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Re: Where are the Paramedics?

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I haven't ranted in a long time, so fair warning. Politically incorrect post

follows.

It is unrealistic to expect counties and communities with low tax bases to

fund paid EMS services at the same salaries that big cities pay.

Volunteers are, of course, very important, but they can't buy equipment and

trucks. Can't tell you how many fundraisers I've attended. Once raised

$17,000 in two days for a down payment on a new ambulance when ours broke

down. The bank lent the money at prime + nothing. We got a uniform and gas

allowance of, as I recall, $10.00 per call responded to, and most of us gave

it back to buy needed equipment. We bought our own pagers. Our wives baked

cakes and pies, and we stayed up all night burning briskets to sell the next

day and couldn't even get drunk because we were on call.

However, that is not the best way to approach this. We all pay exhorbitant

amounts in taxes. If you stop to think about it, we're taxed in every way a

greedy politician can think of. But how much of it goes back to the places

where it's needed for gut level services such as EMS and Fire and Law

enforcement? Not nearly enough. Recent grants for law enforcement resulted

in little towns going hog wild hiring police officers, only to have the grant

money run out and be faced with federal charges if they don't keep the

officers on. They didn't think it through, did they? They don't have the

money to keep them on, so all kinds of shady stuff is going on in these

cities to keep from having to pay it all back.

Instead of the federal government continuously cutting funding for EMS

reimbursements, we need a system of grants that would take up the slack and

fund these systems on a continuous basis. We also need state grants. Texas

sucks gas in the amount of money it spends on services. With surplusses

being touted by every politician, before we go cutting taxes for people with

6 figure incomes and corporations, we need to take care of our poor folks'

medical needs and that means paying some of those poor folks who have EMT and

Paramedic after their name a living wage to do what they love to do. BTW, if

you are mesmerized by thoughts of those great tax cuts both parties are

promising, take a cold shower. You won't see enough for a HappyMeal for your

family and a movie afterward. How many of you will retire with a 30 million

dollar pension granted you after just a few years work? Gee, he might just

have to pay too much in taxes. Won't it be peachy creamy for him to get a

tax cut? I'm sure he'll invest his savings in volunteer EMS services. BTW,

don't think I'm any more kindly toward the other politicians or the other

party. They're all pieces of doggie-doo as far as I'm concerned.

Now, I'm all for tax cuts, but let's start from the bottom, not the top. I

can't feel too sorry for somebody making a six figure salary. Let's hear it

for those making a LOW five figure salary first.

Tax cuts will in no way grow tax bases most of the rural communities of

Texas, unless they build a prison there. That seems to be the major growth

industry in Texas. What happens when we've got more people in jail than are

on the outside? Do y'all have any idea how much it takes to keep one

prisoner in maximum security? About twice and a half of the salary a

Correctional Officer makes. Who pays this? You, every time you buy

anything. Today we surpassed California in the number of people in prison.

Yet California has twice the population we do. And our crime rate is worse

than California. What's wrong here?

We also need to get out of the notion that EMTs and Paramedics are really not

medical care-givers but horizontal-taxi drivers. Some of our worst enemies

are those few but loud ER physicians who spout " evidence based medicine or

nothing " knowing full well that you can't do prospective double-blind studies

on people who are unconscious and emergent. I'm all for " evidence based

medicine " but let's get real about how it can be done. You'll never hear

Bledsoe or Bill knocking the value of EMS. It's only the very

elite nose-in-the-air six figure docs who practice in great trauma centers

who get patients 10 minutes after they're shot who tell the rest of us we

don't make a difference. We know we do, but so far we haven't done what we

need to do to prove it. Some evidence is empirical and perhaps will never be

proved statistically. But these doctors have the ear of politicians. They

can afford to buy $1,000 a plate dinner tickets, dress up in tuxedos and

mingle with the very rich and very politically powerful. And believe me they

do it. They promote their agendas in ways we can't even imagine. They never

promote gut-level EMS.

Rural paramedics could do basic clinic medicine and great home health care

with the education the new curriculum will give them if it's allowed to be

taught. But people are not going to go live and practice state of the art

prehospital medicine in West Barfington Falls (pop. 71 including today's

jackrabbits) for $21,000 a year when it takes half a tank of gas to get to

San Angelo to Walmart to buy groceries at a decent price.

Some paramedics don't want to do clinic medicine, give shots, and all the

stuff the nurses do because it's NOT ADRENALIN DRIVEN. Also, the nurses will

resist to the death the notion of paramedics treading on their turf, except

that none of them would be willing to live in WBF and work for $21,000

either. So it's not a matter of who, with what set of initials after their

name, does the work, it's a matter of paying whomever has the expertise a

reasonable and living wage to do it. The " whomever " happens to be Paramedics

with the National Standard Curriculum. We're the best qualified and equipped

to do this kind of medicine. We cannot do it under the old curriculum. But

we can if we adhere to the new curriculum. If you think it can't be done,

just visit Australia and see how they do it.

Now that leads me to the fact that we're largely our own worst enemy because

we (meaning EMTs and Paramedics) have failed and refused to band together for

our common good. Who belongs to an organization? Huh? Who? If you're not

a part of the solution, you're part of the problem. We happen to have an

organization called EMSAT, the stated purpose of which is to represent the

interests of the EMS community before legislative bodies and in every other

which way possible. It costs $35.00 a year. How many of you have taken the

trouble to join?

Don't whine about loss of jobs and diminishing services if you ain't

politically active. And don't think that somebody else will solve the

problems we're going to have within the next year. Services that serve rural

areas are going to drop like sheep pills because of the new HCFA rules

enacted by our dear friends in Congress.

Where will the volunteers be to take up the slack? I venture to say that

there won't be any increase in volunteers because those laid off from paid

services are not just going down the street to Rosie's Hide-a-Way and flip

hamburgers while still volunteering their services. Nope. Rosie's already

has Lester Eugene and PatsyMarie Ann flippin them burgers, fryin them

frizzen steaks, and warshin them dishes. Nope, the thrown-out medics will

make a sudden career change and either relocate or get serious about their

education and get into something that pays. A fork-lift operator at the

local Target warehouse makes a helluva lot more than a Licenced Paramedic

does in some systems. And has better benefits.

By the time people react to the crash of EMS, systems will have been

destroyed and services will have disappeared. I can name a county that gave

away a well-functioning system to an unproven but highly touted private

provider because of misplaced greed, only to find that the provider dumped

them when the goin got rough and they had to pick up the pieces and put it

all back together. NOW is the time to write, call, email and fax your local,

state, and national politicians to let them know you're MAD AS HELL AND

YOU'RE NOT GOING TO TAKE THIS. Do you even know who they are? Find out.

Also let them know that you're not going to allow some bean-counter making

$500,000 a year to tell you what doctor you can go to, what hospital you can

go to, that you can't call ems, and what prescription drugs you can have.

And that your EMS service has to be destroyed because they won't pay honest

reimbursements for services. And that you're not going to vote to re-elect

county commissioners who don't support EMS and you'll get out and work

against them. Maybe even some of you'd run for election on an EMS platform.

Personal note: I take Zestril (lisinopril) for hypertension. Now my HMO's

prescription plan has been taken over by Merck, and they've written me that

if I want to continue getting the best price for my prescriptions I must take

Prinivil (also lisinopril) instead. Guess who makes Prinivil?

Cousins, we're in for hell with a bob-war tail in EMS if we don't wake up and

make the politicians take notice of us. There's better than 40,000 of us in

the state of Texas, and we can make them notice us if we will. Yes, they're

bought and paid for, but the president of EXXON still has only one vote. As

one successful politician, Tip O'Neal, former Speaker of the House of

Representatives in Warshington said, " All politics is local. " We need to let

each and every single politician who " serves " us know each and every one of

us by name and that we'll vote on ONE ISSUE: EMS funding and the survival of

EMS in America.

One final thought. Our enemies in emergency medicine will always win until

we as gut-level providers have at least the educational credentials to prove

that we're reasonably safe to be cut loose on the poor unsuspecting public.

This means getting college degrees. The nurses did it. So can we.

My opinions are my own.

Gene Gandy

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Please, Please, Please....do not take this wrong, but a salary like $21,000

to $23,600 is not good. I can see why you are having trouble finding

paramedics. Paramedic saleries within the Houston area are between $35,000

to $50,000 with some folks making up to $70,000(putting in a lot of hours).

I just personally fell that Paramedics should not work for less than $32,000

per year. Have you ever wondered why a plumber or mechanic change so much

for the little bit of work they do. Well, we pay them...for not what they

did but, for what they know. This needs to be our standards and nothing less

and..........STOP VOLUNTEERING.

You know, I was at the EMS conference one year and saw a cool t-shirt on

this guy. The front of the shirt read " what if they were no volunteers? "

This message was cute and moreso carried a follow-up to the front. This guy

had put the following on the back of this shirt which read " then they would

be paid " Funny yes.........

I come in peace and leave in peace

>XXXXXXXXXXXXXXXXX EMS in XXXXXXXXXXXXXX is looking for at least 1 Full-Time

>Paramedic and maybe a couple of on-call medics. We work 24 on/48 off Full

>time salary is around $21,000 to 23,600. Insurance, Holidays, yada yada

>yada....

>

>Thanks for listening,

>XXXXXXXXXXX

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Wow. I work for a small EMS in hire. Our budget hasn't had an

increase in 8 years, even though our call volume has increased 400%. If it

were not for our Volunteers, we'd pretty well grind to a halt. Do I wish I

got paid? You bet. Could I justify in my head, " I'm sorry ma'am I can't

come to the aid of your 2yr old daughter because we can't afford staff. "

Exaggeration, yes. But not by much. Thanks for reading..

