Within the EMS field, there is a wide variety of services to go into. In terms of Emergency Medical Technicians, there are four main levels of Emergency Medical Service Providers. A First Responder requires the least amount of certification, but once certified, is not able to work for ambulance services. The next level up is EMT-I or EMT-Basic. EMT-B "provides Basic Life Support (BLS)" [4]. EMT-Basics can provide more patient aid in emergency situations and work in ambulances. The third level of EMTs is EMT-II, which can provide Limited Advanced Life Support (LALS) and also work in ambulances. The highest level in the EMS chain is a Paramedic. A Paramedic has all of the skills and knowledge of the three EMT levels under them in addition to the ability to administer a significantly larger amount of medications. Paramedics also work in ambulances.

While Paramedics tend to receive higher wages than First Responders, EMT-B, and EMT-II, they still do not receive nearly as much as they should. As one works their way up the EMS ladder, the corresponding pay scale does not accurately reflect the change in value of the positions. This is an unfortunate truth because without Paramedics, there would be significantly more deaths in mid-transport. Because the pay is not proportionate to the level of certification, there is hardly any incentive for EMT-I to continue up the ladder to EMT-Paramedic.