I've flown a helicopter air ambulance for a little over three years, and I find it pretty rewarding.
Even at the high end of my company's pay scale, compensation isn't comparable to the major carriers; however, most of my time is in helicopters, rendering me unqualified for the "big money." Still, I'm having the time of my life. Under the current pay scale, without overtime, $75K per year is the most I'll likely make.
My base is in East Tennessee, at the base of the Smokie Mountains, in a rural area. Our program is VFR only and uses only Bell 206L's (Long Ranger). I was offered a single-pilot IFR job with the University of Tennessee last year; however, they pay less to fly a SPIFR twin than I make flying our VFR-only Long Ranger so I gracefully declined.
A typical schedule is usually seven 12-hour days on & seven days off, alternating between day and night shifts. Since our base is close to home, I get to sleep in my own bed every night (or day, depending).
Our base is atypical in that about 85% - 90% of our missions are what we call "scene flights," with the remaining 10% - 15% being hospital to hospital transports. Most of the other bases I've worked at in our company have that ratio reversed.
A scene flight is usually from the location of an accident (i.e. motor vehicle accident, industrial accident, heart attack, stroke, etc.) to the closest level 1 trauma center, while hospital transports are usually to relocate a patient from some podunk hospital to a higher level of care.
I love scene flights because of the variety and the demands on the pilot and aircraft. We're usually landing off-airport, in unprepared confined areas, like farmers' fields, parking lots, road intersections or the interstate, and taking off at or near maximum gross weight with obstacles nearby.
I don't get involved in the medical stuff at all. My job is to get the medical crew and patient from Point A to Point B safely, preferably with the aircraft undamaged. About the only thing I can do for the patient is kill him faster. The nurse and medic take care of the patient and are not involved in the aviation decision-making, with one caveat. Any one of the crew can elect not to take a flight if he's uncomfortable; we call this the "51% rule."
It's not a time-building job -- and in Tennessee it's not an entry-level job either. I've averaged about 250 hours per year for the past three years.
The seven on/seven off schedule leaves plenty of time to do what I want to do while I'm not on hitch; however, there are ample opportunities to "workover" at other bases who are not staffed with four pilots. Workovers are not mandatory, and we get paid time and a half plus travel and per diem for workovers away from home base. Other companies differ somewhat. I'm sure that some of our guys (& gals) who workover frequently make over 100K per year. I like the time off, and I use some of it to keep fixed-wing current & proficient by instructing in a couple clubs at our local grass strip.
As Avbug stated, the work is rewarding at times and poignant at other times, depending on the victim, the circumstances and the likely outcome. Still, on balance, it does feel pretty good to know that you're helping people in rural communities get faster emergency medical treatment.