Beyond Clinical Care (Part 1)

Why do dedicated Clinicians leave the profession when their medical skills are exceptional?  

In the first installment of this two-part series, Bill Seifarth and Scott Moore, an attorney with WMK Law Group, examine the non-clinical factors that lead to professional separation. Scott Moore, an expert in employment law, observes that most employee retention challenges are related to conduct or personal stressors rather than clinical incompetence. The discussion highlights how orientation programs frequently neglect essential topics such as financial stability, work-life balance, and burnout.  

Agencies can improve retention by analyzing data related to shift end times and uninterrupted meal breaks to support their staff. This focus on the human element is as vital for long-term success as passing an initial certification examination. Watch the full episode of Registry Insider to learn more about strengthening your organization!

Transcript

SPEAKER_00 0:13

Welcome to the Registry Insider. I'm Bill Seiferth from the National Registry of EMTs. And on today's episode, we're going to be talking about non-clinical topics for EMS agencies, supervisors, and leaders to think about in their role, especially as they're bringing on new EMS clinicians who are entering the workforce. And joining me for today's episode is Scott Moore. And he is a partner from the WMK, I want to make sure I got it right, WMK Law Group. And his area of expertise in law as a lawyer is human resources as well as employment law. So he brings to this conversation quite a bit of experience both in EMS uh as well as in law. So Scott, thanks for joining me for today's episode.

SPEAKER_01 1:05

Thank you for having me. Appreciate it.

SPEAKER_00 1:06

So before we dive into the the topic, introduce yourself and kind of how you got to where you are today.

SPEAKER_01 1:12

Yeah, so um started in EMS back in 1990 when I was 20, 21 years old. Um had dropped out of college, uh, decided, you know, sort of was looking for I was like a home for little wanderers. I was looking for a place to go. Thought I wanted to be a law enforcement officer, but you know, found my way into EMS and then worked my way up into leadership in an EMS organization in the Metro Boston area, worked the the truck a ton. In fact, worked the truck until 2020. Um both in the private side, and then I was a call firefighter in my hometown for 18 years. And um but you know, at some point, you know, during my early management years, figured out that I needed to go back to college, and so I went back on the truck full-time, worked three overnights a week while going to class during the days, and then uh decided to go to law school shortly thereafter. Um, but you know, 9-11 occurred during my second year of law school, and uh in fact I was at the clerking at a law firm on the day 9-11 occurred right across from the airport, and I remember somebody came in and yelled, like, oh my gosh, the plane just hit the tower, so I ran over to the window to look over at Logan Airport because I thought they meant the tower, and they said no, no, no, no, no, in New York. And um, that was the day that I was I was like, Oh, I'll never leave an EMS. I mean, I was still certified, still working, but uh, you know, I just knew that I don't know, it's a it's still to this day, I've in my 36th year of certification, just getting ready to go through the national registry process again. But um, I just from my perspective, I don't know, there's something about uh, you know, I do a presentation around hope and um what I think EMS represents uh for for folks and you know sort of the best humanity has to offer. So um that's what's kept me here all these years, you know. Despite the all the very bad lawyer jokes you'll hear over your life, I feel like um, you know, this is just a career that uh has been so rewarding for me that um and the people are just it, they're just remarkable, and I can't ever picture doing anything else.

SPEAKER_00 3:20

Well, and that um that comment about the the humanity as it relates to EMS, I think segues nicely into our topic. Yeah. Um you and I talked, you know, what are some a few weeks ago or a month or so ago, what are some topics that we could potentially uh discuss on an episode. We're here at the American Animalist Association uh annual conference in uh Las Vegas, and um and you had, I think, a phenomenal topic, which is a non-clinical topic that most don't think about, but yet we suffer from the consequences in the profession as a result of not thinking about it. So uh now that I kind of teed it up, why don't you talk about what are some of the non-clinical considerations that employers, supervisors, leaders, agencies should be considering um in addition to all that clinical stuff that we have to be competent with.

