Not Just 9-1-1: The Expanded Work Environment of United States Emergency Medical Service Clinicians

Recently, there have been annual increases in emergency medical service (EMS) demand with concurrent clinician shortages. Understanding the diverse number of EMS clinicians available for emergent roles is vital for planning and resource management. Our study aims to understand the roles and environments of US EMS clinicians.

This cross-sectional study analyzed nationally certified civilian US EMS clinicians recertifying from October 2021 to April 2022, ages 18-85, with at least one EMS job. Respondents answered questions regarding their primary and secondary EMS roles, including emergent response (with/without 9-1-1), medical transport (non-emergent), clinical services, mobile integrated health (MIH), or none of the above. Next, respondents were asked about the number of jobs needed to make ends meet. All responses were combined with self-reported National Registry profile data (e.g., age, sex). Descriptive statistics were performed.

The study included 33,335 EMS clinicians (response rate: 34.0%). The primary role reported was emergent response with 25,086 (75.3%), including ground ambulance and non-ambulance response. Clinical service roles were reported by 2,427 (7.3%), including settings such as the emergency department and outpatient clinics. Medical transport roles accounted for 2,346 (7.0%), including ground interfacility and critical ground care. Educators and administrators made up 1,453 (4.4%). Overall, roles varied by sex, and 48.8% of respondents reported needing more than one job to make ends meet.

Our evaluation highlights various US EMS clinician roles. These findings suggest the need for continued focus and attention on EMS roles, compensation structures, and sex distributions to ensure a resilient, diverse, and adequately supported EMS workforce.