Joe

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So what do these counties do that have a population of 15,000 or less? They

can barely pay their Sheriff's deputies. They wouldn't have a fire

department if it wasn't for their vollies. I know this will probably start

a fire storm but we got to realize that there are some poor counties out

there, who wouldn't have an EMS system without their volunteers. Some of

these big city systems got to realize that when you get out away from these

large metropolitian areas, reality sets in. We got some dirt poor

communities out there and their Volunteers have got some of the biggest

hearts in the business, because they are not in it for a pay check but to

actually serve their fellow citizen. They don't go looking for a paycheck

but how they can help out the old lady down the road on their own free time

with equipment they probably purchased out of their own pocket. Not to

mention their EMS system can barely buy uniforms.

I guess I am to new in this business to be caught up in all the politics. I

seem to want to be a paramedic for my own self enrichment, personal growth

and to give back to my community. What is it JFK said " Ask not what your

country can do for you but what you can do for your country. "

As our fellow brother pointed out, this is all said in love and respect.

Let the flames begin.

Sloan

- Re: [texasems-L] Where are the Paramedics?

Please, Please, Please....do not take this wrong, but a salary like $21,000

to $23,600 is not good. I can see why you are having trouble finding

paramedics. Paramedic saleries within the Houston area are between $35,000

to $50,000 with some folks making up to $70,000(putting in a lot of hours).

I just personally fell that Paramedics should not work for less than $32,000

per year. Have you ever wondered why a plumber or mechanic change so much

for the little bit of work they do. Well, we pay them...for not what they

did but, for what they know. This needs to be our standards and nothing less

and..........STOP VOLUNTEERING.

You know, I was at the EMS conference one year and saw a cool t-shirt on

this guy. The front of the shirt read " what if they were no volunteers? "

This message was cute and moreso carried a follow-up to the front. This guy

had put the following on the back of this shirt which read " then they would

be paid " Funny yes.........

I come in peace and leave in peace

>XXXXXXXXXXXXXXXXX EMS in XXXXXXXXXXXXXX is looking for at least 1 Full-Time

>Paramedic and maybe a couple of on-call medics. We work 24 on/48 off Full

>time salary is around $21,000 to 23,600. Insurance, Holidays, yada yada

>yada....

>

>Thanks for listening,

>XXXXXXXXXXX

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,

Please, Please, Please...do not take this wrong......I am a plumber, I am a

paramedic, I am a volunteer....and I know how to use spell check......

(sorry, you lit the flame-thrower and I couldn't pass it up). ... ;-) ...

I agree, the quoted salary you referenced seems very low. But, I don't

understand your logic about volunteerism. My experience has been that

volunteer services were created to fill a void when no other method of

providing adequate emergency response existed.

Maybe we should push for eliminating the 24/48 system. By my calculations,

an annual salary of $32,000 in a 24/48 system can be obtained by a rate of

$9.54 per hour based upon working 52 weeks a year and being paid O.T. for

all hours over 40 in any given week, but the same annual salary would

require a rate of $15.38 per hour based upon 40 hours weekly, 52 weeks a

year. Why that is almost a 65% increase in your hourly wage!!!!!

Makes more sense than blaming low salaries upon volunteerism.

Steve Tatum

p.s. .....it takes approximately 7 years to get that Master Plumber license

so I can do that " little bit of work " I do.

Re: [texasems-L] Where are the Paramedics?

> Please, Please, Please....do not take this wrong, but a salary like

$21,000

> to $23,600 is not good. I can see why you are having trouble finding

> paramedics. Paramedic saleries within the Houston area are between

$35,000

> to $50,000 with some folks making up to $70,000(putting in a lot of

hours).

>

> I just personally fell that Paramedics should not work for less than

$32,000

> per year. Have you ever wondered why a plumber or mechanic change so much

> for the little bit of work they do. Well, we pay them...for not what they

> did but, for what they know. This needs to be our standards and nothing

less

> and..........STOP VOLUNTEERING.

>

> You know, I was at the EMS conference one year and saw a cool t-shirt on

> this guy. The front of the shirt read " what if they were no volunteers? "

> This message was cute and moreso carried a follow-up to the front. This

guy

> had put the following on the back of this shirt which read " then they

would

> be paid " Funny yes.........

>

> I come in peace and leave in peace

>

>

>

>

> >XXXXXXXXXXXXXXXXX EMS in XXXXXXXXXXXXXX is looking for at least 1

Full-Time

> >Paramedic and maybe a couple of on-call medics. We work 24 on/48 off Full

> >time salary is around $21,000 to 23,600. Insurance, Holidays, yada yada

> >yada....

> >

> >Thanks for listening,

> >XXXXXXXXXXX

>

> _________________________________________________________________________

> Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

> Share information about yourself, create your own public profile at

> http://profiles.msn.com.

>

>

>

>

>

>

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- You're comparing apples and oranges.

We ALL support the work of volunteer firefighters

and medics; in fact, I bet a survey would show

you that a surprising number of us started as

volunteers somewhere. However, I am no longer a

volunteer Firefighter/EMT; I'm a PAID FF/EMT.

You can not expect me to bring my 17 years of

fire and EMS experience to your county, along

with my wife and three children, for $23K/year.

Ain't happening for two reasons: First, my 17

years of experience and training is worth more

than $23K. Second, I work two jobs to make ends

meet now, and my SIDE JOB pays more than $23K.

You do the math.

You can not compare the motivation of a local

volunteer who is gainfully employed in your town

with a paramedic who answers an employment

advertisement. Each person has different reasons

for doing what they do. I'm not saying that a

paid person provides better service than a

volunteer or vice versa. What I am saying is

that you're going to have to motivate me more

than $23K/year to move to west Texas, and I'm

sure I'm not the only person who feels that way.

This is not a flame by any means; I'm simply

trying to explain to you that your inability to

find a medic who will move to west Texas for

$23K/year shouldn't surprise you too much. After

all, if you're going to move somewhere anyway,

wouldn't you move somewhere that you can make a

living wage?

stay safe - phil

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Uvalde and San is in the same boat. Any medics who don't want to go

to W. Tx can call me. Mike (830)278-2855

[texasems-L] Where are the Paramedics?

>Just checking, but is it just me or is there a lack of Paramedics out

there?

>I have seen several ads looking for Medics, and we recently ran an Ad for a

>Paramedic and had just a few respond.

>

>So if anyone knows of any medics who whish to work in West Texas, here goes

>our ad.

>

> County EMS in Colorado City is looking for at least 1 Full-Time

>Paramedic and maybe a couple of on-call medics. We work 24 on/48 off Full

>time salary is around $21,000 to 23,600. Insurance, Holidays, yada yada

>yada.... Now we cant pay like East Texas does, but hmmm. we got good

>Bar-B-Q.

>

>Thanks for listening,

>

>

>Please call to have an application sent to you.

>

>

>_________________________________________________________________________

>Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

>Share information about yourself, create your own public profile at

>http://profiles.msn.com.

>

>

>

>

>

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I am sorry but if it wasn't for US VOL. then the man in the car accident out

here would have died becuse of time response for mbulance from town to reach

us.

Re: [texasems-L] Where are the Paramedics?

> Please, Please, Please....do not take this wrong, but a salary like

$21,000

> to $23,600 is not good. I can see why you are having trouble finding

> paramedics. Paramedic saleries within the Houston area are between

$35,000

> to $50,000 with some folks making up to $70,000(putting in a lot of

hours).

>

> I just personally fell that Paramedics should not work for less than

$32,000

> per year. Have you ever wondered why a plumber or mechanic change so much

> for the little bit of work they do. Well, we pay them...for not what they

> did but, for what they know. This needs to be our standards and nothing

less

> and..........STOP VOLUNTEERING.

>

> You know, I was at the EMS conference one year and saw a cool t-shirt on

> this guy. The front of the shirt read " what if they were no volunteers? "

> This message was cute and moreso carried a follow-up to the front. This

guy

> had put the following on the back of this shirt which read " then they

would

> be paid " Funny yes.........

>

> I come in peace and leave in peace

>

>

>

>

> >XXXXXXXXXXXXXXXXX EMS in XXXXXXXXXXXXXX is looking for at least 1

Full-Time

> >Paramedic and maybe a couple of on-call medics. We work 24 on/48 off Full

> >time salary is around $21,000 to 23,600. Insurance, Holidays, yada yada

> >yada....

> >

> >Thanks for listening,

> >XXXXXXXXXXX

>

> _________________________________________________________________________

> Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

> Share information about yourself, create your own public profile at

> http://profiles.msn.com.

>

>

>

>

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<

,

It may not matter to some people...it may not matter at all. But speaking for

myself and myself alone I will not stop volunteering out of some petty hope

that someone significant will die and I'll suddenly get a paycheck. I went

into EMS because I had a genuine desire to help people and because there is

nothing cooler than speeding down the highway with lights and sirens blaring.

I do this for money so I can support myself but I also volunteer because I

know that without me my community service will be another person short and

that may make a difference at 4am when we have to roll-over a call to the

paid service in the next town because no one else was there to make a legal

truck. I volunteer because it is my community and because one day it could be

myself, someone in my family, or someone I knew growing up with who needs

that ambulance. I will not give up my life, one of theirs, or anyone else's

(weather it be the wealthy town lady or the vagrant that paws through trash

cans) just so we can be paid for that work.

<What is it that

<make us VOLUNTEER.

<

It isn't a virus. That's for sure.

<By the way, how many nurses to you see volunteering their time. I think we

<are the only profession that really puts our jobs before our families. Do

<we not care about them, too.

<

This is a rather moot point but do you know how many nurses I know who work

ungodly hours away from their homes, their families, their spouses? They may

stay in it for the money or because they don't have the time or motivation to

make a career change but most do it because they genuinely love the work and

can't see themselves doing anything else. Do you honestly think that for us

in EMS a paycheck will make a difference? Paid or volunteer we will all put

our jobs before our families. We do it when we work those 24/48 hour shifts

or when we respond to our pagers in the middle of dinner or before your kid's

volleyball game.

