Scarce Supply

Chris Goodrich decided to become a paramedic for the sheer thrill of it - of trying to administer CPR in the back of a fast-moving ambulance, of opening someone's airway so they can breathe, of helping to save a life.

But he doubts he'll stay in the profession for good.

"I'm giving it a good five years, at least," said Goodrich, 24, who is in the basic emergency-medical technician class at The University of Texas at Brownsville and Texas Southmost College. "Eventually, I'll need to make more money ... but right now, my motivation is fulfillment. Saving a life is fulfilling."

Goodrich has three more semesters to go - and a national exam to pass - before he becomes a certified paramedic. In the region's training programs, most students drop out before reaching that point, however.

Because of low pay and numerous opportunities to work as a basic emergency-medical technician, the Rio Grande Valley is graduating fewer paramedics, and some local emergency services are seeing a shortage as a result.

"It's a cyclical thing - there are times when there are more openings, and times when we're fully staffed," said Rene Perez, director of transport services at South Texas Emergency Care Foundation, which provides emergency service to Harlingen and several cities in Cameron County. "Overall, there is a shortage of paramedics in the industry because not enough people are graduating."

At UTB-TSC, about 25 students usually start the one-semester, basic EMT course, said Adiel Garcia, program director for the emergency-medical science program. Of those, about half make it to the paramedic course, and only a handful complete it, he said.

About one-third of students quit because they find the program too challenging; another one-third drop out because with a basic certification, they already can work for an EMS organization, Garcia said.

Pay is also a major factor, he said.

"Sometimes, there's no incentive (to continue)," Garcia said. "You have all that extra responsibility and an extra year of school, and at some places you only make another $1 an hour."

But paramedics are definitely needed on the region's ambulances, he said. Paramedics have extra training in using medical equipment, can administer medicines and read heart monitors, which basic EMTs do not.

"We're still referred to as ambulance drivers, and it's not like that anymore," said Pete Moreno, coordinator of the EMT program at Texas State Technical College-Harlingen. "It's an ER on wheels."

Garcia is fond of an anecdote that appears in a recent national survey on EMT and paramedic pay. According to the survey, UPS drivers on average make more than a paramedic at the top of his or her salary range.

"Delivering patients earns you less money than delivering packages," Garcia said.

According to the survey, which appears in the October issue of the Journal of Emergency Medical Services, basic EMTs in the south central United States make a median of about $23,000 a year, and paramedics, $34,000. In Texas, the hourly median wage for EMTs and paramedics combined is $12.84 per hour, according to statistics from the U.S. Department of Labor.

Nurses, respiratory therapists and other health professionals make significantly more than EMTs and paramedics - registered nurses make a median of $57,000 per year, according to the Department of Labor. Respiratory therapists' median pay is about $47,000. Licensed vocational nurses make about $37,000.

"When you compare (pay ) to other medical professions, it's low," Moreno said.

In the McAllen-Edinburg-Mission metropolitan area, EMTs and paramedics' hourly median pay is $11.67 per hour. Some basic EMTs make as little as $7 an hour, and paramedics less than $9, local officials said.

Those numbers can be slightly misleading, though, because EMTs and paramedics log numerous hours of overtime, Moreno said.

Still, low pay stops many people from enrolling in EMT courses in the first place, Garcia speculated.

"Very few want to be paramedics as their first choice," he said. "Some want to go into nursing, but can't get in because there are limited slots in nursing schools, for example."

Many factors drive pay scales for EMTs and paramedics, including market forces and the low Medicaid and Medicare reimbursements EMS providers receive, Perez said.

"It's not that you don't want to pay more, but there are constraints on the business side," he said. 

As demand for nurses and other health-care professionals increases, local schools are seeing dwindling enrollment in EMT and paramedic courses.

At South Texas College, 42 students completed the basic EMT program in 2006, said EMT program coordinator Robert Gonzalez. The following year, about 30 students finished. Even fewer have completed the paramedic program - nine in 2006, and four the following year, he said.

"We get calls (from services) asking for more paramedics, but we don't have them right now," Gonzalez said.

STC also has a one-year program that allows paramedics to become registered nurses, so some students who complete the program never go to work as paramedics, he said.

"There's a big influx of students heading to the nursing program," Gonzalez said.

Some EMS providers say they haven't had trouble filling job openings - yet. But that could change, they said.

"Right now, we have enough to put two paramedics on each ambulance," Perez of South Texas Emergency Care Foundation said. "But some services just don't have enough."

The state requires all emergency vehicles to have at least two people certified in emergency care on board, but whether or not paramedics are required varies by the type of service the EMS organization provides, officials said.

Still, paramedics provide a higher level of care than other EMTs, and are an important presence, said Lenny Perez, Brownsville Fire Department chief. The city's EMS program is part of the fire department.

Brownsville requires all new hires to become certified as paramedics "to provide the highest quality of care," Perez said.

It's easier to attract and keep paramedics at the fire department because the combined firefighter/paramedic positions pay well, he said. Within two years, they make about $39,000.

Even if the pay is generally low, youthful idealism and energy will keep some people, like 23-year-old Jesse Montalvo, in the profession for a time.

"It's going to be exciting, but you can only do it for so long," said Montalvo, a UTB-TSC student in the EMT program.

After working as a paramedic for a few years, Montalvo plans to go to medical school.