By Florida Center for EMS
The EMS workforce is often described as the frontline of healthcare — agile, resourceful and under immense pressure. Yet, until recently, few studies have comprehensively captured the voices of those working in the field. That has now changed.
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The Florida Center for Emergency Medical Services (FL-CEMS), housed within the Morsani College of Medicine at the University of South Florida, has released “Vital Signs: Findings from Florida’s 2024 EMS Workforce Statewide Survey”. With more than 49,000 EMTs and paramedics participating, this dataset is not only the largest of its kind in Florida’s history, but also one of the most detailed EMS workforce assessments available nationally.
What it reveals is both sobering and instructive: satisfaction gaps; structural inconsistencies; and signs of systemic strain, particularly among early-career professionals. At the same time, the report highlights opportunities for meaningful improvement, including enhanced organizational support, leadership visibility and a more intentional approach to professional development.
What Florida’s EMS workforce is telling us
1. Retention is most fragile early in the career
Among respondents with less than 2 years of experience, satisfaction scores were notably lower, especially in urban areas. These early-career professionals frequently cited challenges with job clarity, lack of mentorship and difficulty navigating agency culture. The implication is clear: onboarding matters. Without structured support, our newest clinicians appear to be more likely to exit the profession prematurely.
| More: Year one: Creating a career path for new EMTs
2. Pay dissatisfaction is a persistent theme
While wage concerns have long been acknowledged in EMS, the Florida data quantifies it with stark clarity. Paramedics in hospital-based and private EMS systems expressed the lowest levels of satisfaction with compensation. Conversely, fire-based EMS agencies reported significantly higher satisfaction. This is driven not only by pay, but also by the perception of leadership support and schedule predictability.
3. Mental health burdens are significant and unevenly addressed
A substantial number of respondents reported symptoms of anxiety, sleep disruption and chronic pain. Yet access to psychological support varied dramatically depending on agency type. Hospital-based and third-service EMS systems were least likely to provide structured mental health resources, underscoring the need for system-level wellness interventions.
4. Interest in mobile integrated healthcare is strong, especially among paramedics
More than 60% of respondents viewed MIH, telehealth and alternate destination programs as good uses of their skillset. Still, participation remained low due to organizational, legal and training-related barriers. The findings suggest enthusiasm for innovation exists, but implementation support does not.
5. Job satisfaction is shaped by context
Geography and agency structure matter. EMTs in both rural areas and large cities reported higher rates of job satisfaction compared to their counterparts in mid-sized or suburban communities. Meanwhile, paramedics, particularly those in urban third-service agencies, expressed more dissatisfaction, revealing a nuanced landscape of occupational contentment.
Comparing the data: Florida’s survey and the EMS Trend Survey
The Florida survey results align closely with the EMS Trend Survey results, produced by EMS1 and Fitch & Associates, which engaged over 1,200 EMS professionals across the U.S., culminating in the What Paramedics Want in 2025 report. While different in methodology and scale, the findings speak with a unified voice on several fronts:
Points of alignment
- Burnout is the profession’s top concern. The EMS Trend Survey ranked burnout as the No. 1 critical issue, with 76% of respondents identifying it as such. While the Florida survey did not explicitly use the term “burnout,” the underlying indicators — emotional exhaustion, dissatisfaction and mental health symptomatology — paint the same picture.
- Leadership quality influences satisfaction. The What Paramedics Want in 2025 report noted that over 50% of respondents rarely received praise or feedback from supervisors. Florida’s data similarly showed that providers in fire-based agencies, often characterized by stronger internal leadership pipelines, reported higher satisfaction than those in private or hospital-based systems.
- Wellness support remains inadequate. What Paramedics Want in 2025 reported that 50% of EMS professionals were dissatisfied with the physical and mental wellness services offered by their employers. Florida’s data corroborates this, particularly among paramedics and those working outside fire-based systems.
Key differences
- Depth of organizational analysis. The Vital Signs report offers granular insights by provider level, agency type, tenure and community size that allow for targeted analysis of workforce dynamics. National trend surveys, while useful, often lack this level of specificity.
- Burnout was inferred, not directly measured. The EMS Trend Survey included burnout as a selectable item, while FL-CEMS relied on satisfaction metrics, mental health indicators and open-text responses to assess provider well-being.
- Greater optimism for alternate care models in Florida. Florida respondents expressed a higher willingness to participate in MIH and telehealth programs than was reflected in the national EMS Trend Survey data. Yet actual implementation remains limited. This reflects a national readiness gap between provider interest and operational capacity.
Moving from data to action
Both reports reach the same conclusion: EMS is not broken, but it is brittle, and its people are calling for change. Among the most critical takeaways for agency leaders, policymakers, and educators:
- Prioritize early-career engagement. Structured onboarding, coaching and defined career ladders can reduce early attrition.
- Institutionalize wellness and don’t improvise it. Mental health support and physical readiness programs must be predictable, accessible and not reliant solely on peer support models.
- Leadership matters more than ever. Agencies with visible, communicative leaders consistently performed better in satisfaction measures. Recognition, feedback and empathy aren’t perks. They are imperatives.
A final note on EMS job satisfaction
The data from Florida’s workforce survey, when paired with national insights, provides a compelling mandate for transformation. At FL-CEMS, we view these findings not as a crisis to react to, but to learn from and develop nuanced responses. About the author
Established in 2024 with generous grant support from the State of Florida’s Department of Public Health, the Center for Emergency Medical Services (FL-CEMS) is housed at the University of South Florida’s Morsani College of Medicine. FL-CEMS is dedicated to advancing the field of emergency medical services through pioneering research, high-quality education, and innovation working with community partners.
Our mission is to enhance patient outcomes and refine EMS methodologies by leading advancements in prehospital emergency care, improving and modernizing EMS educational curricula, developing robust strategies for effective disaster preparedness, optimizing function and design of EMS systems and promoting cutting-edge EMS research.
