“The only thing standing between you and your goal is the bullshit story you keep telling yourself as to why you can’t achieve it.”

— Jordan Belfort, 'The Wolf of Wallstreet'

In the summer of 1997, I moved to the San Francisco bay area to be closer to my fiancé. The four hour commute between my apartment and the love of my life had become too problematic, so I took a job with a small mom and pop ambulance service in a semi-rural area south of San Jose.

It was hands-down the worst EMS job I ever had. On my first day, I was given an oversized, unwashed shirt from a former employee and placed on a medic unit with no orientation and minimal introductions.

The ambulances were in terrible condition, and the stations were worse. The local emergency room was shocked when I arrived with basic patient care accomplished and delivered a professional hand-off report. When our unit was cancelled enroute to a call, the owner of the company frequently came up on the radio and demanded that we continue to the scene to collect billing information from the caller.

A few short months later, I washed and ironed that same oversized uniform shirt and politely turned it back in. Everything in my experience told me to move on. That was my fourth EMS employer and I’m now on my seventh. It took seven tries to finally find the EMS job of my dreams.

Unhappy? Do something about it

Today, I earn excellent pay and have outstanding benefits. I work for an employer who is well-respected in the industry and the expectations of my job performance are high. I work alongside experienced and motivated professionals who constantly challenge me.

There are great EMS employers out there, but finding them can take time and getting hired can be a competitive process.

When I tell people how happy I am in my EMS job, I frequently hear the comment that I’m lucky.

I’m not lucky.

It was hard work getting to this place and I was willing to do something that very few folks in EMS seem to be willing to do: quit my job and go get another one when I wasn’t satisfied. I was willing to combine dissatisfaction with action. In EMS we often have plenty of dissatisfaction that results in very little action.

Show me a crappy EMS employer and I’ll show you a bunch of unhappy employees who refuse to leave for one reason or another. Perhaps they feel that they are hopelessly tied to that particular region of the country. (They’re not.) Maybe they feel like things are going to get better if they just wait long enough. (They won’t.) They’ve also convinced themselves that things are no better anywhere else in EMS. (They are.)

But at the heart of the matter, after all of our explanations and rationalizations, the reason we stay with crappy EMS employers is something called loss aversion.

An experiment in loss aversion

Loss aversion is a pretty well-known psychological concept. Economists call it “the endowment effect”. The basic premise is that we place a much higher value on the things which we already possess than on things that we would like to possess. Losing something that we already have has a much more profound psychological effect on us than gaining something new.

Take this basic economic experiment as an example: Students in a college class were randomly divided into three groups: sellers, buyers and choosers.

Students in the seller group were given coffee mugs decorated with their college logo and allowed to set a price for which they would be willing to sell their mug. The buyers were given the option to buy one of the mugs with their own money. The choosers were able to either get a mug or a sum of money that they felt would be equivalent compensation for not getting a mug.

The results demonstrate human loss aversion perfectly. Byers were willing to a buy a mug for an average of $2.87. The choosers were willing to take $3.12 instead of a mug. The sellers were willing to sell the mugs for an average of $7.12. The surprising result is the difference between the choosers and the sellers. Both groups are making the same choice, have a mug or have a sum of money. The only difference between the two groups is that one group already has a mug in their possession.

Simply having the mug in their hand and knowing it belonged to them made the sellers value the mugs twice as high as the choosers. We are hard-wired to avoid loss much more strongly than we are designed to seek opportunity and gain. This is the way our brain works and it’s the reason why you won’t leave your current crappy EMS job.

Embrace the unknown

I bring this up for two reasons. The first one is that there are a bunch of EMS employees who are highly dissatisfied with their EMS work environment but they are held back from finding their happiness by the power of loss aversion.

It’s tough to admit it to ourselves. It’s hard to say, “Look, I know this employer treats me horribly, pays me too little and works me too hard, but I’m scraping by and I’m afraid of moving on much more than I’m afraid of my tiny apartment and my overdue VISA bill.”

The unknown can be scary. It’s not just that way for you. It’s that way for everyone.

The second reason that I bring it up is because loss aversion isn’t good for EMS either. Those groups of loyal EMS employees who stick around regardless of how bad working conditions become keep crappy EMS employers in business. Awful companies depend on loyal employees. This is why they foster fears of retribution if employees seek other jobs and fail. They need you to stay.

If the EMS workforce demanded fair pay and good working conditions and voted with their feet when better opportunities presented themselves, all EMS employers would be forced to compete for employees. As it stands, all the bad companies need to do is hang out a shingle and then convince people that they are the only opportunity in town. Loss aversion does all the rest.

What’s your EMS dream job?

Regardless of your current level of job satisfaction, when was the last time you looked at any other opportunities in our industry? Let’s do a little experiment. Look under 'Jobs’ on EMS1.com, and click on at least three; some should be jobs that you are qualified for and others ones that are out of range for your current level of training and experience.

For each job that you read, ask yourself, “What if…?” What if you decided you wanted to be a paramedic in Ohio or a medical device sales representative in California? What are the job requirements for the positions that sound appealing to you? What kind of a degree would you need to join the EMS faculty at the University of Hawaii? Could you start working on that right now?

Pay particular attention to the jobs that list their location as “nationwide.” That means that you could do that job from anywhere. You could probably do that job from where you are sitting right now. I’m not saying that you need to apply for a new job right now (though perhaps you should.) Just overcoming your personal loss aversion enough to explore what opportunities are out there can be a refreshing exercise. We should all do this more frequently.

When you’re done looking at the EMS1 jobs page, I’d like you to ask yourself, “To what degree is loss aversion keeping me from fulfilling my goals in emergency services?” Then ask, “How long am I going to let it hold me back?”

Goals stated publicly are much more likely to be acted upon. Before you leave, write a comment and tell us what your EMS future holds.