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Is 'brain drain' the threat we think it is?
Several sources contradict the assumption of a high attrition rate in EMS
By Art Hsieh
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Editor's note: An Australian ambulance union has attributed the newest attrition rate figures in EMS to a culture where paramedics are overworked. |
Reviewing this article, I saw the familiar refrain that I assumed was true: We suffer a high turnover rate in EMS.
Intense training, low pay, long hours, no career advancement, injury - all have been cited as reasons for a short-lived career as an emergency care provider. I agree with this notion, but when I went looking for data to support it, to my surprise, I found a few sources that contradicted the assumption of a high attrition rate. In fact, very few studies even look at the issue in the first place.
One such study, published in 2010, indicated as such. The researchers reported that among the responding organizations, the overall weighted mean annual rate of turnover was less than 11 percent. This echoes a salary and workforce survey done in 2008 that reported an 11.4 percent attrition rate. The highest percentage, 13.8, was reported by a smaller study in 2010.
These numbers are much lower than I thought they would be. Perhaps the poor economy has ironically been helpful to the profession. With jobs being more scarce, it's possible that EMS providers are staying put rather than moving onto greener pastures.
Or perhaps salaries and benefits have increased enough to keep people in the business longer than before.
Or maybe we've improved worksite safety and comfort issues.
Who knows? I'm interested in finding out. What are your thoughts?
Sources
- Patterson PD et al. The longitudinal study of turnover and the cost of turnover in emergency medical services. Prehosp Emerg Care. 2010 Apr-Jun;14(2):209-21. (retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883888/ 20 September 2012)
- Williams DM. 2008 JEMS Salary and Workforce Survey. http://www.jems.com/article/training/2008-jems-salary-workplace-sur. Retrieved 20 Sept 2012.
Skip Kirkwood Thursday, September 20, 2012 6:12:11 PM This is one of literally hundreds of non-clinical topics where we need good research. Masters' programs, where are your thesis researchers? 
Gary Walter Thursday, September 20, 2012 7:50:42 PM You're right Skip - but who will fund that research? I read the other day where an EMS administrator told a field medic there is no such thing as PTSD. I think sometimes (often) these statements - and the lack of changes - are financially motivated.
Andy Sutton Thursday, September 20, 2012 9:09:32 PM Skip, you are dead on. Research is one of this professions biggest weaknesses and until our research catches up with our skills, abilities and responsibilities we will never be legitimately recognized as a true profession. My Master's level research will focus on the disparities in EMS education and instructor preparation (the Master's is in Adult Ed...) but I am acutely aware that there is a virtual void when it comes to legitimate EMS research--especially when you filter out the research done by or funded by organizations that may be inherently biased and/or use faulty methods of collecting or analyzing data. Skip Kirkwood Friday, September 21, 2012 5:22:29 AM Gary - how about the medics funding the research? Much of the research in the fire service has been funded by the IAFF, with money provided by firefighter dues (particularly when it comes to health, safety, etc.). When are EMS folks going to STEP UP and start to own their profession? Research, like book-writing, blogging, etc., can be done in your spare time. OR, if we were the least bit organized, we could find some funding for some academic research centers like exist for almost everything else.
EMS is not taken seriously in many quarters because it is approached as a hobby, by people who don't act or sound like professionals. Heck, the physical therapists (along with the nurses and a whole variety of other "allied health" professions) have blown our doors off. Gary Walter Friday, September 21, 2012 7:06:57 PM Good point Skip, I was trying to rally my colleagues here, through the Teamsters and through a FB group I created (with several 100 coworkers on board) - I was dismayed by how little understanding there is to be "professionals." Seemed people would rather, um, complain.
Jack Fitzgerald Thursday, September 20, 2012 6:49:16 PM I have been is EMS sence 1990. I have moved up the ranks to a paramedic in 1998. I half to admit that I mosly have been a volenteer, but I have done full time Medic as well. The main reasons I stoped doing it full time are low wages and the hours, I worked 24 on and 48 off, (if your replacement called in sick or they needed more help you were leld over up to another 24 hours). Leaving very little time for family. And with the low wages and hours, you could not get that so called part time job because you didn't know what hours you could work. 
Pete Medina Thursday, September 20, 2012 6:52:07 PM I agree completely. Many do it for the love of the job...but even then the job still becomes a job. EMS since 1986.
James Hoffman Thursday, September 20, 2012 7:54:30 PM Here is a podcast we did a while back on Longevity in EMS. http://emsofficehours.com/2011/12/14/longevity-in-ems/ 
Daniel Salter Saturday, September 22, 2012 9:21:50 PM No matter how you look at it paramedics need to make more money and have more realistic shifts (schedules). I'm am an RN and a paramedic and I work as an RN, not as a paramedic, simply because the shifts are more controlled and scheduled and I make a LOT more money in the RN role. You can love what you do only so much- you have to make a decent living also. 
