit. I left San Diego EMS 7 years ago and the problem has only gotten worse. The public needs to be aware it's not the fault of the EMS crews that things are like this. These crews are out there busting their butts off to serve the community.
Being an EMT and Paramedic for a private service is an extremely rough job. You get abused and run ragged by the employer and get the same treatment from the people who call you. AMR (GMR) and FALCK are two of the most infamous in the community. The pay is abysmal and working conditions are as well. There will always be a shortage of EMTs and Paramedics if the treatment continues. It’s a fulfilling job that just isn’t sustainable for more than a couple years anymore
We had an “efficiency expert” come to our service to try and improve our unit hour productivity. He talked about “widgets” to which I responded I didn’t spend years of my life learning how to make a widget. As a paramedic I’d like to think I did more for my community than produce widgets. He spoke about how we will be more productive if we spend more time in the rig which led to loss of our hard posts with bathrooms, couches….you know, basic human comforts. I jokingly suggested he put portable toilets in one of the side compartments. I walked by his office a few days later to see him looking at portable toilets on his computer. Within a month I was working for the fire department. Healthcare in our country is a business and won’t change or improve unless CEOs or upper management recognize the human side of this profession. When a crew has to hold over 4 hours past their end of shift because no one else can clear the hospital, that serves only to generate animosity which impacts not only the crew, but the staff at the receiving facility….not to mention the patient who’s arguably have a worse time than any of us. Their focus has to match their bullshit marketing slogans and please, if the ambulance company charges the patient for an IV start, don’t charge them for it in the hospital. That mentality is what drives our medical system into the ground… riptide certainly didn’t help when Covid was in the news. Livable wages are only half the battle. Livable schedules and common decency need to be addressed
@@drwheycooler8423 Yikes, if their salary starts at 60k, with a base wage of $16/hr they are averaging 72 hours each week, for every single week of the year. No wonder there is a shortage
I 100% believe it’s because of the working conditions. First responders have one of the worlds hardest jobs and their pay doesn’t reflect it, that’s not just EMS, its EMS, Fire Departments, and Law Enforcement. The constant over working of the employees, and the constant disrespect from the community towards first responders I think deters away potential applicants. I work as a 911 Dispatcher, and we are seeing the same thing. Lots of things change, but one thing that will never change is how people always need help, people are always getting sick and injured. That doesn’t slow down for no one :(
In most urban environments, fire and police earn waaay more in pay, benefits, health insurance, and pension. Look at San Diego. In that city, firefighters and police officers earn 3x what paramedics do... and many EMTs and paramedics are eagerly waiting to be selected for those better civil service careers.
It's time all the council members do few ride-along with the crews and see first hand what it's like running calls instead of sitting behind their big desk complaining about something they know nothing about.
And have the same problems. No one wants to address the real issues. First that response times do not matter at all for 99% of EMS calls, even serious calls. Second that good patient outcomes require a high level of experience. An experienced EMT who is his professional (regardless of paid for volunteer) who takes his work seriously is 50 times more useful then a new paramedic, or a paramedic that only got the certification because the fire job required it. High preforming EMS systems need by in from local hospitals, and continuing education from experts in the fields of trauma medicine, emergency medicine, neurology, nephrology, cardiology, endocrinology, and pharmacology, just as a begin. And abuse of the 911 system, calling for nonsense should be treated as the serious criminal offense that it is.
@@andrewcruz3837 most likely, depends usually but most states require Covid vax if you want to work. It makes sense for us because we see patients all day long every day. Having the vax isn’t important for just us, but also for our patients
I've been a basic in NJ for four years. I work exclusively urban night shifts. I know what it's like to be running all night. I'm going to medic school in the fall. I'm curious what do you mean by traumatizing. I don't know any EMT or medic who has ever said that in my years of practicing; I've only heard that on the internet.
another item to bring up is alot of your paramedic with 3 to 10 year experiences are going back to school and getting their adn(nursing)(bridge program that only takes a year more of schooling) and getting a $10 to $20, $30 plus an hour increase of pay to work 12 hour shifts in a CONTROLLED setting in an hospital or dr office (with holidays off). This doesn't included travel nursing that pay over $100/hr... I can count at least a dozen paramedics that I know that have either completed their nursing degree or are in school right now. we are losing paramedics faster then we can replace them
EMS should be a local government agency either stand alone or integrated in the Fire Service. Not a for profit contractor. And the pay should be a lot higher
It is in many places. But it is often cheaper to contract it out; in NYC, they have so many calls that they have both fire department and contracted ambulances. Fire department EMS is... serviceable, but not great. Contractors, on the other hand - I would rather be unemployed than work in corporate EMS.
FD's that run EMS fund it the same way a private ambulance company turns a profit, they bill insurance and get reimbursed from medicare/ medicaid. Most companies operate on incredibly small profit margins, so unless an FD is willing to subsidize EMS, the level of service will be the same and they'll have the same staffing issues. FDNY, Baltimore, and Detroit are great examples of municipal EMS services that aren't any better.