SPEAKER_01 4:13

Yeah, you know, um as I think I'm one of the only exclusively EMS-based HR folks or you know, employment lawyers that I know of around. I'm I'm sure there are many. I know Steve Wirth, another great attorney, um, spent some time at Jackson Lewis. But I mean I really have focused all of my all of my practice on that piece. And you know, when when I I get a lot of calls from organizations around the country that talk about, you know, we have an employee issue, and that employee issue is almost never clinical. You know, it's never that they didn't assess the patient correctly or um that they, you know, they failed to use a piece of equipment or identify um you know a a looming medical problem. Almost always it's something related to conduct or some other, really, frankly, the non-clinical aspects of the job. So I've been pushing over the last few years, you know, as I started looking at like orientation programs for organizations, you know, 70, 60 to 85 percent of an orientation program at your traditional ambulance service, whether it be fire or or private, is clinical-based, right? We spend all this time worrying about uh whether they can take a blood pressure or apply a you know 12 lead. And um that's you know, tr I I don't ever see employee failures or terminations tied to clinical medicine. It just really doesn't happen. And and so as I started to look at where those failures were occurring, and I and I I think that you know orientation is often thought of as something that the employer has to do in in order to onboard someone, and I think uh very differently of it. If to me, orientation is supposed to be about preparing your folks to be successful in the role, and you have to get beyond the W for you know I-9 paperwork stuff and get past the sexual harassment training, because by the way, the most part not working. Um, and uh, you know, you really need to start thinking about where are the failures and where do they occur. And often for me it they tend to be things like conduct, uh financial challenges, uh work-life balance issues, and then um, you know, a burnout. And so, you know, when I think about the financial stressors that I experienced in the years I worked the truck, right, you know, they were begging me to work overtime, so I was always working overtime. I would gross my lifestyle up because I'd think to myself, I'm working 70, 80 hours a week. I I want to have a nice car to drive home or have a nice apartment or go on a nice vacation. But the reality was once I grossed my lifestyle up, I had very little opportunity to, you can know those, you know, don't don't buy oversized pants, they'll fit you eventually, right? And then you won't be able to get back into the old one. So um I've really been pushing folks now to start thinking about where are the failures occurring, right? That's part of even when we look at like the Commission of the Accreditation of Animal Services, we say you should be tracking and trending your data and then building training and educational programs around that. And so um finance, right? Uh, you know, I would work 80 hours a week if somebody gets hurt or gets burnt out, of both things, which are pretty common. Um, you know, they're now in this position where they can't throttle down because their lifestyle demands a certain income, and as a result, then they just grind themselves into the ground and they're and and then you see those other conduct-related failures that then create challenges for them. So, you know, pushing people now more about, you know, when I went to high school and it was back in the dark ages, you know, they made us learn how to balance a checkbook, they made us learn how to, you know, take, you know, and and and manage our finances. I think those kind of things aren't happening anymore because we're so focused on in my state like MCAS and standardized testing. But um, and we're presuming parents are doing that, and I don't know that that parents are getting the opportunity to. So um I do think about talking about people about responsible work and managing work-life balance, right? The statistics right now say that 64% value pay in money, 63 60, I'm sorry, 65% value pay in money, 62%, only 3% lower value at work-life balance. And that's not EMS specific because we're not super good at work-life balance, but if that's the case, right, it's like 3% less than money. What are we doing to really measure and understand and ensure that people are getting some level of balance uh in EMS? So, you know, warning new employees about the fact that you're gonna want to work a ton, you know, you're gonna get excited about making extra money, but at some point, you know, that may come at a price and you need to be able to, you know, check yourself. Um so you know, I again I think our focus is, you know, I know like Boston EMS puts people through an entire new paramedic program. They put them through an entire new EMT program. And my first question is, well, are you seeing a lot of failures on the clinical side? I mean, if if you are, then we should be talking to training institutions, right? But we're genuinely not. And so, um, you know, how if your program is supposed to be about making the employee successful, are you measuring whether it's making your employee successful? And um, if you look through all of your separations for, you know, performance improvement plans, you're gonna find that probably 85-90% of those are tied to non-clinical factors. You aren't having those fall uh those people trip and fall there. You're having them trip and fall somewhere else, whether it be the work-life balance, showing up on time, right? Not walking into a station and finding every single person on a mobile device, not not knowing how to communicate with each other. Yeah.

SPEAKER_00 9:53

Yeah. So financial stressor obviously is clearly the number one stressor for for folks in EMS. Um having that ability for by the employer, by the supervisor, to provide some general education, general awareness early on in their career, um, like very early on in their career, can help them be more successful. But also the work-life balance. There's also the the uh the balance generally in life, not just work-life balance, but the the balance in life, uh, because work plays a large part of that. But making sure that it doesn't dominate that and have have visibility, awareness, um, mindfulness, and intentional intentionality about this early on can uh can have a good return for uh for EMS agencies.

