I believe Sean Eddy knew he was playing with fire when he wrote his article on “5 Reasons Why EMS Doesn’t Deserve Higher Pay” posted at the Uniform Stories website. It certainly struck a chord with Adam Smolensky shortly after I posted a link on the High Performance EMS Facebook page. He later contacted me with the following “open letter” as a rebuttal (which did not meet the brevity guideline at the original website). I decided to publish the letter in its entirety, not to insult Sean, but to continue the debate he started. The tone almost made me reconsider publication, but then I considered the recent “What if we’re wrong-a-thon” challenge by blogger Brandon Oto at EMS Basics. So, in the spirit of debate and not wanting to squelch opinion (or even temper in this case), here is “An Open Letter To Author Sean Eddy. By Adam Smolensky, NR-Paramedic”
Why â€œ5 Reasons Why EMS Doesn’t Deserve Higher Payâ€ Demonstrates Basic Economic and EMS Ignorance
A few days ago Sean Eddy (SE) blogged â€œ5 Reasons Why EMS Doesn’t Deserve Higher Pay.â€ This poorly thought out and unsubstantiated personal rant deserves a response breaking down why it’s so wrong. It is not my intent to insult Mr. Eddy, although I will repeatedly do that. I write to him with the same flippant and condescending tone he chose to address his readers with. That being said, in his writing he made the decision to present himself and his experience as the primary and only source of all the information contained in his ramblings. I see it not as an ad hominem attack, but responding to what Mr. Eddy has fairly placed in the space of public comment. Namely: his ignorance.
This ignorance runs so deep that I am going to break down some of his misunderstandings sentence by sentence. All quotes are from Mr. Eddyâ€™s â€œ5 Reasons Why EMS Doesnâ€™t Deserve Higher Payâ€ posted on Uniform Stories unless otherwise indicated and sourced. From here on out Iâ€™ll address Mr. Eddy directly, as Iâ€™m considering this an open letter to him (it was an â€œOp-Edâ€ after all).
Letâ€™s dive right into the introduction of your writing, Sean.
â€œA lot of people arenâ€™t going to like what I have to say, but just because we donâ€™t like something, doesnâ€™t mean it shouldnâ€™t be said.â€ – SE
This is arguably the only part of your blog that could be construed by a rational person as true. Unfortunately for you, itâ€™s not true about what you have to say.
â€œLately, my EMS newsfeeds have been flooded with stories about the â€œoutrageâ€ over our wages.â€ – SE
No one cares about what â€œ…[your] newsfeeds have been flooded withâ€¦â€. What your â€œnewsfeedsâ€œ reflect are not much more than your personal internet habits (please, we donâ€™t want to know, incognito tabs are your friend). So, before you go deciding to fix all of EMSâ€™s problems with your infinite wisdom of: â€œâ€¦quit buying things [you] couldnâ€™t affordâ€¦â€œ, â€œâ€¦do the industry a favor and just quitâ€¦â€œ, and my personal favorite relational narrative advice of yours â€œBut you know what? I freaking grew upâ€¦â€œ, you might want to do a little more research than glancing at a picture on your tumblr account. I hate to be the one to break it to you but, judging by this tantrum you decided to so publicly post, you havenâ€™t quite achieved that life goal of growing up.
(Mr. Eddy is referring to the ongoing dispute in San Diego between the employees of Rural Metro, the current holder of the 911 contract for ambulance response in the city, and corporate Rural Metro over field employee pay rates.) 
You go on to say:
â€œIn some cases, EMTs and paramedics are even walking the streets, holding up signs DEMANDING that we â€˜receive the wages we deserve.â€™ â€œ – SE
Here we really get at the heart of one of your misunderstandings. A lot of the ignorance in these â€œ5 Reasonsâ€¦â€œ stems from the fact that you donâ€™t understand the definition of the word demand.