In Alberta, Canada, EMS is run by the province……..and it has the exact same problems. This is a North American problem and not isolated to any one area. Its absolute chaos
Part of the Reason why I personally hate Private Ambulance Services is they charge people out the ass for services but pay their people crumbs and don't fix any of their equipment. This is why I prefer Fire Based EMS because they get the same pay as the firefighters if not more because of having better training.
I've been in EMS for nearly 30 years. This is a nationwide problem. Enrollment of new students is at an all time low and turnover is at an all time high. The private sector is its own worst enemy. Minimal staffing, substandard fleets and equipment, horrible pay and benefits. 911 should stay with municipal or hospital based. The privates only care about money and will always make promises they aren't able or willing to keep just to get that contract
There is never a shortage of anything. It's the same as with truck drivers or regional airline pilots. Just pay an adequate salary for what you are asking for and people will come.
its a interesting concept for sure but the reality is you dont wanna pay more do you wanna pay more taxes? of course not but you do still want all theese nice city services and even for them to improve right? do you wanna pay more for your flights? no but you still want more pilots flying more planes to more destinations preventing layovers do you wanna pay more for food? no but you still want truck drivers farmers warehouse operators and all the other links in the chain to keep doing what they do im not blaming you times are tough but sadly everyone wants higher pay and all theese nice things but they dont reflect the same sentiment when it comes time to open there wallets and its partly because theres a disconnect you see chicken nuggets for 4 dollars and 2 dollars you make a choice based on price not on the welfare of those chickens to the welfare of the people who worked to bring it to you and you inadvertainly promote and reward brands to always try and get cheaper and when you cant get any cheaper you have to start cutting in quality and wellbeing across the board
If it was just that easy. Too many calls do not pay even the cost to run that call so adding more money into the employees pay just might not be there. In my county one service pulled out because they could not cover the cost and another company started up saying they would cover the area. Not long after they started most of their rigs are now going all over the state to take good paying transfer calls and leaving nobody to take 911 calls. But now they are losing staff because nobody is getting any sleep running calls and they may go bankrupt after just a little over a year in service.
@@Sarge92 There's plenty of money for fancy dinners for city workers, and pensions they vote for themselves are exponential & lifetime, but there's no money to pay for EMS? Bull.
@@mariatorres9789 your 100% correct but that would be a different avenue off of this 1 they should be paid more 2 taxes would have to go up 3 why do we not have money to pay the m and from there wed begin to look into this cause i do think at the minimum half of a potential pay raise could be made by cutting some fat off the budget if not more
@@Sarge92 Taxes wouldn't have to go up, just get people in office to vote & put in by laws, that people on councils can't vote for their own pay raise, & that they can only collect retirement or pensions for the same number of years they were in office, and term limits of 5 years for anyone in office & anyone they're related to by blood or marriage. Kick off the people getting 100k a year, that voted for those permanent paychecks, just for temporarily running a city or county, and make it so only board members that served over 20 years, get a full pension like that. You realize, the gorge city councils & mayors etc that collect 100k, 200k etc per year, because they voted that for themselves, permanently, for when they're out of office? Do you know, that would fund double wages for EMS & firefighters etc? It's outrageous.
I don’t work in California but I have worked in EMS for 11 years and have seen a lot of changes throughout my career as well as political involvement by people who have no idea about the EMS industry. It’s easy for the fire chief and city council to throw it all on the contracted ambulance service. But the fact of the matter is we have extreme shortages of EMTs and Medics nationwide. Staffing as well as recruitment and retention have became nearly impossible. The FD take over of EMS may alleviate the problem somewhat by forcing FF/EMT’s and FF/Medics to run EMS calls but this will inevitably lead to burn out amongst the firefighters as well and the fire chief will face the same shortages. An increase in pay and benefits helps but it doesn’t fix the overall problem. High call volume and lack of staffing due to burnout, injuries and illness(both physical and mental) continue to plague the EMS system nationwide.
So...shorter shifts (12h max), better pay, and here's a thought, universal health care similar to the NHS (oh hush, I said similar, not identical) including mental health and the ability to deny transport to chronic abusers.....might help?
The Fire Chief in this situation likely is pushing for fire based EMS. Making the company out to be the issue advances that plan. Hes advocating whats best for his city and department in all reality
Everyone wants to blame the companies. It is their fault to an extent. Yeah, pay is shit and it should be raised A LOT. Why is it you can get a job flipping burgers and get paid more than an EMS worker? No schooling or anything required to ask if you want cheese on that... But like everyone has been saying too. Let's start having the city's educate the public on does this need an ambulance or can I go to urgent care? The system is broken and everyone is pointing fingers at everyone else.
