How can technology help to address the paramedic shortage?
Author: Rachel Engel
The U.S. is facing a paramedic shortage, as agencies nationwide report low EMS recruitment and retention, with a 100% turnover rate in EMS providers every four years, according to a survey by the American Ambulance Association (AAA), an EMS advocacy group.
In 2021, the AAA sent a letter addressed to congressional leaders describing the current paramedic shortage as "crippling" and outlining its impact on communities. The advocacy group acknowledged that EMS recruitment challenges go back longer than a decade and pointed to the recent COVID-19 pandemic as having exacerbated the issue.
"The challenge is to make sure that the paramedics and EMTs of the future know that EMS is a rewarding destination," the letter read.
As agencies grapple with the EMS shortage and attempt to limit the impact on their communities, technology advancements offer a way to help public safety organizations across the country.
Aggravating factors to EMS recruitment and retention
The paramedic shortage and downturn in EMS recruitment in the U.S. is a widespread problem. According to JEMs, “Across the country, local emergency medical services operations are increasingly challenged to staff ambulances, leading to excessive wait times for patients in potentially life-threatening situations.”
On-time response rates are declining as agencies find it more and more difficult to adequately staff ambulances across shifts. Identifying the factors that are contributing to the EMS shortage is key to rectifying the problem.
The mean salary for paramedics and EMTs in the U.S. was $49,500 in 2021, according to the most recent figures from the Bureau of Labor Statistics, though the amount can vary greatly depending on location. This is below the national average wage index, which for 2021 was $60,575.07 according to the Social Security Administration.
Mental health considerations
First responders are 10% more likely than the average population to be diagnosed with acute stress disorder or post-traumatic stress disorder (PTSD). EMS providers are typically the first to arrive on scene, which can mean dangerous, high-pressure and exhausting conditions which puts EMTs or paramedics at a high risk of developing depression and anxiety or PTSD. In addition, EMS providers will likely be exposed to traumatic incidents multiple times over the course of a single 24-hour shift, with little time in between to reflect on what they witnessed.
According to the 2022 EMS Trend Report, 37% of survey respondents report symptoms of burnout, with 69% of respondents saying they plan to leave their current employer within the next four years.
Long offload times at hospitals have further exacerbated the paramedic shortage, with 67% of NAEMT survey respondents reporting increased offloading times at hospital emergency departments in April 2021, reducing the number of ambulances and personnel available to answer subsequent 911 calls.
Another major challenge for paramedics is the large number of non-emergency calls they receive. According to the Centers for Disease Control and Prevention, there are more than 130 million annual patient visits to emergency departments nationwide, yet only 14.2% result in hospital admission. Responding to non-emergent calls places increased burdens on the EMS system.
Per CBSnews.com, “AMR, the nation's largest private ambulance provider, announced its ending non-emergency transport in Los Angeles County. The company cites low Medicaid reimbursement as a major reason for a $3.5 million budget deficit in that market alone.”
Per the announcement on AMR’s website, “California has not increased Medi-Cal reimbursement for private ambulance operators since the late 1990s. The current Medi-Cal base rate for private ambulance services sits just above $100, which is far below our cost of providing the transport.”