Let the debates begin.

Poe, EMT-I

lems222@...

cindyinthesky@...

Then the Lord said to Cain, " Where is your brother, Abel? "

" I don't know, " he replied. " Am I my brother's keeper? "

Genesis 4:9

This book is dedicated to Jesus Christ and the principles that He taught. Two

thousands ago His parable of the Good Samaritan set the standards to which we

in EMS still strive to meet.

Emory , MD, FACEP

Basic Trauma Life Support, fourth edition.

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Hot and heavy about volunteering.

I say it again...DO NOT VOLUNTEER. Make them pay you for what you know.

There is money and I assure you the first time someone dies because there

was not a paramedic around (if that even matters) it will change.

Have you ever picked up a newspaper and read about the child that died

because there were no ambulance available. What do you really think was the

end result. They added more ambulances and they found a way, they always

do.

I know some of you can sit and honestly say, that crap happens around your

town every day but, still you try and push for more people and equipment and

still your hit with the big " no " . Unfortunately, just you or I meeting

death still will not pave the way to that new truck. It must take someone

like a county commissioner, county judge, city counsel person or some one

with a hell of alot of money.

By the way, how many nurses to you see volunteering their time. I think we

are the only profession that really puts our jobs before our families. Do

we not care about them, too. Why is most of the world, after their

education, start a family, buy a new home and live happy lives. But,

paramedics, after education, find a another job (aside from the one they

really care about, EMS) and volunteer. Is it the Pager that excites

everyone or maybe the discounts at the local Dairy Queen. What is it that

make us VOLUNTEER. It must be a virus.

However, before totally misunderstanding my POINT. I do not believe that a

city, county, or private paramedic is any better person or have better

skills than a volunteer. I know and work with many volunteers who can run

circles around this Paramedic. My point is DO NOT VOLUNTEER. MAKE THEM PAY

YOU.

P.S I supposed I really got off my original point about the low salary.

Raise the pay and you will get paramedic. Take make away from the doctors

or something. hehehehe

Come-on

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Hot and heavy about volunteering.

I say it again...DO NOT VOLUNTEER. Make them pay you for what you know.

There is money and I assure you the first time someone dies because there

was not a paramedic around (if that even matters) it will change.

Have you ever picked up a newspaper and read about the child that died

because there were no ambulance available. What do you really think was the

end result. They added more ambulances and they found a way, they always

do.

I know some of you can sit and honestly say, that crap happens around your

town every day but, still you try and push for more people and equipment and

still your hit with the big " no " . Unfortunately, just you or I meeting

death still will not pave the way to that new truck. It must take someone

like a county commissioner, county judge, city counsel person or some one

with a hell of alot of money.

By the way, how many nurses to you see volunteering their time. I think we

are the only profession that really puts our jobs before our families. Do

we not care about them, too. Why is most of the world, after their

education, start a family, buy a new home and live happy lives. But,

paramedics, after education, find a another job (aside from the one they

really care about, EMS) and volunteer. Is it the Pager that excites

everyone or maybe the discounts at the local Dairy Queen. What is it that

make us VOLUNTEER. It must be a virus.

However, before totally misunderstanding my POINT. I do not believe that a

city, county, or private paramedic is any better person or have better

skills than a volunteer. I know and work with many volunteers who can run

circles around this Paramedic. My point is DO NOT VOLUNTEER. MAKE THEM PAY

YOU.

P.S I supposed I really got off my original point about the low salary.

Raise the pay and you will get paramedic. Take make away from the doctors

or something. hehehehe

Come-on

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I just want to say that when you are offering $24,000 per year, it is best

to look towards the paramedics that are graduating from class. But when you

do this, you will have to worry about them leaving to work for a service in

a larger market for no less than $38K per year.

Junior

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Being a volunteer in West Texas and knowing how our economy is I can say

that if it was not for the volunteers out here than alot of people would not

be here. We have areas in which it takes an hour to get to a hosp. These

people leave there jobs to respond to a call because someday it may be them

that needs that Volunteer. And after all some of you who say to stop

volunteering may be passing thru our area and actually need one of us.

Should we stop volunteering when there is no Law in this state requiring

EMS/Fire service.

Frederick

West Odessa

Re: [texasems-L] Where are the Paramedics?

> I just want to say that when you are offering $24,000 per year, it is best

> to look towards the paramedics that are graduating from class. But when

you

> do this, you will have to worry about them leaving to work for a service

in

> a larger market for no less than $38K per year.

>

> Junior

>

>

>

>

>

>

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To all:

Gene makes very salient points. I work for one of those rural services in

West Texas. We make $3.33/hour with no benefits, something about us not being

real city employees because we respond from our homes to the station to pick up

the rig. We are on call 24/7. We average 250 calls a year, some of which occur

back to back or at the same time. We have 3 full-time Paramedics and 1

part-time. The part-timer has a " real " job elsewhere. When we mamage to get

time off, we are usually at the station doing paperwork, cleaning, ordering,

setting up classes, teaching, and generally keeping the service alive. This

year, in his infinite wisdom, our city manager decided to cut our budget by

$26,000. Mind you, this budget contained only nonessential items like rig

maintainance, supplies, our meager salaries, etc. There is no uniform budget.

(Do other services really buy uniforms for their staff? :-)) So far the city

seems blissfully ignorant that HCFA is going to decrease reimbursements and that

we will no longer be able to bring in about half our slated budget in

reinbursements.

Yes, " politics is local " and we have been to every city meeting, buttonholed

council members, and generally made ourselves vocal. Net result zero so far.

The mayor has even made the statement that " we can't afford you people " . This

when they pay the city administrator $40,000 a year and give the local golf

course $105,000 in free water, staff and equipment.

I know I'm venting, but this is the reality of small-town EMS in West Texas.

There are no easy answers. Being politically proactive is only part of the

equation. We have to be viewed as a profession and professionals before the

citizens we serve will take us seriously.

Jeanne E. Amis, RN, LP

Marfa, Texas

wegandy@... wrote:

> I haven't ranted in a long time, so fair warning. Politically incorrect post

> follows.

>

> It is unrealistic to expect counties and communities with low tax bases to

> fund paid EMS services at the same salaries that big cities pay.

>

> Volunteers are, of course, very important, but they can't buy equipment and

> trucks. Can't tell you how many fundraisers I've attended. Once raised

> $17,000 in two days for a down payment on a new ambulance when ours broke

> down. The bank lent the money at prime + nothing. We got a uniform and gas

> allowance of, as I recall, $10.00 per call responded to, and most of us gave

> it back to buy needed equipment. We bought our own pagers. Our wives baked

> cakes and pies, and we stayed up all night burning briskets to sell the next

> day and couldn't even get drunk because we were on call.

>

> However, that is not the best way to approach this. We all pay exhorbitant

> amounts in taxes. If you stop to think about it, we're taxed in every way a

> greedy politician can think of. But how much of it goes back to the places

> where it's needed for gut level services such as EMS and Fire and Law

> enforcement? Not nearly enough. Recent grants for law enforcement resulted

> in little towns going hog wild hiring police officers, only to have the grant

> money run out and be faced with federal charges if they don't keep the

> officers on. They didn't think it through, did they? They don't have the

> money to keep them on, so all kinds of shady stuff is going on in these

> cities to keep from having to pay it all back.

>

> Instead of the federal government continuously cutting funding for EMS

> reimbursements, we need a system of grants that would take up the slack and

> fund these systems on a continuous basis. We also need state grants. Texas

> sucks gas in the amount of money it spends on services. With surplusses

> being touted by every politician, before we go cutting taxes for people with

> 6 figure incomes and corporations, we need to take care of our poor folks'

> medical needs and that means paying some of those poor folks who have EMT and

> Paramedic after their name a living wage to do what they love to do. BTW, if

> you are mesmerized by thoughts of those great tax cuts both parties are

> promising, take a cold shower. You won't see enough for a HappyMeal for your

> family and a movie afterward. How many of you will retire with a 30 million

> dollar pension granted you after just a few years work? Gee, he might just

> have to pay too much in taxes. Won't it be peachy creamy for him to get a

> tax cut? I'm sure he'll invest his savings in volunteer EMS services. BTW,

> don't think I'm any more kindly toward the other politicians or the other

> party. They're all pieces of doggie-doo as far as I'm concerned.

>

> Now, I'm all for tax cuts, but let's start from the bottom, not the top. I

> can't feel too sorry for somebody making a six figure salary. Let's hear it

> for those making a LOW five figure salary first.

>

> Tax cuts will in no way grow tax bases most of the rural communities of

> Texas, unless they build a prison there. That seems to be the major growth

> industry in Texas. What happens when we've got more people in jail than are

> on the outside? Do y'all have any idea how much it takes to keep one

> prisoner in maximum security? About twice and a half of the salary a

> Correctional Officer makes. Who pays this? You, every time you buy

> anything. Today we surpassed California in the number of people in prison.

> Yet California has twice the population we do. And our crime rate is worse

> than California. What's wrong here?

>

> We also need to get out of the notion that EMTs and Paramedics are really not

> medical care-givers but horizontal-taxi drivers. Some of our worst enemies

> are those few but loud ER physicians who spout " evidence based medicine or

> nothing " knowing full well that you can't do prospective double-blind studies

> on people who are unconscious and emergent. I'm all for " evidence based

> medicine " but let's get real about how it can be done. You'll never hear

> Bledsoe or Bill knocking the value of EMS. It's only the very

> elite nose-in-the-air six figure docs who practice in great trauma centers

> who get patients 10 minutes after they're shot who tell the rest of us we

> don't make a difference. We know we do, but so far we haven't done what we

> need to do to prove it. Some evidence is empirical and perhaps will never be

> proved statistically. But these doctors have the ear of politicians. They

> can afford to buy $1,000 a plate dinner tickets, dress up in tuxedos and

> mingle with the very rich and very politically powerful. And believe me they

> do it. They promote their agendas in ways we can't even imagine. They never

> promote gut-level EMS.