Falck just pulled out of Seattle I think because their Danish parent company decided it wasn't profitable for them. It has made things pretty rough for us working for other companies. Sometimes you might have to wait hours for an ambulance while we're running call after call for 24 hours straight
Just hope the residents of San Diego arnt upset with us the providers, and understand we are here to do a job and are tired, over worked and we still show up to work everyday to give the people of San Diego our best, I don’t do anything but come in, do my job and go home. I just hope the residents understand that the boots on the ground are not to blame. Cheers 🤘🏻🤘🏻
Correct me if I am wrong, but all of what is happening was "predicted" by critics and spoken about by other cities that had taken on Falck services previously?
You're correct, the union leadership from the Alameda County operation went to SD city council to tell them what a horrible job they were doing in the Bay Area, SD got exactly what the union said they would get.
Was a Paramedic for 17 years. Pay was $19.50 an hour when I left in 2021. 1 day of experience, 40 years experience, they get paid the same at most ambulance services. Takes 2 years of college to become a Paramedic. I went to CDL school last year. Takes 3 weeks. You get 1 year experience driving a truck, you can get a local job for $21-$26 an hour. I sleep every night in my truck. No alarm waking me up after 20 minutes for a “constipation times 2 weeks” 911 call. I work 8-9 hours a day. That is much as the government will allow a truck driver to work (70 hours a week). Private EMS companies will ask you to work back, to back, to back, to back 24 hour shifts with no sleep. There are no government laws against it. Do you really want that 80 hours of no sleep medic doing your medical care? Driving you anywhere?
make ems it’s own county entity. there’s no need to make it part of the fire dept esp if you have firefighters who didn’t sign up for that job. a third service county ems is by far the best option. not cheap but you see how cheap goes by how falck and amr handle the county.
It's very simple to fix this issue. Pay enough for EMTs and Medics to live a decent life. As a EMT I don't work in EMS because it doesn't pay enough for me to afford rent. If you want people to consider EMS as a career it needs to be appealing enough over other options. In most areas being a EMT pays the same as working at McDonalds, so why would I work all the forced over time and see all the terrible things us EMTs have to see when I can have the same living working in fast food.
Increase in pay will help but people also don’t understand that it’s not appropriate to call 911 for a cough that you’ve had for a month and you think you’ll get seen faster if you go by ambulance. At least half of the calls we get are bs and you don’t need emergency services. Go to a urgent care or drive yourself. Take an Uber.
One problem is the dispatchers. They don't know how to properly triage calls. Dispatchers need to quit trying to take a call, get the info, and dispatch it within seconds. They need to take a few seconds get all the info and tell half the patients to suck it up and go see a primary care doc. in the morning. A stubbed toe at 3 in the morning doesn't warrant an engine company with 4 ffs and a ems crew with 3 medics. Yes, that is the bullshit we run all day everyday. Yet people in high places turn a blind eye to the money they throw out the window running these senseless non-emergency incidents. It's not ems or fire administrative personnel getting up 3 times a night for bull shit so why should they want to fix the problem. Out of sight, out of mind is their moto.
Maybe increase the pay to a respectable rate!!! The government is constantly disrespecting Paramedics and treating them like absolute shit despite the PTSD they encounter!!!
Hospitals should be required to take full responsibility for a patient within 10 minutes of their arrival at said hospital. Keep in mind, EMS still has to clean & restock before they can take another call. Hospitals are using EMS, employed by someone else, to supplement their ED staff. Risking the public's safety.
@@andreamurphy1126 yeah it is. On the east coast (Baltimore-DC area) ambulances are regularly stuck at hospitals for 3+ hours at a time. The hospitals are abusing ambulances as extra bed space, refusing to take over care of the pt.
Hospitals don't have the staff either to take responsibility within 10 minutes (if the patient isn't critical). You can't pull EMTs or medics out of a hat to solve this issue in the same way you can't pull nurses out of a hat. It's a huge systemwide shortage of healthcare workers in general in addition to the public wasting the time of EMS with 2 AM toepain and abdominal pain calls, which hospitals also have to deal with when they arrive and monitor for hours. No easy fix.
Country wide issue that I'm convince will never be solved. I made more money at Fedex year 1 than the FDNY ems after 4 years on. EMS is the best job in the world in theory, but once you work some years you recognize this isn't what they fed you in EMT school.
San Diego Fire definitely needs to take over the Ambulance/Paramedic Service. My FD did this years ago and the difference is like day & night. FD Paramedic Rescue Ambulances run only dedicated 9-1-1 calls in their service area.... No interfacility transfers or non-emergency runs that tie up ambulances. It is also much cheaper to run an FD Paramedic Ambulance service.... as the "for profit" aspect is removed from the provider in question.
Like many, when I had an actual emergency I drove myself. Was I safe to drive? Probably not. I could not afford the 3-5k an ambulance would have cost and there was no one else to help me during Covid. Most people have no idea an ambulance is totally private. This is what needs to change. Make it public and unionized like police and fire. It’s an essential public service and must be maintained that way so it serves people.
