sdiener

haha .... touche.

http://www.vidacare.com/reports/Insertion%201.mpg

"The whole PUM concept is a joke. It has not worked out anywhere it has been implemented. The dickwads that sell it (Fitch and Associates and some other idiot) make all sorts of promises about how it will save the area huge money and will pay for itself within so many years. It never has. It never will. They always end up spending more money than they ever have had to before. Subsidies go up, not down. Response times go up, not down. None of the promises are ever fulfilled. " Dustdevil, Please excuse me for I am sure I do not have the backing of your experience, and I definately don't proclaim to be an expert... but in persuit of an academic debate: Where is the proof that the PUM concept is a joke? SSM and Dynamic deployment, response time reliability, a dedicated medical control board, oversight by an authority - if practiced correctly, these will make for an excellent EMS system for the PATIENT. Obviously in terms of the provider, the PUM system sucks balls... but then again, do we forget that we are here for other reasons than to play with loud boxes that have flashy red lights on them? In my examination of the Tulsa, KCMO, Pinellas County systems, these all appear to be well run systems with the PATIENT in the forefront of the decisisons. Paramedics plus has replaced AMR in several cases with great success. Providers are somewhat happy, they get great experience, and they get out and go to the fire department, or a cushy third service (godwilling). Yes, you sit in an ambulance for 12 hours, your unit is probably run ragged, benefits are crap, pay is crap, you eventually hate your job, and like I said want to get out. But the system in theory works; for cheaper than what you would pay for a huge fire department based system Lets take Baltimore City for example. Population close to a million, high density, hospitals close together, two 8 hour day shifts, two 14 hour night shifts. All 22 medics are on 24 hours a day. Taking computer records, and my memory may be a little hazy, The biggest call volume of the day is at 3:00 in the afternoon and the evening hours of friday, saturday, and sunday. The computers can show you this. There are NEVER 22 calls at 3:00 in the morning. In fact the most at that time of night might have been maybe 7 going at any one time. Yet the city is still paying 44 providers (sometimes 2 medics per ambulance, sometimes 1), 24 hours a day, 365 days a year. This is a tremendous disallocation of resources. In addition, ambulances are pretty much randomly dispatched wherever they are needed. When I was riding, in the city, a 20 minute response time was NOTHING. And this is because they didn't know where the units where. Oh, and medical accountibility, hah! There are great paramedics, but there are some downright AWFUL providers in there as well. However, lets say you had 22 ambulances on dynamic deployment shifts, with SSM, and geolocation. Same pay, same benefts. However, now you added non emergency transports, and interfacility transports to the mix. Well, now you make more money because the non emergency transports actually pay - as opposed to those citydwellers that we all love. You can actually operate off of less a budget than before because the non emergency transports subsidize your emergency transports. Or keep the same budget, and you can now afford new ambulances, or god for bid, other benefits for your providers. PUMS will only work though if certain conditions are met, including a dense population, about 1 million people, the monopoly of a provider, and if old data has been kept. As I said, the providers hate PUMS, because they stay busy as all hell. However, the patient and the taxpayer benefit in the end. What do ya think? BTW, from what I can tell, AMR does suck at PUMS Sam

mmmmm cable

i am not sure where you can make 80,000 a year on no overtime anywhere within a 100 miles of richmond. However, I know that NJ pays their medics upwards of 21 an hour with plenty of overtime to spare. I bring this all up because, while I want a richmond-"esque" experience, I don't think 12 an hour would get me anywhere later. (except a medic/ff job somewhere else). Plus there is no human resource coordiantor, no director for RAA under the big Jerry... and just a lack of information when I called. However, Richmond was talking about some sort of incentive program addition. I smell a 50 cent raise. Good job AMR. Who has worked for them anyway? Anyone? Bueler.... Sam

Ok guys, So I have National Registry, and a Bachelor's in Emergency Health Services. Is it at all transferrable, or do I have to go back to school even further? I know this is posted, but different tid bits are all over the place and I can't put it all together. Sam

Just to let you all know, AMR in Richmond, VA is starting paramedics at 12.03 an hour.... How do you all feel about that? How do you live on that?

My Dad's a doc .... 60 hours a week, and he is 50 years old. He has made the same salary for probably 10 years. But medicare is collapsing, reimbursements suck, and yes its a minimum of 12 years to practice any kind of medicine. Did I mention that his Alma Matter, GW SOM, had 13,000 applicants for 150 spots. I wanted to go to medical school, so I got the Bachelors - with an extremely high gpa, I had the extracurriculars, and I would like to think I could have gotten in. But becoming a paramedic definately opened my eyes a little bit, and where else would I get to work truly independantly. However you cut it, paramedics are making their own patient care decisions. Those assessment skills we develop in the field are the same ones MDs and RNs learn in their classes. We intubate, do central lines (EJs), can give antibiotics (in wilderness ems), suture (on oil rigs). I see every paramedic as an MD... we just don't get paid as much. So maybe in the end I will end up a doc, but until I decide if I REALLY want to go, NREMT-P is as cool as MD. We even get more letters after our name!

Does anyone have any experience with sunstar ems in Pinellas County Florida. If so, what has it been. You can message me privately if you don't want to post here. Thanks Guys, Sam

FormerEMSlt .... I am kind of set on leaving maryland. It seems like they have fallen behind, and I don't feel it is neccessarily the best place for me to grow as a medic. Thanks guys for your feedback thus far.... where else looks good? Sam

p3 medic, I found it very interesting when i looked into Boston's ALS system works. Do they pay you as a BLS provider when you have an ALS cert? What makes an ALS provider want to work in a system that makes them function at the basic level?

I think that the quality of life would be extremely important to me. I would be moving away from my nice family in a nice home in maryland, and it would be nice to be in an area with a lot of young people like myself (22) to hang out with and an area with a lot of culture. I wouldn't like to get burned out, but I know that this is a byproduct of being a paramedic in any large city...... I guess I am looking for progressive systems, that treat their employees well, have a good record of service, in an area that would be suitable for someone like me. The location really isn't much of an issue.

Hey guys, Anyone here work, or did work for the RAA (AMR). What was your experience, good pay, benefits, etc...? How were the employees treated? Sam NREMT-P

Brothers, I am looking for jurisdictions that are EMS only, preferably not AMR, and progressive - such as Austin, Tx... Does anyone know of any? BTW - i am looking to get a lot of experience, and I am a new paramedic. I really am not into fighting fire. Thanks all Sam