EMS Survey - My comments, for what it's worth...

[vs-eh?]

I came across this a couple of weeks ago....

http://www.emsresponder.com/survey/

Has this ever been posted before?

I was going to comment on it then, but seeing the overwhelming banal posts of people so desperate to get into chat it kind of put me off. I see now that this has kind of tapered and hopefully people in EMS who can string a sentence or two together can comment on my comments, while reflecting on their own state/province (word to run on sentences).

Theme's that often appear in these forums are: education, wages, and respect. I will leave out the "vollie" issue, because I have never encountered it. I decided to look at the survey through the eye's of those issues. In my opinion, the main point that affects all three core issues comes down to this, judging by this survey...

You have too many fucking EMS personnel in any given state.

I decided to take my home province (Ontario) and compare it to a similarly sized American state (Pennsylvania). By size I am referring to population, not area (Ontario is approximately nine times the area of Pennsylvania). The stats for Ontario seem to be accurate, at least from my general knowledge and opinion. I am going to assume that they are generally as accurate for other provinces and states. The survey itself is from 2005.

Some interesting (shocking?) numbers...Ontario will always be the first number mentioned. If addition is required I approximated.

EMS personnel - 6600 vs. 49,200 (I didn't include MD's). The numbers for Ontario anyway seem to be accurate for the number of "actively practicing" paramedics in the province. I will assume it is similar for Pen.

EMS services - 50 vs. 1,400 (Excluded air, and I know there may be some overlap with services providing two or more levels of care)

Why is there such a HUGE difference in numbers and how does this affect the three key areas of wage, education, and respect?

1) I realize that our health care systems are significantly different. Does that account for the disparity in numbers? Is it simply a money game?

2) I realize that EMS and Fire are far more tightly linked in the US than in Canada. I also realize that many FF's are cross-trained to at least the EMT-B level (I assume). This is non-exsistant in Ontario.

3) I realize that education standards are very different.

This post is already to long. I will reserve further comments until later. Seven times the EMS personnel and in excess of 25 times the number of services. That is flabbergasting to me. It typifies to me the need for more specialization for EMS from fire and the need for (again) greater education. It is pretty hard to "get respect" from the public when there are so many people for a given population who are in "EMS".

More later....

[paramedicmike]

One thing I can address straight away, VS, is that Pennsylvania's numbers are skewed from the start. Not that you would know or have that information available to you. I don't know how PA disseminates this little tidbit of information.

The reason that the numbers are so high for PA is that PA certifications have *no* expiration date. I know several people certified as medics in PA. If they decide to move to California for 20 years and then come back, their certifications will still be valid. What's more, if they decide tomorrow that they'll never work another day as an EMS provider, their certs will still be valid until they die.

Of that number you listed, only a percentage are actually working as active EMS providers. Unfortunately, to my knowledge, there is no tracking how many of that total number is active.

But it's still a rather disgusting looking number in comparison, isn't it?

Does the US have too many EMS providers? Absolutely. If I remember correctly, this has been touched on several times in these forums with regards to EMT mills and all the other shady ways to try and be something for little or no effort.

How does it affect wage, education and respect? Negatively, just like one would think it might. Many of those are rural volunteer providers who have a hard time keeping current (if they make such an effort) given the demands of their lives.

I don't think it's a money game. Much of the Commonwealth is rural. There are a multitude of rural volunteer agencies that act more as social clubs with the shiny trucks in the bays. Although, I suppose it could be a money game in the sense that with so many Johnny Bravo's wanting to do it for free allow the existence of so many volunteer organizations and very little in the way of paid positions.

I agree with your assessment that many paid FDs require their FFs to be EMTs as well. They may never use that training. But it still counts in the numbers game.

Hope this helps clarify some of the confusion. At the very least, it should be good to stop you from beating your head against the wall in an attempt to understand what's going on down here.

-be safe

[BEorP]

One thing I can address straight away, VS, is that Pennsylvania's numbers are skewed from the start. Not that you would know or have that information available to you. I don't know how PA disseminates this little tidbit of information.

The reason that the numbers are so high for PA is that PA certifications have *no* expiration date.

The Ontario A-EMCA also has no expiration date, but it seems as though they only included active Paramedics in the numbers for Ontario in this survey. (Maybe I missed it somewhere and they explicitly stated that they were only counting active for Ontario but were counting all certified for PA.)

[mediccjh]

V/S, Mike is correct...once you are a Paramedic in Pennsylvania, you are one for life; however, you are required to attain 18 hrs of continuing education and have your Service Medical Director sign off for you to practice. That is why the PA EMT-P numbers are skewed.