>

> Rural paramedics could do basic clinic medicine and great home health care

> with the education the new curriculum will give them if it's allowed to be

> taught. But people are not going to go live and practice state of the art

> prehospital medicine in West Barfington Falls (pop. 71 including today's

> jackrabbits) for $21,000 a year when it takes half a tank of gas to get to

> San Angelo to Walmart to buy groceries at a decent price.

>

> Some paramedics don't want to do clinic medicine, give shots, and all the

> stuff the nurses do because it's NOT ADRENALIN DRIVEN. Also, the nurses will

> resist to the death the notion of paramedics treading on their turf, except

> that none of them would be willing to live in WBF and work for $21,000

> either. So it's not a matter of who, with what set of initials after their

> name, does the work, it's a matter of paying whomever has the expertise a

> reasonable and living wage to do it. The " whomever " happens to be Paramedics

> with the National Standard Curriculum. We're the best qualified and equipped

> to do this kind of medicine. We cannot do it under the old curriculum. But

> we can if we adhere to the new curriculum. If you think it can't be done,

> just visit Australia and see how they do it.

>

> Now that leads me to the fact that we're largely our own worst enemy because

> we (meaning EMTs and Paramedics) have failed and refused to band together for

> our common good. Who belongs to an organization? Huh? Who? If you're not

> a part of the solution, you're part of the problem. We happen to have an

> organization called EMSAT, the stated purpose of which is to represent the

> interests of the EMS community before legislative bodies and in every other

> which way possible. It costs $35.00 a year. How many of you have taken the

> trouble to join?

>

> Don't whine about loss of jobs and diminishing services if you ain't

> politically active. And don't think that somebody else will solve the

> problems we're going to have within the next year. Services that serve rural

> areas are going to drop like sheep pills because of the new HCFA rules

> enacted by our dear friends in Congress.

>

> Where will the volunteers be to take up the slack? I venture to say that

> there won't be any increase in volunteers because those laid off from paid

> services are not just going down the street to Rosie's Hide-a-Way and flip

> hamburgers while still volunteering their services. Nope. Rosie's already

> has Lester Eugene and PatsyMarie Ann flippin them burgers, fryin them

> frizzen steaks, and warshin them dishes. Nope, the thrown-out medics will

> make a sudden career change and either relocate or get serious about their

> education and get into something that pays. A fork-lift operator at the

> local Target warehouse makes a helluva lot more than a Licenced Paramedic

> does in some systems. And has better benefits.

>

> By the time people react to the crash of EMS, systems will have been

> destroyed and services will have disappeared. I can name a county that gave

> away a well-functioning system to an unproven but highly touted private

> provider because of misplaced greed, only to find that the provider dumped

> them when the goin got rough and they had to pick up the pieces and put it

> all back together. NOW is the time to write, call, email and fax your local,

> state, and national politicians to let them know you're MAD AS HELL AND

> YOU'RE NOT GOING TO TAKE THIS. Do you even know who they are? Find out.

> Also let them know that you're not going to allow some bean-counter making

> $500,000 a year to tell you what doctor you can go to, what hospital you can

> go to, that you can't call ems, and what prescription drugs you can have.

> And that your EMS service has to be destroyed because they won't pay honest

> reimbursements for services. And that you're not going to vote to re-elect

> county commissioners who don't support EMS and you'll get out and work

> against them. Maybe even some of you'd run for election on an EMS platform.

>

> Personal note: I take Zestril (lisinopril) for hypertension. Now my HMO's

> prescription plan has been taken over by Merck, and they've written me that

> if I want to continue getting the best price for my prescriptions I must take

> Prinivil (also lisinopril) instead. Guess who makes Prinivil?

>

> Cousins, we're in for hell with a bob-war tail in EMS if we don't wake up and

> make the politicians take notice of us. There's better than 40,000 of us in

> the state of Texas, and we can make them notice us if we will. Yes, they're

> bought and paid for, but the president of EXXON still has only one vote. As

> one successful politician, Tip O'Neal, former Speaker of the House of

> Representatives in Warshington said, " All politics is local. " We need to let

> each and every single politician who " serves " us know each and every one of

> us by name and that we'll vote on ONE ISSUE: EMS funding and the survival of

> EMS in America.

>

> One final thought. Our enemies in emergency medicine will always win until

> we as gut-level providers have at least the educational credentials to prove

> that we're reasonably safe to be cut loose on the poor unsuspecting public.

> This means getting college degrees. The nurses did it. So can we.

>

> My opinions are my own.

>

> Gene Gandy

>

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:

I think there is truth in what you are saying, but it is a bitter and

distasteful truth many of our brothers and sisters won't be able to swallow

without gagging.

In just about every profession I know, save one, it is considered

unprofessional to give of one's professional time and expertise for free. To

do so would tend to minimize the value of the knowledge and expertise being

provided and would harm the profession as a whole. The exception is the

legal profession, where a certain number of civil cases have traditionally

been handled pro bono. Even that is slowly giving way to firms' need to

spend more hours on revenue-producing cases in order to pay the higher

personnel costs they now must deal with.

I think, to a certain extent, it is true that many counties in Texas have

not found a way to pay for decent EMS personnel compensation over the years

because they knew they could depend on volunteers who would do their best

for free. However, now that volunteers are drying up and EMS services in

some areas can no longer reliably field responders 24/7, we have not seen

any move on the part of counties toward establishing paid departments or

personnel. I think it is because the money is NOT there, at least not just

lying around. In order to pay for this kind of service, county commissioners

and judges would have to increase taxes or divert funds away from other

popular programs. Even with the current prosperity, increasing taxes is a

good way not to be re-elected. It is also a sad fact that people don't even

tend to think of EMS until it is they who need it. It only becomes an issue

of public concern when something very local and very major occurs with EMS

at its focus. That kind of event usually results in a kneejerk reaction by

the politicos who are under pressure to do something (and usually don't take

the time to think things through first). Bottom line is that we can expect

no practical, sensible action regarding EMS from public officials if it

means new taxes or greater demands on existing revenues.

Now we come to your suggest that people stop volunteering. ly, if I

could hop into my handy-dandy chronoporter and jump back 20 or so years into

the past, that is a message I could cheerfully and honestly deliver. If much

of our EMS system had never become dependent on volunteers, I think things

would be different for all of us, probably better and more professional, but

possibly even worse than they are now.

Well, this is reality, not science fiction (but its a good idea for a short

story.... hmmm hold on while I jot a few notes here....), and there is no

way you can expect the remaining volunteers to make a choice between the

members of their communities, to whom they feel a duty, and the profession

they are part of. Many have left volunteer EMS and fire service over the

last few years and the ones remaining are holding on with all their might

because they know nothing is likely to take their place if they are gone.

It took 25 years for EMS to get to the state it is in today and merely doing

away with volunteers won't correct the salary inequities. A big part of the

problem is that EMS as it is normally played in Texas just doesn't have a

big enough role in the medical delivery system to be constantly visible and

to generate a high enough civic value. We focus on one or two specific

things, 911 calls and routine transfers. In many cities EMS is set up as a

secondary function for fire fighters, who often don't want it (which is

pretty lame considering they run more EMS calls than fire calls in most

systems). Most volunteer systems combine EMS with fire fighting and struggle

to pay for the basic necessities for either. In just about every system, EMS

is handled as a public safety function, which it shouldn't be. To correct

the salary, and other, problems EMS in Texas suffers will take time and a

shift in paradigms. We have to shift from the idea of EMS as a public safety

function to the concept of EMS as a public health function. We have to move

toward a time when EMS personnel focus on managing ALL the

out-of-clinical-site health needs of a community or a county. Only when the

value of EMS in the overall healthcare system increases by this means can we

expect the medics to see better salaries. They will pay for that by longer

duration of training, using the new national curriculum, and by the need to

hold EMS or allied-health degrees. Fire-based EMS systems will either have

to adopt EMS as a primary function, equal and separate from fire suppression

divisions, and responsible to the public health system, or will have to get

out of EMS. Private EMS will have to recognize that this type of system is a

business opportunity because it offers more potential profit centers, but

must also abandon the common practices of underbidding what it actually

costs to provide service and then trying to save money by scimping on

paramedic salaries. All these things, and other things as well will all

have to happen if we want to see paramedics paid what they should be. Sad as

it is to say, saving lives on the streets alone just does not produce enough

value to justify improved salaries. As I said, a lot of paradigms will have

to shift. This kind of change in thinking often moves only slightly faster

than do tectonic plates, so I wouldn't count on all this unfolding real

soon. There's the pity. A lot of current conditions make this a perfect time

for EMS to move in this direction, but its too hard to shift our own

mindsets so we can get moving.

Dave

Re: [texasems-L] Where are the Paramedics?

>

> Hot and heavy about volunteering.

>

> I say it again...DO NOT VOLUNTEER. Make them pay you for what you know.

> There is money and I assure you the first time someone dies because there

> was not a paramedic around (if that even matters) it will change.

>

> Have you ever picked up a newspaper and read about the child that died

> because there were no ambulance available. What do you really think was

the

> end result. They added more ambulances and they found a way, they always

> do.

>

> I know some of you can sit and honestly say, that crap happens around your

> town every day but, still you try and push for more people and equipment

and

> still your hit with the big " no " . Unfortunately, just you or I meeting

> death still will not pave the way to that new truck. It must take someone

> like a county commissioner, county judge, city counsel person or some one

> with a hell of alot of money.

