Event Medical Services should NOT be priced by the hour.

Event medical services are often misunderstood as a form of "manpower support" that can be priced by the hour in the same way as event ushers, helpers, or technical crew. While hourly pricing may appear simple, transparent, and straightforward, it does not accurately reflect the very nature medical services: risk tolerance, clinical responsibility, and duty of care in events. Earlier in our work, I used hourly pricing for my company. As our experience grew, it became clear that this isn't suitable nor sustainable, and it does not always reflect what was required to support events safely.

EvMS Providers (including my team) should instead adopt a risk based pricing model that considers the event’s characteristics (e.g. activities, time, location, participant population), its anticipated clinical presentations, and the consequences of delayed or inadequate response. Here I'll explain why per-hour pricing is wholly insufficient for medical services, and how a risk-based model better aligns with safety outcomes, and what this means for event organisers.

Failure of the Per-Hour Model.

Hourly pricing assumes that value increases in proportion to time spent. This assumption works mostly well for roles where output is directly linked to hours worked. Medical services do not function this way.

The primary driver of medical resourcing is the risk profile of the event. Risk does not scale linearly with time.

A short event, such as a 3-hour Muay Thai championship carries significantly higher medical risk than a long event, such as a 12-hour pop up sculpture exhibition.

It depends on the crowd size, participant vulnerability, activity intensity, environment, and access to care. Pricing solely by the hour understates the true cost of readiness and overstates the relevance of time as a determinant of safety.

A per-hour pricing model would misleadingly suggest that the exhibition requires more medical “value” simply because it lasts longer, when in reality the combative championship event demands higher clinical capability and readiness despite its shorter duration.

A risk based pricing model accounts for this difference by aligning medical coverage with the types of conditions that are most likely to present. EvMS providers should account for factors above, including medical/traumatic presentations that are likely to occur.

Not all Medics are Equal.

Another limitation of hourly pricing is that it fails to distinguish between levels of clinical capability. Medical personnel and capabilities are not interchangeable: a first aider, an emergency medical technician, a paramedic, a registered nurse, and a doctor each bring different skills, knowledge, competencies, and are authorised (or limited) to make different clinical decisions and perform clinical skills. The clinical responsibility borne by an onsite medical team exists continuously from the moment coverage begins, regardless of whether an incident occurs or not. A single medical emergency will demand immediate high-consequence decisions that carries legal, ethical, and reputational consequences far beyond the duration of the event itself. The presence of "higher trained" clinicians is not a matter of seniority or prestige, but of the capability of managing higher consequence scenarios appropriately. The cost of medical coverage therefore reflects not just the presence of personnel, but the level of responsibility they assume.

If you are selling personnel hours, you encourage value engineering where critical medical elements can be influenced by non-medical event organisers / clients to be removed incrementally to meet a budget target.

I’ve encountered situations where an event organiser requested for a very specific type of medical personnel (first aider), yet was unable to provide the medical risks associated with their activities. Without understanding those risks, how would a first aider be appropriate for managing the potential medical consequences of the event? They could not provide me an answer beyond "our budget limits it (to a first aider)".

For these reasons, EvMS providers are better off quoting as coverage packages rather than per-hour line items. A coverage package represents a defined level of medical readiness and responsibility for the event as described. It includes personnel, equipment, planning, and clinical oversight required to manage foreseeable scenarios safely. This approach reduces ambiguity and also provides clarity to clients by defining what level of medical support they are engaging, rather than asking them to assemble or pick-and-choose medical coverage without the expertise to judge its adequacy.

The most important shift you can make in your quotation is that you must present medical coverage as a defined outcome, not a collection of adjustable inputs like hours or personnel. Clients should feel that they are accepting a professionally determined configuration, not assembling one. Instead of listing “2x First Aiders for 4x hours”, the quote line item should read something like “Event Medical Coverage – [Coverage Level / Event Type]”. This immediately signals to the client they are buying a level of assurance, not time. Under that heading, you can then state what the coverage includes. For example, you describe that the coverage includes on-site medical personnel, medical equipment, clinical readiness for the full event duration, and responsibility for medical assessment and escalation. This framing subtly shifts the client’s mindset from “hours worked” to “coverage provided.”

Losing the Wrong Clients to Gain the Right Ones

Will this turn event organisers / clients away? Inevitably, but necessary.

