Addressing the EMS Workforce Challenge

     Thirty years ago, when the practice of modern EMS was still new and NAEMT was a young association, the main focus of EMS was on clinical issues and patient care. Hot topics were cardiac care, trauma care and airway management. We didn't discuss the needs, concerns and working conditions of the people who provided patient care.

     In recent years, the EMS industry's view has widened. We now recognize that there is a critical connection between good patient care and the workforce that provides it. Not only do we need to ensure that we have an EMS workforce that is prepared, healthy and motivated, we also need to make sure we have enough EMTs and paramedics to do the job. Reports of EMS worker shortages have become common, and recent NAEMT surveys show that recruitment/retention is one of our members' top concerns.

     As EMS organizations across the nation seek to understand and address recruitment and retention, they are discovering that the issue is complex and includes much more than creative recruitment campaigns. It is really about the need for an in-depth understanding of the workforce, which, unfortunately, we don't know much about. This is being confirmed by the EMS Workforce for the 21st Century Project (conducted at University of California, San Francisco, and funded by NHTSA), which is finding a critical shortage of data and research on the EMS workforce.

     As an industry and a profession, EMS needs to become more knowledgeable about workforce issues.

     First, we need to recognize the breadth and importance of these issues. The EMS workforce impacts almost every critical aspect of EMS--quality of patient care, costs, operations and organizational structure. Workforce issues include virtually everything about workers, including: education, recruitment, working conditions, pay and compensation, worker motivation, health and safety, retention and career paths.

     Second, we need to get our arms around the diversity and complexity of the EMS workforce. Because of the way EMS has evolved and is delivered--different EMS provider levels, different types of EMS systems and the diverse ways in which workers are rewarded and compensated--trying to generalize about the EMS workforce is impossible. We need to come up with creative ways to understand the different segments of the workforce and recognize that each segment has its own unique attributes and problems.

     Finally, we all need to support EMS workforce research and data collection. The only way we can address worker needs intelligently is with more information about our workforce.

     The National Registry of EMTs' LEADS research project continues to provide valuable insights into the industry, and we need to support these efforts. NAEMT, with help from the Prehospital Care Research Forum, is now offering an annual $5,000 grant to fund EMS workforce research. For more information, go to www.naemt.org.

     State EMS offices can help provide needed data using their regulatory capabilities to learn as much as possible about workforce issues in their states and sharing that information nationally.

     In the coming year, the EMS Workforce for the 21st Century Project will release an important document explaining what we know about workforce issues, what we don't know, where we need to go and how to get there. All major national associations and organizations will have an opportunity to provide input on this document and help chart the future.

     We now know that workforce issues will be one of the major challenges facing our industry and profession in the coming decades. NAEMT will continue to take a leadership role in addressing workforce needs. The quality of care we deliver to patients depends on the quality of the people we place in the field. We have a responsibility to providers to make sure they are understood, cared for and supported in a manner befitting the dedication and courage they display every day.

Patrick Moore is the president-elect of NAEMT. He has been involved in EMS for almost 35 years and has been an instructor/coordinator for more than 25 years. He is a past recipient of the Arkansas EMT Instructor/Coordinator Award, the Dr. E.P. Hammons Arkansas EMS Leadership Award, the NAEMT Instructor/Coordinator of the Year Award and the Jeffrey S. Harris State Leadership Award.