>

> By the way, how many nurses to you see volunteering their time. I think we

> are the only profession that really puts our jobs before our families. Do

> we not care about them, too. Why is most of the world, after their

> education, start a family, buy a new home and live happy lives. But,

> paramedics, after education, find a another job (aside from the one they

> really care about, EMS) and volunteer. Is it the Pager that excites

> everyone or maybe the discounts at the local Dairy Queen. What is it that

> make us VOLUNTEER. It must be a virus.

>

> However, before totally misunderstanding my POINT. I do not believe that

a

> city, county, or private paramedic is any better person or have better

> skills than a volunteer. I know and work with many volunteers who can run

> circles around this Paramedic. My point is DO NOT VOLUNTEER. MAKE THEM

PAY

> YOU.

>

> P.S I supposed I really got off my original point about the low salary.

> Raise the pay and you will get paramedic. Take make away from the doctors

> or something. hehehehe

>

> Come-on

>

>

>

> _________________________________________________________________________

> Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

> Share information about yourself, create your own public profile at

> http://profiles.msn.com.

>

>

>

>

>

>

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AMEN.

PS

- Re: [texasems-L] Where are the Paramedics?

<

,

It may not matter to some people...it may not matter at all. But speaking

for

myself and myself alone I will not stop volunteering out of some petty hope

that someone significant will die and I'll suddenly get a paycheck. I went

into EMS because I had a genuine desire to help people and because there is

nothing cooler than speeding down the highway with lights and sirens

blaring.

I do this for money so I can support myself but I also volunteer because I

know that without me my community service will be another person short and

that may make a difference at 4am when we have to roll-over a call to the

paid service in the next town because no one else was there to make a legal

truck. I volunteer because it is my community and because one day it could

be

myself, someone in my family, or someone I knew growing up with who needs

that ambulance. I will not give up my life, one of theirs, or anyone else's

(weather it be the wealthy town lady or the vagrant that paws through trash

cans) just so we can be paid for that work.

<What is it that

<make us VOLUNTEER.

<

It isn't a virus. That's for sure.

<By the way, how many nurses to you see volunteering their time. I think we

<are the only profession that really puts our jobs before our families. Do

<we not care about them, too.

<

This is a rather moot point but do you know how many nurses I know who work

ungodly hours away from their homes, their families, their spouses? They may

stay in it for the money or because they don't have the time or motivation

to

make a career change but most do it because they genuinely love the work and

can't see themselves doing anything else. Do you honestly think that for us

in EMS a paycheck will make a difference? Paid or volunteer we will all put

our jobs before our families. We do it when we work those 24/48 hour shifts

or when we respond to our pagers in the middle of dinner or before your

kid's

volleyball game.

Let the debates begin.

Poe, EMT-I

lems222@...

cindyinthesky@...

Then the Lord said to Cain, " Where is your brother, Abel? "

" I don't know, " he replied. " Am I my brother's keeper? "

Genesis 4:9

This book is dedicated to Jesus Christ and the principles that He taught.

Two

thousands ago His parable of the Good Samaritan set the standards to which

we

in EMS still strive to meet.

Emory , MD, FACEP

Basic Trauma Life Support, fourth edition.

______________________________________________

FREE Personalized Email at Mail.com

Sign up at http://www.mail.com/?sr=signup

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; The problem with your argument is that in many areas the volunteers

are the only option for their own friends and family. The dead child you

speak of could be the son or daughter of a close friend or family member.

How could you live with yourself if you refused to wear the pager and

someone you know died as a result of lack of response. I both volunteer and

manage a good size paid service. I know that wages are low but I also know

that the volunteer is the heartbeat of EMS. I am aware that our politicians

will not fork over big bucks until forced to. I am just not willing to

undergo the death and injury that will take place in the interim. M Farris

Re: [texasems-L] Where are the Paramedics?

>

>

>Hot and heavy about volunteering.

>

>I say it again...DO NOT VOLUNTEER. Make them pay you for what you know.

>There is money and I assure you the first time someone dies because there

>was not a paramedic around (if that even matters) it will change.

>

>Have you ever picked up a newspaper and read about the child that died

>because there were no ambulance available. What do you really think was

the

>end result. They added more ambulances and they found a way, they always

>do.

>

>I know some of you can sit and honestly say, that crap happens around your

>town every day but, still you try and push for more people and equipment

and

>still your hit with the big " no " . Unfortunately, just you or I meeting

>death still will not pave the way to that new truck. It must take someone

>like a county commissioner, county judge, city counsel person or some one

>with a hell of alot of money.

>

>By the way, how many nurses to you see volunteering their time. I think we

>are the only profession that really puts our jobs before our families. Do

>we not care about them, too. Why is most of the world, after their

>education, start a family, buy a new home and live happy lives. But,

>paramedics, after education, find a another job (aside from the one they

>really care about, EMS) and volunteer. Is it the Pager that excites

>everyone or maybe the discounts at the local Dairy Queen. What is it that

>make us VOLUNTEER. It must be a virus.

>

>However, before totally misunderstanding my POINT. I do not believe that a

>city, county, or private paramedic is any better person or have better

>skills than a volunteer. I know and work with many volunteers who can run

>circles around this Paramedic. My point is DO NOT VOLUNTEER. MAKE THEM

PAY

>YOU.

>

>P.S I supposed I really got off my original point about the low salary.

>Raise the pay and you will get paramedic. Take make away from the doctors

>or something. hehehehe

>

>Come-on

>

>

>

>_________________________________________________________________________

>Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

>Share information about yourself, create your own public profile at

>http://profiles.msn.com.

>

>

>

>

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Why should they give you money? the point you just proved is that you will

carry the service instead of your community supporting it. If you stopped

being taken for granted they will come around.

kelly bryan

>

>Reply-To: egroups

>To: egroups

>Subject: Re: [texasems-L] Where are the Paramedics?

>Date: Tue, 29 Aug 2000 08:57:07 -0700

>

>To all:

> Gene makes very salient points. I work for one of those rural

>services in

>West Texas. We make $3.33/hour with no benefits, something about us not

>being

>real city employees because we respond from our homes to the station to

>pick up

>the rig. We are on call 24/7. We average 250 calls a year, some of which

>occur

>back to back or at the same time. We have 3 full-time Paramedics and 1

>part-time. The part-timer has a " real " job elsewhere. When we mamage to

>get

>time off, we are usually at the station doing paperwork, cleaning,

>ordering,

>setting up classes, teaching, and generally keeping the service alive.

>This

>year, in his infinite wisdom, our city manager decided to cut our budget by

>$26,000. Mind you, this budget contained only nonessential items like rig

>maintainance, supplies, our meager salaries, etc. There is no uniform

>budget.

>(Do other services really buy uniforms for their staff? :-)) So far the

>city

>seems blissfully ignorant that HCFA is going to decrease reimbursements and

>that

>we will no longer be able to bring in about half our slated budget in

>reinbursements.

> Yes, " politics is local " and we have been to every city meeting,

>buttonholed

>council members, and generally made ourselves vocal. Net result zero so

>far.

>The mayor has even made the statement that " we can't afford you people " .

>This

>when they pay the city administrator $40,000 a year and give the local golf

>course $105,000 in free water, staff and equipment.

> I know I'm venting, but this is the reality of small-town EMS in West

>Texas.

>There are no easy answers. Being politically proactive is only part of the

>equation. We have to be viewed as a profession and professionals before

>the

>citizens we serve will take us seriously.

>Jeanne E. Amis, RN, LP

>Marfa, Texas

>

>wegandy@... wrote:

>

> > I haven't ranted in a long time, so fair warning. Politically incorrect

>post

> > follows.

> >

> > It is unrealistic to expect counties and communities with low tax bases

>to

> > fund paid EMS services at the same salaries that big cities pay.

> >

> > Volunteers are, of course, very important, but they can't buy equipment

>and

> > trucks. Can't tell you how many fundraisers I've attended. Once raised

> > $17,000 in two days for a down payment on a new ambulance when ours

>broke

> > down. The bank lent the money at prime + nothing. We got a uniform and

>gas

> > allowance of, as I recall, $10.00 per call responded to, and most of us

>gave

> > it back to buy needed equipment. We bought our own pagers. Our wives

>baked

> > cakes and pies, and we stayed up all night burning briskets to sell the

>next

> > day and couldn't even get drunk because we were on call.

> >

> > However, that is not the best way to approach this. We all pay

>exhorbitant

> > amounts in taxes. If you stop to think about it, we're taxed in every

>way a

> > greedy politician can think of. But how much of it goes back to the

>places

> > where it's needed for gut level services such as EMS and Fire and Law

> > enforcement? Not nearly enough. Recent grants for law enforcement

>resulted

> > in little towns going hog wild hiring police officers, only to have the

>grant

> > money run out and be faced with federal charges if they don't keep the

> > officers on. They didn't think it through, did they? They don't have

>the

> > money to keep them on, so all kinds of shady stuff is going on in these

> > cities to keep from having to pay it all back.

> >

> > Instead of the federal government continuously cutting funding for EMS

> > reimbursements, we need a system of grants that would take up the slack

>and

> > fund these systems on a continuous basis. We also need state grants.

>Texas

> > sucks gas in the amount of money it spends on services. With surplusses

> > being touted by every politician, before we go cutting taxes for people

>with

> > 6 figure incomes and corporations, we need to take care of our poor

>folks'

> > medical needs and that means paying some of those poor folks who have

>EMT and

> > Paramedic after their name a living wage to do what they love to do.

>BTW, if

> > you are mesmerized by thoughts of those great tax cuts both parties are

> > promising, take a cold shower. You won't see enough for a HappyMeal for

>your

> > family and a movie afterward. How many of you will retire with a 30

>million

> > dollar pension granted you after just a few years work? Gee, he might

>just

> > have to pay too much in taxes. Won't it be peachy creamy for him to get

>a

> > tax cut? I'm sure he'll invest his savings in volunteer EMS services.

