Differences in Characteristics between EMS Clinicians with Patient Care and Non-Patient Care Roles

Emergency medical services (EMS) play a key role in access to prehospital emergency care. While EMS has defined levels of certification, the roles in the care paradigm fulfilled by these clinicians vary. The aim of this study is to describe the national differences between EMS clinicians with primary non-patient care vs. patient care roles.

We performed a cross sectional evaluation of nationally certified EMS clinicians in the United States who recertified in 2020. As part of the recertification process, applicants voluntarily complete profile questions regarding demographic, job, and service characteristics. We compared the characteristics between individuals self-reporting primary patient care roles vs. non-patient care roles. Using logistic regression, we determined independent predictors for having a non-patient care role.

In 2020, 126,038 people completed recertification. Of the 96,661 completing the profile, 80,591 (83.4%) indicated that they provided patient care, and 16,070 (16.6%) did not provide patient care as a primary role. Non-patient care personnel were more likely to be older (median 43 years old vs 34 years old), and to have a higher level of education (bachelor's degree or more: OR 2.25, 95%CI [2.13-2.38]) compared with patient care practitioners. Non-patient care personnel were less likely to be female (0.67 [0.64-0.70]) and minorities (OR 0.80 [0.76-0.84]). Non-patient care personnel reported longer work experience (16 years or more: OR 6.30 [5.98-6.64]), were less likely to hold part time positions (OR 0.62 [0.59-0.65]), and were less often attached to more than one agency (OR 0.83 [0.79-0.86]). Non-patient care personnel were less likely to work in rural settings (OR 0.81 [0.78-0.85]).

EMS clinicians in non-patient care roles account for 17% of the study population. The odds of performing as a non-patient care practitioner are associated with characteristics related to demographics and workforce experience. Future work will be necessary to identify mechanisms to encourage diversity within the patient care and non-patient care workforces.