â€œYou keep using that word [demand], I do not think it means what you think it means. â€œ â€“ Inigo Montoya, The Princess Bride
You seem to think that â€œto demandâ€ is synonymous with â€œto begâ€. You imply that here:
â€œâ€¦ stand in the streets with my hands out waiting for someone to throw me a bone.” – SE
This couldnâ€™t be further from the truth and is where your thought process could be helped with a deeper understanding of democracy. Our society is a Republic (lands and infrastructure are shared â€œpublicâ€ goods) and then a democracy (majority rule), specifically America is a representative democracy (majority is represented by elected officials who make decisions / vote). Our entire system is built around the idea that you do exactly what the workforce in San Diego is doing to catalyze change. Those EMTâ€™s and Paramedics who are in your words â€œâ€¦ walking the streets, holding up signsâ€¦ â€¦with [their] hands out waiting for someone to throw [them] a bone.â€ Are continuing in the strongest and most honorable traditions of American democracy that exist. Your blatant mischaracterization of that, for what I would glean from your article is the purpose of narcissistic bragging, is disgusting. You embarrassed yourself, and thatâ€™s not a melodramatic overstatement. You insult every person that struggled throughout the American Labor Movement and expose your historic incompetence. It is childish to implicate that if we donâ€™t like it we can quit and move on when you say:
â€We werenâ€™t forced into this job. We applied, interviewed, tested and ACCEPTED a job offer that included an hourly rate. We gave our word that we would do our job to the best of our abilities for an agreed-upon salary.â€ – SE
Not only is this implication untrue, undemocratic, and totalitarian in nature, it has a very real misunderstanding of a basic economic principle bundled within it: agency. Letâ€™s address why your statement, misguided as it is, has no place in the discussion at all anyway though, just for fun.
That statement is an Ignoratio Elenchi, or â€œirrelevant conclusionâ€. You state that we werenâ€™t forced into this job and that we accepted an offer at an hourly rate, both true. Then the funny part: â€We gave our word that we would do our job to the best of our abilities for an agreed upon salary..â€. Do you imagine that agreement lasts forever? Your implication is that itâ€™s therefore shameful in some way to do what? You already made it clear you think â€œdemandingâ€ a raise is akin to begging for a hand out. As well as, that to actively seek higher pay by doing anything other than quitting is disgraceful, and that youâ€™re above such things. Do you see the logical disconnect here? No one agreed to indentured servitude for a fee and no one agreed to lifelong employment at a certain rate and no one agreed to not organize and advocate for the workforce. Your argument is an irrelevant conclusion because you are trying to imply that people are breaking some sort of honor based promise to do what? Never fight for a raise? This is a for-profit company we’re talking about and this is exactly how democratic capitalism works.
You are witnessing the market putting pressure on an employer through the individual actions of independent players that have economic and political agency. What you whine about, that employees should stand up for themselves, is literally whatâ€™s happening. Then you, in your narcissism, criticize them for doing it in a more difficult way than you did, by fighting instead of running to another system (as we see you mention below).
â€œBy going out and now complaining or making demands, we have effectively gone back on our word.â€ – SE
This is, and Iâ€™m not exaggerating, THE stupidest economic statement that may ever have been published about EMS. You might damn well deserve an award for that, honestly. You imagine that at will employment results in a loss of oneâ€™s economic agency to the point that it is â€…effectively [going] back on [your] word.â€ to fight for higher compensation. When someone accepts a job offer, itâ€™s not about their â€wordâ€. Itâ€™s a business agreement for services as a qualified Paramedic. In that role a Paramedic treats the public. Separate from the clinical aspect, the role of Paramedic in their personal life is primarily an economic one. You talked about growing up before, grownups donâ€™t provide professional services for poverty level compensation because Sean Eddy thinks that once you sign on to work in EMS you are honor bound to poverty or running away or working two jobs.
â€œWe Need Higher Education Standards
Can I say that again? WE NEED HIGHER EDUCATIONAL STANDARDS. You want to picket about something? Picket about that! And no, higher pay doesnâ€™t come first. You donâ€™t go to your local mediocre burger joint and voluntarily pay them double what they normally charge with the hopes that it will somehow motivate them to make a better burger. So why should our employers do it? After all, if all weâ€™ve been able to accomplish is to compare ourselves to fast food workers, then we have accomplished nothing. You want better pay? Produce a better product.â€œ – SE
This is an interesting point, itâ€™s wrong, but in an interesting way. You actually caught a lot of people in the social media response with this point who said that your delivery was flawed, but at least this idea was correct. Iâ€™m a huge advocate of increased education in EMS for all kinds of clinical reasons, unfortunately for your list, education has little to do causatively with pay.
