Real EMS(part 2)

 Where Are All the Medics Going?

I recently noticed the National Registry of EMTs mentioned an article called “Not Just 9-1-1: The Expanded Work Environment of United States Emergency Medical Service Clinicians.” After reading it, I thought it was important to discuss it—not from an academic perspective, but from a real-life standpoint we all know.

The article isn’t wrong. But it also doesn’t tell the whole story.

There’s no mystery here.
There’s no hidden data point. And we really don’t need another study to explain what’s happening.

EMS call volumes keep going up. The number of people willing to work on the truck keeps going down. Every street medic already knows why.

What the Numbers Actually Say (and What They Really Mean)

The study reports that about 75% of EMS clinicians still say their main job is emergency response. That might look fine on paper. But here’s what really matters: almost half of EMTs and paramedics say they need more than one job just to get by.

During the first 20 years of my EMS career, I held two full-time jobs. Not part-time work or side gigs—two real jobs. I also took as much overtime as I could get. 

I didn’t do this to be a hero. I did it because that’s what it took to get by. That’s not about being tough. It shows the system is broken.

So when people leave ambulance work for hospitals, clinics, transport jobs, or any job with a steady schedule, it’s not because they've lost their passion. It’s because those jobs offer what EMS often can’t: stability, less physical strain, lower risk, and sometimes just enough pay to get by.

This isn’t complicated. It comes down to simple math.

EMS isn’t Being Used for emergencies anymore

Another part of the problem that rarely gets discussed honestly is how EMS is actually used today.

Many of our calls aren’t real emergencies. EMS has turned into a ride service for the emergency room. People use the ER as their primary doctor and call EMS to get there. Some even think arriving by ambulance means they’ll be seen sooner. That’s not true.

But the call still gets generated. The truck still responds. The crew still gets tied up.

And while we’re busy with non-emergency transports, real emergencies keep happening.

This increases the workload without adding real purpose, and it burns out crews faster than any busy shift ever could.

EMS Was Never Set Up to Compete Like This

EMS started as emergency care.
Then we were asked to take on more, and then even more.

Healthcare grew. Call volume grew. Our responsibilities grew as well.

Pay didn’t.

Now, people act surprised when no one wants to do this work for the pay we get.

The Pool Is Drying Up

Here’s another hard truth: fewer people want to do this job. That shouldn’t surprise anyone.

Becoming a paramedic takes a lot. The training is long and tough. Then you need continuing education, recertifications, extra credentials, and now in many places, a degree on top of it all. That’s a significant investment of time, money, and energy.

People see all of that, then look at the pay, the schedule, the risks, the physical strain, and the burnout, and they decide to walk away before they even start.

The pool of people willing to do this work is shrinking.

The Part Nobody Wants to Say Out Loud

People aren’t leaving EMS because they don’t care about patients.

They’re leaving because EMS doesn’t value them enough.

They’re tired, broke, worn out, and burned out. And they’re done pretending this is normal.

You can’t build a reliable emergency response system with people who are one bad shift or one surprise bill away from falling apart.

This Isn’t a Staffing Shortage — It’s a Retention Failure

Our problem isn’t just getting new people in. We're also losing the ones we have.

This isn’t just a workforce shortage. It’s what happens when people get burned out, and we act surprised when they leave.

We didn’t run out of medics. We just pushed them too hard.

People aren’t giving up on EMS. They’re leaving a system that won’t change.

Until EMS learns to pay people like professionals, stops praising exhaustion, and values experience, the calls will keep piling up, and the trucks will stay empty. No amount of studies or pizza parties will fix that.