SPEAKER_01 10:39

Yeah, I think you know it's funny, I I do a session around recruitment and retention using data. Right? And we have a tendency to focus on like UHU and response time compliance, and I think to myself, like, well, you know, you should be taking a look at your data, because I think data's like light bulbs, right? You know, the more you have, the better you can see. And um, you know, we should be taking a look at data and saying, like, okay, what percentage of our people are getting out on time? Right, because I don't know about you, but when I work the truck regularly, all day long I would I would be hustling all day long, but get me a lunch and get me out on time, or within a reasonable period of time. And the organization to me that would say, okay, hey, come work here, right? 85% of our employees got out on time last week. And of the 15% that got out late, they got out within 20 minutes of their shift end time. Why? Because here at this organization, we know that you work so that you can live, not the other way around. And or, and hey, you know, 90% of our people got an uninterrupted lunch break, right? In some states it's mandatory. Um, most folks think they're exempt from that, which they're not. But um again, the message that you're sending when you're focusing on, you know, 90% of our people utilized all of their paid time off last year. And of those who made requests, they got notified within 24 hours of whether that was approved or denied. Right? And I and then going to your employees who may be who may be, you know, amassing huge chunks of paid time off and saying, hey, you know, I noticed that you're not taking any time off, or you know, is there any reason for that? You know, and and they could that could tell you things about your organizational, not only about your organizational culture, right? Um, but it also can tell you things about potentially your employees. We had one employee one time who I'd gotten complaints, people thought maybe she was using substances turned out um because she looked disheveled often. They found her sleeping in her car. Turned out she was homeless. And had we really started to take a look at the data, right? Had I gone back and taken a look at the fact that about two months before that she started taking every possible shift she could, whereas she was a normally a you know, 50-hour a week employee. Now she was working 80, 90, 100 hours a week. And um I might have at least noticed that trend, and I could have come back into her and just said, hey, I noticed you're working a ton of hours, is everything going okay? Because I'll tell you, when I approached her to talk to her about the substance discussion, I didn't directly have the substance discussion. She broke down and told me that she had become homeless. Right? So I think often we have this tendency, and and and some some of I blame SHR lawyers because we're afraid we're going to maybe uh in uh invite some, you know, some problem, legal issue around checking in with your folks. But I think the employer that's spending time trying to ensure, you know, if if the message you're sending is we want to make sure that you're balancing your work and your and your life, that financially, if you're working 100 hours, what are you doing with that money? And let's talk to you about, hey, why should you maybe sign up for our health savings account, right? Because a health savings account is a triple tax savings. Yeah. You it you if if you're an employee who's spending a ton of money on health care, if you are putting um a certain chunk of money aside, it gets invested, you know, first of all, it's taken out pre-tax, it gets invested like a 401k, it grow its growth is tax-free. And if it's spent on medical expenditures, well then that expense is tax-free. And so you could essentially self-fund your own higher deductible plan, make your weekly deduction less, your weekly contribution to healthcare less, and and provide yourself with greater security because the number one debt that most people are not in a position to handle is a is a medical debt, right? And so um, you know, helping if we think those things are happening uh in the home, I'm not sure they are. And, you know, this way these are most folks coming in are young adults, right? Who have not necessarily, and even if they are getting at home, what's the worst that could happen by you giving that plan, you know, or providing some resources around that. Now, I will tell you as a former HR for a very large company, when we would hold the day the financial planner would come in, no one would sign up for meetings. But uh so I go, okay, well, that's because first of all, you're offering it Monday through Friday at the daytime in a meeting room. You have to speak to them in a language doing podcasts, right? Talking to them uh through reels or through TikTok or whatever. You know, again, um I gave Brian, my law partner, a hard time because when we merged our firms, I said, You're gonna have to get rid of the beefel at AOL.com email address. And he was like, Why? I've had that forever. I said, It should what might as well be beefel at Paul Revere's ride, right? Revolutionary wartime. Um, and he was like, Don't be a smart ass, right? So I think it's about delivering it, recognizing that you have multiple generations of your workforce, what the um the language that each group understands is different, and so the message has to be catered to the group that you're trying to talk to. And and that I think is where often we're falling down because we only have so many resources.

SPEAKER_00 15:57

Yeah. So thank you for joining me for today's episode to talk about this. We're gonna do a second episode um continuing the conversation on um employment considerations as it relates to EMS and the non-clinical aspect of it. Um but before we um end this episode, where can folks go to find out more, certainly about you and your firm um and if they want to reach out to you, uh, where can they go to uh find that information?

SPEAKER_01 16:22

Yeah, sure. No, I'll I I'm grateful, of course, to you know get an opportunity to share some thoughts. Um if folks are interested in contacting us, it's uh Worflemore Kelly Law Group or WMKlaw.com, lawgroup.com. And so um if go in any search engine and plug it in, if you plug in Scott Moore, EMS attorney, it's gonna come up. So um, but certainly you can email, you know, it's just that's more at wmklawgroup.com and we you know be more than happy to direct you. And and some of that's not just for where folks can get resources. I also know that I I no longer work at truck full-time, and most of the calls I'm getting are from folks who are having some issue. You know, I want to be more proactive. If your listeners have ideas or if any piece of this resonates with them, right, I'm happy to build resources around that, right? Because I recognize they run services full time. Yeah. And so I think this is an area that um, you know, much of what our firm does we make available to pretty much anybody. And so um, you know, I think it's a rising tide sort of thought process.

SPEAKER_00 17:24

But good, great. Well, thank you for joining me for this episode. And uh we'll reconnect on uh the next episode shortly after this episode. So great. Thank you for joining us as well, and as always, stay safe. Thank you for joining us for this episode. If you wouldn't mind, please click the like and subscribe button as well as the notification so you can get notifications about the coming episodes. Also for the latest and greatest happening.