You have a really drastic misunderstanding of the issue of wage stagnation and further-more, of the economic factors that determine pay in a workforce. According to the Economic Policy Institutes position on â€œCauses of Wage Stagnationâ€, specifically about the current status:
â€Low-wage Americans are not the only workers affected by stagnant wages and rising inequality. The middle class has also experienced stagnating hourly wages over the last generation, and even those with college degrees have seen no pay growth over the last 10 years. Since the late 1970s, wages for the bottom 70 percent of earners have been essentially stagnant, and between 2009 and 2013, real wages fell for the entire bottom 90 percent of the wage distribution. Even wages for the bottom 70 percent of four-year college graduates have been flat since 2000, and wages in most STEM (science, technology, engineering, and math) occupations have grown anemically over the past decade. â€ 
There are a host of factors that affect the wages of a workforce, but increased education standards arenâ€™t one of the ones EMS has to worry about in relation to pay. Increased education generally equals a higher pay rate inside of a high wage, high demand workforce. Overall, if you have a PhD in Comparative Latin Poetry about Flowers, you are going to have a hard time finding a market that employs you at a high wage. Inside the industry where that PhD would hypothetically work they might be paid above less educated workers but when compared across the board their PhD isnâ€™t going to get them anything intrinsically. The situation EMS finds itself in is the overall compensation bracket for the profession being too low, rather than the mobility from lower to higher paid practitioner. You have confused the two. Paramedics for instance, already make the top pay grade in the EMS industry for field personnel. A paramedic with a bachelors doesnâ€™t bring any value to the market above one without right now. Until they do (whether they should or not is another discussion) education isnâ€™t the solution youâ€™re making it out to be. There is no such thing as a BSP (Bachelors of Science in Paramedicine) the way there is a BSN (Bachelors of Science in Nursing) which directly makes a difference in clinical responsibility or positionâ€¦ or pay.
We see another example with doctors. Pay in the medical doctor profession is actively managed not by simply relying on the education of a doctor, but by regulating the number of doctors available and thereby manipulating the market to always have a high demand. That results in higher pay. According to a Duke Law article:
â€œIn other words, the AMA represents both the buyers and the sellers of physician services in determining the output of physicians. Given this anomalous position, it is difficult to believe that the AMA will ever permit the number of physicians to be produced that the public is willing to support with its patronage.â€ 
If higher educated professions are stagnating as well then exactly why do we need increased education standards to increase pay? Again, I support increased education standards for other reasons, but your logic is absolutely wrong when it comes to the issue of pay.
â€œWe Are Responsible for Our Own Actionsâ€ – SE
â€œWeâ€ really needed to hear that so â€œweâ€ can pull ourselves up by the bootstraps and achieve the American dream just like you did, Sean. Thanks. Weâ€™ve already discussed how demand doesnâ€™t mean â€œto begâ€. That pretty much explains where you came up with this half-cocked idea that picketing is anything but literally taking responsibility for their own situation. Your writing is so poor that you are now listing one of the most important things EMS workers could do to increase pay as a â€œreasonâ€ why they donâ€™t deserve it.
â€œYou want better pay? Produce a better product.â€ – SE
I realize that from the attitudes in this article you likely just found yourself introduced to Ayn Rand and are awash in wonderful libertarian economic ideas. You do realize that EMS isnâ€™t a commodity â€œproductâ€, right? No? Oh, well EMS is a public service. Thatâ€™s why private EMS companies contract with municipalities to provide emergency response. Additionally even in the inter-facility transport world, the product or service is entirely economically detached from the pay rate of providers. You are appropriating economic terminology you donâ€™t understand to try to frame the workforce as being to blame for not providing a â€œproductâ€ worthy of the pay they are demanding. A full explanation of market forces determining workforce pay is outside the scope of this letter, but I encourage you to read about it before insultingly opening your mouth again with things like â€œâ€¦so just shut up about it.â€œ I mean, clearly the workers in Apple factories are making fortunes since they are making a luxury, high quality product. At least by your logic.
â€œIf we want higher pay, we need to make changes all around.â€ – SE
This is called bad writing. It was easy to miss because you cleverly couched it in a lot of other really horrible writing and ideas, but I caught it. Your vague assertions illustrate what you really have to say: nothing. You donâ€™t understand any of the topics in your list much less the bigger economic picture of American EMS and hence, your article doesnâ€™t say anything. Weâ€™ll see that more clearly as you meander off on tangents and then struggle to conclude what isnâ€™t a coherent string of thoughts. What â€œâ€¦changes all around.â€ are you talking about? Change what? Be specific.