>BTW,

> > don't think I'm any more kindly toward the other politicians or the

>other

> > party. They're all pieces of doggie-doo as far as I'm concerned.

> >

> > Now, I'm all for tax cuts, but let's start from the bottom, not the top.

> I

> > can't feel too sorry for somebody making a six figure salary. Let's

>hear it

> > for those making a LOW five figure salary first.

> >

> > Tax cuts will in no way grow tax bases most of the rural communities of

> > Texas, unless they build a prison there. That seems to be the major

>growth

> > industry in Texas. What happens when we've got more people in jail than

>are

> > on the outside? Do y'all have any idea how much it takes to keep one

> > prisoner in maximum security? About twice and a half of the salary a

> > Correctional Officer makes. Who pays this? You, every time you buy

> > anything. Today we surpassed California in the number of people in

>prison.

> > Yet California has twice the population we do. And our crime rate is

>worse

> > than California. What's wrong here?

> >

> > We also need to get out of the notion that EMTs and Paramedics are

>really not

> > medical care-givers but horizontal-taxi drivers. Some of our worst

>enemies

> > are those few but loud ER physicians who spout " evidence based medicine

>or

> > nothing " knowing full well that you can't do prospective double-blind

>studies

> > on people who are unconscious and emergent. I'm all for " evidence based

> > medicine " but let's get real about how it can be done. You'll never

>hear

> > Bledsoe or Bill knocking the value of EMS. It's only the

>very

> > elite nose-in-the-air six figure docs who practice in great trauma

>centers

> > who get patients 10 minutes after they're shot who tell the rest of us

>we

> > don't make a difference. We know we do, but so far we haven't done what

>we

> > need to do to prove it. Some evidence is empirical and perhaps will

>never be

> > proved statistically. But these doctors have the ear of politicians.

>They

> > can afford to buy $1,000 a plate dinner tickets, dress up in tuxedos and

> > mingle with the very rich and very politically powerful. And believe me

>they

> > do it. They promote their agendas in ways we can't even imagine. They

>never

> > promote gut-level EMS.

> >

> > Rural paramedics could do basic clinic medicine and great home health

>care

> > with the education the new curriculum will give them if it's allowed to

>be

> > taught. But people are not going to go live and practice state of the

>art

> > prehospital medicine in West Barfington Falls (pop. 71 including today's

> > jackrabbits) for $21,000 a year when it takes half a tank of gas to get

>to

> > San Angelo to Walmart to buy groceries at a decent price.

> >

> > Some paramedics don't want to do clinic medicine, give shots, and all

>the

> > stuff the nurses do because it's NOT ADRENALIN DRIVEN. Also, the nurses

>will

> > resist to the death the notion of paramedics treading on their turf,

>except

> > that none of them would be willing to live in WBF and work for $21,000

> > either. So it's not a matter of who, with what set of initials after

>their

> > name, does the work, it's a matter of paying whomever has the expertise

>a

> > reasonable and living wage to do it. The " whomever " happens to be

>Paramedics

> > with the National Standard Curriculum. We're the best qualified and

>equipped

> > to do this kind of medicine. We cannot do it under the old curriculum.

>But

> > we can if we adhere to the new curriculum. If you think it can't be

>done,

> > just visit Australia and see how they do it.

> >

> > Now that leads me to the fact that we're largely our own worst enemy

>because

> > we (meaning EMTs and Paramedics) have failed and refused to band

>together for

> > our common good. Who belongs to an organization? Huh? Who? If you're

>not

> > a part of the solution, you're part of the problem. We happen to have

>an

> > organization called EMSAT, the stated purpose of which is to represent

>the

> > interests of the EMS community before legislative bodies and in every

>other

> > which way possible. It costs $35.00 a year. How many of you have taken

>the

> > trouble to join?

> >

> > Don't whine about loss of jobs and diminishing services if you ain't

> > politically active. And don't think that somebody else will solve the

> > problems we're going to have within the next year. Services that serve

>rural

> > areas are going to drop like sheep pills because of the new HCFA rules

> > enacted by our dear friends in Congress.

> >

> > Where will the volunteers be to take up the slack? I venture to say

>that

> > there won't be any increase in volunteers because those laid off from

>paid

> > services are not just going down the street to Rosie's Hide-a-Way and

>flip

> > hamburgers while still volunteering their services. Nope. Rosie's

>already

> > has Lester Eugene and PatsyMarie Ann flippin them burgers, fryin them

> > frizzen steaks, and warshin them dishes. Nope, the thrown-out medics

>will

> > make a sudden career change and either relocate or get serious about

>their

> > education and get into something that pays. A fork-lift operator at the

> > local Target warehouse makes a helluva lot more than a Licenced

>Paramedic

> > does in some systems. And has better benefits.

> >

> > By the time people react to the crash of EMS, systems will have been

> > destroyed and services will have disappeared. I can name a county that

>gave

> > away a well-functioning system to an unproven but highly touted private

> > provider because of misplaced greed, only to find that the provider

>dumped

> > them when the goin got rough and they had to pick up the pieces and put

>it

> > all back together. NOW is the time to write, call, email and fax your

>local,

> > state, and national politicians to let them know you're MAD AS HELL AND

> > YOU'RE NOT GOING TO TAKE THIS. Do you even know who they are? Find

>out.

> > Also let them know that you're not going to allow some bean-counter

>making

> > $500,000 a year to tell you what doctor you can go to, what hospital you

>can

> > go to, that you can't call ems, and what prescription drugs you can

>have.

> > And that your EMS service has to be destroyed because they won't pay

>honest

> > reimbursements for services. And that you're not going to vote to

>re-elect

> > county commissioners who don't support EMS and you'll get out and work

> > against them. Maybe even some of you'd run for election on an EMS

>platform.

> >

> > Personal note: I take Zestril (lisinopril) for hypertension. Now my

>HMO's

> > prescription plan has been taken over by Merck, and they've written me

>that

> > if I want to continue getting the best price for my prescriptions I must

>take

> > Prinivil (also lisinopril) instead. Guess who makes Prinivil?

> >

> > Cousins, we're in for hell with a bob-war tail in EMS if we don't wake

>up and

> > make the politicians take notice of us. There's better than 40,000 of

>us in

> > the state of Texas, and we can make them notice us if we will. Yes,

>they're

> > bought and paid for, but the president of EXXON still has only one vote.

> As

> > one successful politician, Tip O'Neal, former Speaker of the House of

> > Representatives in Warshington said, " All politics is local. " We need

>to let

> > each and every single politician who " serves " us know each and every one

>of

> > us by name and that we'll vote on ONE ISSUE: EMS funding and the

>survival of

> > EMS in America.

> >

> > One final thought. Our enemies in emergency medicine will always win

>until

> > we as gut-level providers have at least the educational credentials to

>prove

> > that we're reasonably safe to be cut loose on the poor unsuspecting

>public.

> > This means getting college degrees. The nurses did it. So can we.

> >

> > My opinions are my own.

> >

> > Gene Gandy

> >

>

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Yes! When people find out there is not an EMS system in your areas because

it is so rural and there are no volunteers they will not come, hence, no

tourism! You hit the politicians in the the best place... their pockets!

You are missing the point, you are not being " dogged " for being a volunteer,

we are saying to you MAKE THEM PAY YOU FOR WHAT YOU KNOW!

kelly bryan

>

>Reply-To: egroups

>To: <egroups>

>Subject: Re: [texasems-L] Where are the Paramedics?

>Date: Tue, 29 Aug 2000 10:28:07 -0500

>

>Being a volunteer in West Texas and knowing how our economy is I can say

>that if it was not for the volunteers out here than alot of people would

>not

>be here. We have areas in which it takes an hour to get to a hosp. These

>people leave there jobs to respond to a call because someday it may be them

>that needs that Volunteer. And after all some of you who say to stop

>volunteering may be passing thru our area and actually need one of us.

>Should we stop volunteering when there is no Law in this state requiring

>EMS/Fire service.

>

> Frederick

>West Odessa

> Re: [texasems-L] Where are the Paramedics?

>

>

> > I just want to say that when you are offering $24,000 per year, it is

>best

> > to look towards the paramedics that are graduating from class. But when

>you

> > do this, you will have to worry about them leaving to work for a service

>in

> > a larger market for no less than $38K per year.

> >

> > Junior

> >

> >

> >

> >

> >

> >

>

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,

Saying " Don't Volunteer, Make them Pay You " is a nice sounding sentiment. Very

much like saying " You're worth more than $40,000. Don't work for less than

$50,000. Make them pay you more " . That dead child will surely motivate them in

that way as well, right?

Fact is, you don't have to volunteer. But many,many communties will not have an

EMS service if the volunteers cease to volunteer. They don't have to have one,

and as much as we like to think the public is on our side, the choice between

paying more taxes and having to get an ambulance from 30 miles away is not as

clear as you'd think ( " I hate more taxes! And besides, they can wait another 15

minutes can't they? Most folks are not really hurt or sick afterall, just

wasting my tax dollars " ). Trust me, it is that way.

So don't volunteer if you don't want. But they WON'T pay you.

=Steve=

wrote:

> Hot and heavy about volunteering.

>

> I say it again...DO NOT VOLUNTEER. Make them pay you for what you know.

> There is money and I assure you the first time someone dies because there

> was not a paramedic around (if that even matters) it will change.

>

> Have you ever picked up a newspaper and read about the child that died

> because there were no ambulance available. What do you really think was the

> end result. They added more ambulances and they found a way, they always

> do.

>

> I know some of you can sit and honestly say, that crap happens around your

> town every day but, still you try and push for more people and equipment and

> still your hit with the big " no " . Unfortunately, just you or I meeting

> death still will not pave the way to that new truck. It must take someone

> like a county commissioner, county judge, city counsel person or some one

> with a hell of alot of money.