Price shopping is a predictable behaviour in markets where outcomes are rare, invisible, and/or poorly understood. Event medical services sit in that category -- often unseen and unused if nothing goes wrong, and then being lamented that $xxxx.xx was spent on being unused. Like insurance, most policyholders fortunately do not get to experience a life-changing illness; similarly most events do not experience serious medical incidents, so event organisers rarely get to see their money spent on EvMS in action.

The clients most likely to walk away are those whose determinant factor is compliance signalling rather than safety. These are organisers who price shop for the cheapest available option to be able to say “we've had medics” on a checklist without considering who those medics are, or what they can/cannot do. They might insist a single first aider or two for the Muay Thai championship, even when its medical risk calls for a paramedic. For them, price is not just a constraint but the defining feature of value. Yes, you might feel the initial pinch when losing these clients reduces your revenue volume, but it also reduces exposure to the very incidents that most threaten a medical provider: under-resourced high-liability events. The risk ain't worth it.

However, not all price-sensitive clients are the same. I'm not in a vacuum; events operate under real financial constraints particularly for student-led* or community-based event organisers. There is an important distinction between 1) price-driven and 2) price-constrained clients. Price-driven clients actively seek the lowest cost regardless of implications. Price-constrained clients have limited budgets but still care about doing things properly if the trade-offs are explained clearly.

A risk-based pricing approach will almost certainly lose the first group of clients (price-driven), but it can still retain a significant portion of the second ground (price-constrained), especially if you pair it with respectful communication, clear boundaries, and structured alternatives. A risk-based pricing model does not ignore budgets. Adjustments can often be made by modifying event parameters or implementing additional risk mitigation measures beyond reducing medical coverage.

There is also a counterintuitive effect: being explicit about risk and pricing can actually increase trust among some price-shopping clients. Many clients price-shop because they do not understand what they are buying and assume all providers are functionally identical. When you explain without alarmism why pricing differs and what those differences mean, it creates differentiation where none existed before. Some clients will still choose the cheaper option, but there's a healthy amount that will recognise that they were previously comparing things that were not equivalent. Confidence and competency breeds trust.

Consider the long game: clients who value only price rarely become loyal. They bail and switch as soon as someone else is cheaper. Clients who accept a risk-based model, even reluctantly, are more likely to return, accept price adjustments over time, and maybe even recommend you to others because they understand what they are paying for. Aim for being trusted. When clients see you as a trusted authority, you don’t have to constantly prove your expertise or justify your fees -- they’re choosing you because they trust your judgment.

*having worked with plenty of student-led event organisers, I will write an article soon on negotiating and dealing with them from an empathetic perspective.

For the Event Organisers

What this changes for organisers is responsibility and sequence. Before deciding who event organisers want on-site, clients need to be clear about what could realistically happen at their event (or let experienced medical professionals assess and make that determination).

When risks are not clearly identified, choosing medical personnel: first aider, EMT, paramedic, or nurse, becomes guesswork rather than planning. That guesswork only moves liability onto deployed responders and back onto the organiser if an incident exceeds the capability of the deployed team and it becomes a nasty finger-pointing game.

It also means that organisers should expect professional medical providers to challenge requests that are not risk justified. This is not obstruction or upselling; it is governance and responsibility. Just as an organiser would expect an engineer to question unsafe staging plans, or a pilot would expect a aircraft technician to warn about metal fatigue, a medical provider has a duty to question resourcing decisions that are disconnected from actual risk.

When a provider insists on assessing risk before confirming personnel, they are protecting the organiser as much as themselves.

So yes, adopting a risk-based pricing model and communicating will turn some clients away. But it will not turn away all price-sensitive clients, but it will filter out those who treat medical coverage as a box-ticking compliance exercise.

Over time, this approach produces a portfolio of engagements that is sustainable. A pricing model grounded in risk and clinical reality is not about charging more for the sake of it but on ensuring that when medical care is required, it is adequate, defensible, and effective.

This is the standard we choose to work to, and the standard we expect events we support to share.

At REDSTAFF Medical, we don’t just provide personnel. We help organisers understand, plan for, and manage risk so their events can run safely and confidently. Our focus is not on selling hours now but on providing the right medical capability to keep events safe and uneventful.

This post was first published on Mervin Leo's LinkedIn on 23 December 2025.