â€œWeâ€™re Not Looking At The Big Picture
We like to pretend that EMS financial problems begin and end with our paychecks. The fact is, we are an industry thatâ€™s still in its infancy. Our reimbursement structure has literally failed to the point of nearly collapsing the industry. Those services that donâ€™t have the luxury of a nice tax base are forced to employ measures like cost-shifting in order to make ends meet. Plus, letâ€™s not forget that payroll remains the single largest expense for most services. For the thousands of EMS services that are barely getting by with what little reimbursement they are getting, a massive increase in payroll expenses just isnâ€™t feasible. We are barking up the wrong tree here.â€ – SE
You keep saying that word [we]. I donâ€™t think it meansâ€¦ never mind.
In reading the above statement it sounds like you think that the compensation rate of employees is somehow reflective of the payment structure or income of the company they work for. In fact, thatâ€™s not the case at all. Thatâ€™s why clerks at the apple store and cashiers at Wallmart, despite working for some of the richest companies on the planet, arenâ€™t getting a cut of those profits. However, according to you, itâ€™s dishonorable or would be in some way â€œâ€¦going back on [their] wordâ€¦â€ to ask for more money as an employee. At a very basic level it is true that if a company doesnâ€™t have enough money coming in they would be unable to cover labor costs. That doesnâ€™t mean there is a causative relationship between corporate revenue and worker pay as you imply. Please enlighten the EMS world about how â€œlooking at the bigger pictureâ€ is why we donâ€™t deserve better pay in a more concrete way for us.
â€œWe Refuse To Give Up The â€œLife Saverâ€ Titleâ€ – SE
This is so out of left field and irrelevant that I question whether you thought through this â€œwritingâ€ at all before publishing it. Let me explain something to you Sean, not only do some of us save lives (I suspect you may not), but some people have even lost their lives in the pursuit of it. How many EMS helicopter crashes are we on this year so far? Now Iâ€™m not one to be melodramatic but your little â€œholier than thouâ€ preaching about how you are the humblest of providers and that anyone with the audacity to imagine they saved a life is a â€œâ€¦glory, hogging, selfish, simplisticâ€¦â€ person was shameful. Iâ€™m very sorry that your glory is being â€œhoggedâ€ by those people out there doing good work. And that your only recourse is to cry about it online, but Iâ€™m going to give you one guess as to who the narcissistic, glory-hogging, selfishâ€¦ well, you get the idea. Itâ€™s the person who said this bit of self-serving, completely lacking in any actual information or content, blatant brag:
â€œNobody owes me a thing and Iâ€™ll be damned if Iâ€™m going to stand in the streets with my hands out waiting for someone to throw me a bone. I took control of my life. I paid off debt, I learned how to budget, I quit buying things I couldnâ€™t afford and I prepared for financial emergencies. And guess what? I did it all on a…wait for it…EMS SALARY. Now I do cool things like go on trips, take on new hobbies and actually enjoy life. Funny how that becomes possible when I take action rather than stand around crying and waiting for someone to fix all my problems.â€ – SE
Aren’t you the bastion of self-congratulatory self-sufficiency that we should all emulate?! Or should we take a moment to point out that no, you didnâ€™t? In fact, you failed to make it and had to move somewhere else, somewhere easier. Is your solution that everyone should just abandon their families homes, friends, and lives, to move somewhere â€œwith a lower cost of livingâ€ like you? That is after-all what you responded to a successful, financially stable, 20+ year career San Diego Paramedic with in this Facebook post:
â€œAnd I did live and work in California. Guess what? I quit and moved to a place with a better cost of living. I didn’t blame anyone. I took control of my situation and found a place that better suited my needs and goals. So, no, I reject your invitation, because that would be stupid.â€– SE
Iâ€™m not going to address your comments about medical directors. Once again, they have no bearing on the topic at hand and are a desperate attempt at drawing a conclusion from sketchy and unclear associations that have no relationship in reality.
In reference to fast food workers you say:
â€œI guarantee you that your paycheck FAR exceeds what theyâ€™re making, so just shut up about it.â€ – SE
Gee, thanks Sean. This is going to feed a lot of people and pay a lot of bills, I see where your wisdom really impacts the community. Despite your guarantee, which I can only imagine is worth about as much as your â€œwordâ€ that binds you into indentured servitude, I donâ€™t feel comfortable just trusting you on this.
