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On any given day, Eric Mailman may transport a baby born into a neonatal intensive care unit from one hospital to another, or he could answer a call for an elderly person in cardiac arrest.
The paramedic and operations coordinator at Northern Light Health's medical transport and emergency care in Bangor, Maine, can answer anywhere between four and 17 calls in a day, on shifts that can stretch from 12 to 24 hours. The only guarantee is that work will be busy and unpredictable.
"The positive is that you get to step in on the chaos of the worst day of someone's life and bring some calm and peace — to me that is priceless," Mailman said. "But there are days when you can't intervene, where things are out of your control. It's impossible to help everybody, and those days are the hardest."
At Northern Light, some 170 people work in emergency medical services and transport, but the system is currently about 10 percent understaffed. Challenges are many in hiring — the community is rural, and while the pay and benefits can be competitive, the job itself is a big commitment, requiring sometimes up to two years of training, recertification and continuing education. Roughly five years ago, there were 15 to 20 applicants per open position, says Joe Kellner, vice president of emergency services and community programs at Northern Light. Today, however, it's not uncommon to post a job and have zero applicants respond, he said.
The tight labor market is particularly weighing on the health sector. The health-care industry added 42,000 new jobs in January, with more than 22,000 in ambulatory health-care services and another 19,000 in hospitals, according to Friday's closely watched Labor Department report. The health-care sector has added 368,000 jobs over the past year, while unemployment continues to hover near historic lows.
"Fewer people are entering the profession, unemployment is low, and this is also a job that many people used to get into through volunteerism and in local communities — there is a lot less of that," Kellner says. "The pathway in is harder and harder, but we try to create solutions for that."
Northern Light's system is run in partnership with a larger nine-hospital system throughout the state, allowing for more reliable funding and options for those using emergency medical services as a stepping stone to other areas of health care. The company also reimburses for tuition, offers competitive paid time off and a retirement plan with a matching employer contribution. Highly trained paramedics are paid about $27 an hour.
Emergency medical technicians and paramedics like Mailman are in demand, not just in Bangor but around the country. Challenges persist beyond just finding people to fill jobs in more rural areas, however — 2017 median nationwide pay was just more than $33,000, or about $16 an hour.
Funding can also be an issue in some communities, as reimbursements from insurers, patients, and Medicare and Medicaid are outpaced by wage pressures and costs to operate. This is especially common in volunteer programs, funded in large part by community donations and local taxpayer dollars.
"If people really want to feel confident that they can call 911 and someone will come, they need to support their community so it will provide that kind of service," says Kathy Robinson, program manager for the National Association of State EMS Officials.
The need for EMT and paramedic workers comes as the health-care sector continues to boom.
"The strong economy definitely has an impact," says Ani Turner, co-director of sustainable health spending strategies at nonprofit research organization Altarum. "We are at full employment, so along with expanded insurance coverage in the Affordable Care Act that started to take effect part way through 2014, we have a lot of people that now have health insurance coverage. More people with health benefits, more people with insurance increases the demand for health care and therefore health jobs."
Much of this growth came from the ambulatory sector, with an emphasis on outpatient care, which added 37,800 jobs in December 2018. What's more, out of the 30 fastest-growing occupations through 2026, per BLS, nearly half fall under the health-care category, and analysts say there's likely no slowing down ahead. The workforce continues to age, as does the population in need of care, the opioid epidemic persists, and the pool of skilled labor remains tight.
With all that growth, there's no doubt demand will continue within systems like Northern Light, where trained professionals like Mailman are ready to answer the call.
"I love my job. I can't imagine doing anything different than what I do," Mailman said.