>

> By the way, how many nurses to you see volunteering their time. I think we

> are the only profession that really puts our jobs before our families. Do

> we not care about them, too. Why is most of the world, after their

> education, start a family, buy a new home and live happy lives. But,

> paramedics, after education, find a another job (aside from the one they

> really care about, EMS) and volunteer. Is it the Pager that excites

> everyone or maybe the discounts at the local Dairy Queen. What is it that

> make us VOLUNTEER. It must be a virus.

>

> However, before totally misunderstanding my POINT. I do not believe that a

> city, county, or private paramedic is any better person or have better

> skills than a volunteer. I know and work with many volunteers who can run

> circles around this Paramedic. My point is DO NOT VOLUNTEER. MAKE THEM PAY

> YOU.

>

> P.S I supposed I really got off my original point about the low salary.

> Raise the pay and you will get paramedic. Take make away from the doctors

> or something. hehehehe

>

> Come-on

>

>

> _________________________________________________________________________

> Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

> Share information about yourself, create your own public profile at

> http://profiles.msn.com.

>

--

P. , CCP, EMT-P

Instructor Trainer NSC, AHA, ASHI

SPT Enterprises, Inc.

PO Box 294136

ville, TX 75029-4136

Phone

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Let the debate begin....

First off your job should not be put in front of your family, nothing upsets

me more than to go into a firestation and see wives standing there asking

their husbands when are they coming home ( of course they just brought

supper to the station for them). Children running around the fire hall

climbing in out of equipment that they always get hurt on and dad yelling at

them to get off that new pumper! Then you have the typical folks sitting

back smoking their cancer sticks, room so thick with smoke your eyesw water,

or they are standing out in the bay. Laughing and cussing and talking about

old war stories or the wreck they just went on. Important things children

need to hear. Then the folks start talking about Bob and Sue getting

a divorce because Sue said Bob worked 2 jobs to support the family and

he was never home because he was out volunteering with what little free time

he had. The last straw was when he left the babies 1st birthday because the

tones dropped, she begged him to stay but the citizens of our community

needed him. Where were the citizens of this great community when Bob

lost one of his jobs last year? Of course the volunteers where there to

help with the groceries because they are caring folks, where were the

citizens of this fine community? Not concerned about Bob but when

those tones drop, rest your worried little soul he is on his way....

You cannot tell me this is not true! You have missed the point! You are

intelligent, caring and NEEDED! We are not telling you to sacrifice

someones life here (haven't you learned yet that if GOD wants them he is

taking them not matter what you do). We are just saying make everyone

realize how wonderful a Paramedic is, and whether or not they want ot pay

for it they will have to because we as a whole are tired of being " ambulance

drivers " !

It would also distress me to know that you would leave your childs

activities to go and help Mrs. off of the toilet for the third time

today (or are you one of those who only responds to the " good calls " ). Your

child could have the greatest moment of their life and you missed it. I can

always explain to my child that Mommie was out making a living to put bread

on our table and those stupid Nike's on her feet. She can understand that.

These are my own thoughts, I share this e-mail with my husband, again these

are my conerns and mine alone.

EMT-P

>

>Reply-To: egroups

>To: egroups

>Subject: Re: [texasems-L] Where are the Paramedics?

>Date: Tue, 29 Aug 2000 17:16:41 -0400 (EDT)

>

>AMEN.

>

>PS

>

>- Re: [texasems-L] Where are the Paramedics?

>

>

>

><

>

>,

>It may not matter to some people...it may not matter at all. But speaking

>for

>myself and myself alone I will not stop volunteering out of some petty hope

>that someone significant will die and I'll suddenly get a paycheck. I went

>into EMS because I had a genuine desire to help people and because there is

>nothing cooler than speeding down the highway with lights and sirens

>blaring.

>I do this for money so I can support myself but I also volunteer because I

>know that without me my community service will be another person short and

>that may make a difference at 4am when we have to roll-over a call to the

>paid service in the next town because no one else was there to make a legal

>truck. I volunteer because it is my community and because one day it could

>be

>myself, someone in my family, or someone I knew growing up with who needs

>that ambulance. I will not give up my life, one of theirs, or anyone else's

>(weather it be the wealthy town lady or the vagrant that paws through trash

>cans) just so we can be paid for that work.

>

><What is it that

><make us VOLUNTEER.

><

>It isn't a virus. That's for sure.

>

><By the way, how many nurses to you see volunteering their time. I think we

><are the only profession that really puts our jobs before our families. Do

><we not care about them, too.

><

>This is a rather moot point but do you know how many nurses I know who work

>ungodly hours away from their homes, their families, their spouses? They

>may

>stay in it for the money or because they don't have the time or motivation

>to

>make a career change but most do it because they genuinely love the work

>and

>can't see themselves doing anything else. Do you honestly think that for us

>in EMS a paycheck will make a difference? Paid or volunteer we will all put

>our jobs before our families. We do it when we work those 24/48 hour shifts

>or when we respond to our pagers in the middle of dinner or before your

>kid's

>volleyball game.

>

>Let the debates begin.

>

> Poe, EMT-I

>

>lems222@...

>cindyinthesky@...

>

>Then the Lord said to Cain, " Where is your brother, Abel? "

> " I don't know, " he replied. " Am I my brother's keeper? "

>Genesis 4:9

>

>

>This book is dedicated to Jesus Christ and the principles that He taught.

>Two

>thousands ago His parable of the Good Samaritan set the standards to which

>we

>in EMS still strive to meet.

> Emory , MD, FACEP

>Basic Trauma Life Support, fourth edition.

>

>

>______________________________________________

>FREE Personalized Email at Mail.com

>Sign up at http://www.mail.com/?sr=signup

>

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We are not telling you to let folks die! Please get over that... I would

like to state, when you are standing at the doors of Consumer Credit

Counseling you will understand. We will always be ambulance drivers, my

apologies for trying to improve the pay and family lives of the EMS

community that is so greatly under appreciated, with an opinion on how to

hopefully make folks see. Therefore, I will continue to get may pay-check,

pay all of my bills, have plenty to put into savings for my early

retirement, go to all my childrens activities, spend my free time with my

family, and wash my dog with a clear concious. I would like to see the same

for you, but I will be content and accept your ideas as well. However, I

still feel that when you guys get tired of being taken for granted, things

will change, for the better for EMS.

Paid EMT-P

>

>Reply-To: egroups

>To: egroups

>Subject: Re: [texasems-L] Where are the Paramedics?

>Date: Tue, 29 Aug 2000 22:12:49 -0500

>

>,

>

>Saying " Don't Volunteer, Make them Pay You " is a nice sounding sentiment.

>Very

>much like saying " You're worth more than $40,000. Don't work for less than

>$50,000. Make them pay you more " . That dead child will surely motivate

>them in

>that way as well, right?

>

>Fact is, you don't have to volunteer. But many,many communties will not

>have an

>EMS service if the volunteers cease to volunteer. They don't have to have

>one,

>and as much as we like to think the public is on our side, the choice

>between

>paying more taxes and having to get an ambulance from 30 miles away is not

>as

>clear as you'd think ( " I hate more taxes! And besides, they can wait

>another 15

>minutes can't they? Most folks are not really hurt or sick afterall, just

>wasting my tax dollars " ). Trust me, it is that way.

>

>So don't volunteer if you don't want. But they WON'T pay you.

>

>=Steve=

>

> wrote:

>

> > Hot and heavy about volunteering.

> >

> > I say it again...DO NOT VOLUNTEER. Make them pay you for what you know.

> > There is money and I assure you the first time someone dies because

>there

> > was not a paramedic around (if that even matters) it will change.

> >

> > Have you ever picked up a newspaper and read about the child that died

> > because there were no ambulance available. What do you really think was

>the

> > end result. They added more ambulances and they found a way, they

>always

> > do.

> >

> > I know some of you can sit and honestly say, that crap happens around

>your

> > town every day but, still you try and push for more people and equipment

>and

> > still your hit with the big " no " . Unfortunately, just you or I meeting

> > death still will not pave the way to that new truck. It must take

>someone

> > like a county commissioner, county judge, city counsel person or some

>one

> > with a hell of alot of money.

> >

> > By the way, how many nurses to you see volunteering their time. I think

>we

> > are the only profession that really puts our jobs before our families.

>Do

> > we not care about them, too. Why is most of the world, after their

> > education, start a family, buy a new home and live happy lives. But,

> > paramedics, after education, find a another job (aside from the one they

> > really care about, EMS) and volunteer. Is it the Pager that excites

> > everyone or maybe the discounts at the local Dairy Queen. What is it

>that

> > make us VOLUNTEER. It must be a virus.

> >

> > However, before totally misunderstanding my POINT. I do not believe

>that a

> > city, county, or private paramedic is any better person or have better

> > skills than a volunteer. I know and work with many volunteers who can

>run

> > circles around this Paramedic. My point is DO NOT VOLUNTEER. MAKE THEM

>PAY

> > YOU.

> >

> > P.S I supposed I really got off my original point about the low salary.

> > Raise the pay and you will get paramedic. Take make away from the

>doctors

> > or something. hehehehe

> >

> > Come-on

> >

> >

> >

>_________________________________________________________________________

> > Get Your Private, Free E-mail from MSN Hotmail at

>http://www.hotmail.com.

> >

> > Share information about yourself, create your own public profile at

> > http://profiles.msn.com.

> >

>

>--

> P. , CCP, EMT-P

>Instructor Trainer NSC, AHA, ASHI

>SPT Enterprises, Inc.

>PO Box 294136

>ville, TX 75029-4136

>Phone

>

>

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just a quick question, who will take care of you or your family if you are

injured or even killed in the line of (volunteer) duty??? Is it really worth

that price?

Re: [texasems-L] Where are the Paramedics?