â€œMost of them are only employed part-time, donâ€™t enjoy the â€œtime-and-a-halfâ€ that we see working long-hour shifts, and donâ€™t have near the benefits package we doâ€ – SE
Ok, you forced me into it:
â€œYou keep using that word [we], I do not think it means what you think it means.â€ â€“ Inigo Montoya, The Princess Bride
Let’s just get one quick point about this out of the way before we get in to â€œweâ€. You’re telling us: â€œYou make more than â€œpart timeâ€ fast food workers while working full time as EMT’s and Paramedics with â€œlong-hourâ€ shifts.â€ And your entire point is that this is proof that we are paid adequately? You’re arguing that we should improve our â€œproductâ€ so that we can compete economically with part time fast food workers and you thought it was a good idea to write that down, put your name on it, and publish it? Do you read your own writing? How is the sentence you wrote above a logical statement about anything at all? It’s once again gibberish.
When you say â€œweâ€ who exactly are you talking about? What is â€œourâ€ benefits package that youâ€™re referring to? This is literally gibberish as well. You are alluding to some uniform system that â€œweâ€ all get benefits from in order to trick the inattentive reader into thinking we are all part of some organization that provides an apparently awesome â€œbenefits packageâ€. See, this is some of that horrible writing that I was talking about that you were able to use to camouflage some of the just bad writing. The only word for the above sentence is gibberish, literally. What we call this in the literate community is intellectual dishonesty.
In closing I would just like to summarize your, Sean Eddyâ€™s, opinion on â€œWhy EMS Doesnâ€™t Deserve Higher Payâ€:
1) â€œEMS doesnâ€™t deserve higher pay because [they] donâ€™t deserve anything.” This is a meaningless filler statement with no traction in reality Sean. Even with your misunderstanding the definition of demand and its relationship to what we do or do not deserve it’s hard to glean an actual idea from this statement.
2) â€œEMS doesnâ€™t deserve higher pay because [they] need higher education standards.” An Interesting opinion supported by an assured â€œguaranteeâ€ from Sean Eddy himself. Although, the Economic Policy Institute and every class of successful 7th grade social studies graduates ever have relatively concrete proof heâ€™s wrong, please draw your own conclusions.
3) â€œEMS doesnâ€™t deserve higher pay because [they] are (arenâ€™t?) responsible for our own actions.â€œ This is literally an incoherent statement Sean.
4) â€œEMS doesnâ€™t deserve higher pay because [they] arenâ€™t looking at the big picture.â€œ Well, I donâ€™t think I could have made up a better statement that represents what your actual hurdle to understanding economics is; you have no idea what the big picture is.
5) â€œEMS doesnâ€™t deserve higher pay because [they] are glory-hogging, selfish, and simplistic.“Â Oh… sorry, you wanted me to quote the earlier part, where you said â€œ[They] refuse to give up the â€˜Life Saverâ€™ label.â€œ Oh well, thatâ€™s how it goes, I hope Iâ€™m not hogging your glory now.
With all sincerity Sean, take your own advice: â€œâ€¦do the industry a favor and just quit.â€ Both EMS and writing. Especially any writing having to do with economics, a topic you clearly have zero understanding of.
-Adam Smolensky, NR-P
1. Community Support for San Diego EMS Facebook Page (https://www.facebook.com/groups/467869550055343/)
2. NBC San Diego Local News â€œParamedics, EMTâ€™s Picket For Higher Wagesâ€ (http://www.nbcsandiego.com/news/local/Paramedics-EMTs-Picket-for-Higher-Wages- 305406521.html)
3. Wikipedia Page of â€œIgnoratio Elenchiâ€ (http://en.wikipedia.org/wiki/Ignoratio_elenchi)
4. Economic Policy Institute â€œCauses of Wage Stagnationâ€ (http://www.epi.org/publication/causes-of-wage-stagnation/)
5. Duke Law â€œThe A.M.A and the Supply of Physiciansâ€ [PDF] (http://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=3288&context=lcp) 7. Facebook Comment From Sean Eddy (https://www.facebook.com/EMSWorldFans/posts/897310160310734? comment_id=897477680293982¬if_t=like&hc_location=ufi)