Prehospital providers have classically been salaried lower than many other medical providers. In order to advocate for an improvement in salary, the work must be justified. Other medical professionals, such as nurses, have created degree-competencies (such as graduate degrees in nursing) in order to carve a niche for themselves. To accomplish this in the prehospital arena, there must be advocates for the cause that are willing to conduct research that demonstrates improved outcomes with prehospital interventions. Thereafter, expansion of scope may be possible through increased education that converts the provider from a protocol-follower to a critical thinker. This is the point at which significant increases in salary are justifiable. The critical care paramedic course, which provides a foundation for prehospital providers to engage in interfacility transport of seriously ill patients is one current example of this concept in action.