> To all:

> Gene makes very salient points. I work for one of those rural

services in

> West Texas. We make $3.33/hour with no benefits, something about us not

being

> real city employees because we respond from our homes to the station to

pick up

> the rig. We are on call 24/7. We average 250 calls a year, some of which

occur

> back to back or at the same time. We have 3 full-time Paramedics and 1

> part-time. The part-timer has a " real " job elsewhere. When we mamage to

get

> time off, we are usually at the station doing paperwork, cleaning,

ordering,

> setting up classes, teaching, and generally keeping the service alive.

This

> year, in his infinite wisdom, our city manager decided to cut our budget

by

> $26,000. Mind you, this budget contained only nonessential items like rig

> maintainance, supplies, our meager salaries, etc. There is no uniform

budget.

> (Do other services really buy uniforms for their staff? :-)) So far the

city

> seems blissfully ignorant that HCFA is going to decrease reimbursements

and that

> we will no longer be able to bring in about half our slated budget in

> reinbursements.

> Yes, " politics is local " and we have been to every city meeting,

buttonholed

> council members, and generally made ourselves vocal. Net result zero so

far.

> The mayor has even made the statement that " we can't afford you people " .

This

> when they pay the city administrator $40,000 a year and give the local

golf

> course $105,000 in free water, staff and equipment.

> I know I'm venting, but this is the reality of small-town EMS in West

Texas.

> There are no easy answers. Being politically proactive is only part of

the

> equation. We have to be viewed as a profession and professionals before

the

> citizens we serve will take us seriously.

> Jeanne E. Amis, RN, LP

> Marfa, Texas

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I just wanted to give you some insight on a service that is still going

strong and has been for over 24 years now. The West Volunteer Ambulance

Service currently has 69 volunteers ranging from ECA, to Paramedic level. I

would like to see everyone in EMS paid also. But, lets face it, it's not

going to happen. My service realized how hard it is to keep volunteers active

and on the call list several years ago. We recruit new volunteers and

potential students from either Mc Lennan Community College or from the Premed

courses at Baylor University. Most large " PAID " services will not offer new

EMS personnel straight out of school a chance at a job with all of the right

training to make sure they are comfortable with their skills before turning

them loose on the streets. What we offer them is a lot of training and hands

on with F.T.O.s that spend the extra time to make sure that if they can't do

the job that they are retrained until they can perform their skills and

function on the streets. Iam speaking from past services that have worked

with that gave you a set amount of hours and that if you were not cleared

than you were out the door. EMS education has always been set up to give the

student the BASIC knowledge to perform the skills to treat a patient in the

pre-hospital setting. But, the classes do not teach enough street smarts on

how to function in the real world.

These are proven facts from watching green EMS personnel straight out of

school. Paid services around me have an average of burn out level of two

years. But in those same services that have hired several of our volunteers

(after having Volunteered for about a year) are still working. Some for over

10 years or more. I have had over 23 volunteers in the last 9 years leave to

become doctors. Seven of the 23 currently are doctors and still try to stay

in contact with us. Because we helped them in the starting of their carrier.

My point is that volunteer services can and have helped build EMS services

that are running strong today, and the part that was stated earlier from

another writer about volunteers are not educated properly. My volunteers get

better on going continuing education than most of the services around us,

because they are not punching a time clock. We do not have to pay them for

those extra 10 hours a month for run review.

Tom Marek

West E.M.S.

Supervisor

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What rock have you been living under. Doctors have

given of their time to help people out when they could

not pay. Just look in the news of all of the cases,

where professionals give of their time.

It's called voluntering. Giving to others and not

expecting money in return. This is a concept and a

principle that this country was built on. Or did you

forget little things like that. Read the bible, it

might answer a few things for you.

I do not volunter to keep paid out, I do it because I

care about people and our county does not have enough

tax base to have all paid fire and ems. In fact we

have vol. police.

When we find more money, we hire more paid. Some

times there just is not enough money for every thing.

May be if all you are concerned about is money, you

need to go to college and learn a job that pays big

bucks. Of course that will mean that you have to

spend several years in school learning a profession.

--- Dave wrote:

> :

>

> I think there is truth in what you are saying, but

> it is a bitter and

> distasteful truth many of our brothers and sisters

> won't be able to swallow

> without gagging.

>

> In just about every profession I know, save one, it

> is considered

> unprofessional to give of one's professional time

> and expertise for free. To

> do so would tend to minimize the value of the

> knowledge and expertise being

> provided and would harm the profession as a whole.

> The exception is the

> legal profession, where a certain number of civil

> cases have traditionally

> been handled pro bono. Even that is slowly giving

> way to firms' need to

> spend more hours on revenue-producing cases in order

> to pay the higher

> personnel costs they now must deal with.

>

> I think, to a certain extent, it is true that many

> counties in Texas have

> not found a way to pay for decent EMS personnel

> compensation over the years

> because they knew they could depend on volunteers

> who would do their best

> for free. However, now that volunteers are drying up

> and EMS services in

> some areas can no longer reliably field responders

> 24/7, we have not seen

> any move on the part of counties toward establishing

> paid departments or

> personnel. I think it is because the money is NOT

> there, at least not just

> lying around. In order to pay for this kind of

> service, county commissioners

> and judges would have to increase taxes or divert

> funds away from other

> popular programs. Even with the current prosperity,

> increasing taxes is a

> good way not to be re-elected. It is also a sad fact

> that people don't even

> tend to think of EMS until it is they who need it.

> It only becomes an issue

> of public concern when something very local and very

> major occurs with EMS

> at its focus. That kind of event usually results in

> a kneejerk reaction by

> the politicos who are under pressure to do something

> (and usually don't take

> the time to think things through first). Bottom line

> is that we can expect

> no practical, sensible action regarding EMS from

> public officials if it

> means new taxes or greater demands on existing

> revenues.

>

> Now we come to your suggest that people stop

> volunteering. ly, if I

> could hop into my handy-dandy chronoporter and jump

> back 20 or so years into

> the past, that is a message I could cheerfully and

> honestly deliver. If much

> of our EMS system had never become dependent on

> volunteers, I think things

> would be different for all of us, probably better

> and more professional, but

> possibly even worse than they are now.

> Well, this is reality, not science fiction (but its

> a good idea for a short

> story.... hmmm hold on while I jot a few notes

> here....), and there is no

> way you can expect the remaining volunteers to make

> a choice between the

> members of their communities, to whom they feel a

> duty, and the profession

> they are part of. Many have left volunteer EMS and

> fire service over the

> last few years and the ones remaining are holding on

> with all their might

> because they know nothing is likely to take their

> place if they are gone.

>

> It took 25 years for EMS to get to the state it is

> in today and merely doing

> away with volunteers won't correct the salary

> inequities. A big part of the

> problem is that EMS as it is normally played in

> Texas just doesn't have a

> big enough role in the medical delivery system to be

> constantly visible and

> to generate a high enough civic value. We focus on

> one or two specific

> things, 911 calls and routine transfers. In many

> cities EMS is set up as a

> secondary function for fire fighters, who often

> don't want it (which is

> pretty lame considering they run more EMS calls than

> fire calls in most

> systems). Most volunteer systems combine EMS with

> fire fighting and struggle

> to pay for the basic necessities for either. In just

> about every system, EMS

> is handled as a public safety function, which it

> shouldn't be. To correct

> the salary, and other, problems EMS in Texas suffers

> will take time and a

> shift in paradigms. We have to shift from the idea

> of EMS as a public safety

> function to the concept of EMS as a public health

> function. We have to move

> toward a time when EMS personnel focus on managing

> ALL the

> out-of-clinical-site health needs of a community or

> a county. Only when the

> value of EMS in the overall healthcare system

> increases by this means can we

> expect the medics to see better salaries. They will

> pay for that by longer

> duration of training, using the new national

> curriculum, and by the need to

> hold EMS or allied-health degrees. Fire-based EMS

> systems will either have

> to adopt EMS as a primary function, equal and

> separate from fire suppression

> divisions, and responsible to the public health

> system, or will have to get

> out of EMS. Private EMS will have to recognize that

> this type of system is a

> business opportunity because it offers more

> potential profit centers, but

> must also abandon the common practices of

> underbidding what it actually

> costs to provide service and then trying to save

> money by scimping on

> paramedic salaries. All these things, and other

> things as well will all

> have to happen if we want to see paramedics paid

> what they should be. Sad as

> it is to say, saving lives on the streets alone just

> does not produce enough

> value to justify improved salaries. As I said, a lot

> of paradigms will have

> to shift. This kind of change in thinking often

> moves only slightly faster

> than do tectonic plates, so I wouldn't count on all

> this unfolding real

> soon. There's the pity. A lot of current conditions

> make this a perfect time

> for EMS to move in this direction, but its too hard

> to shift our own

> mindsets so we can get moving.

>

> Dave

> Re: [texasems-L] Where are the Paramedics?

>

>

> >

> > Hot and heavy about volunteering.

> >

> > I say it again...DO NOT VOLUNTEER. Make them pay

> you for what you know.

> > There is money and I assure you the first time

> someone dies because there

> > was not a paramedic around (if that even matters)

> it will change.

> >

> > Have you ever picked up a newspaper and read about

> the child that died

> > because there were no ambulance available. What

> do you really think was

> the

> > end result. They added more ambulances and they

> found a way, they always

> > do.

> >

> > I know some of you can sit and honestly say, that

> crap happens around your

> > town every day but, still you try and push for

> more people and equipment

> and

> > still your hit with the big " no " . Unfortunately,

> just you or I meeting

> > death still will not pave the way to that new

> truck. It must take someone

> > like a county commissioner, county judge, city

> counsel person or some one

> > with a hell of alot of money.

> >

> > By the way, how many nurses to you see

> volunteering their time. I think we

> > are the only profession that really puts our jobs

> before our families. Do

>

=== message truncated ===

__________________________________________________

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