By Anthony W. Minge, EdD
As we continue to evaluate the evolving EMS landscape, several critical challenges persist. In 2025, burnout was officially ranked as the #1 concern impacting EMS, reflecting growing concerns within the field. Survey responses show that burnout affects a staggering 76% of EMS professionals, with 25% of respondents ranking it as the most critical issue in their agency, highlighting the urgent need for action to address the mental and physical well-being of EMS personnel.
The rise of burnout
Recognizing the growing prevalence of burnout in EMS providers, we added it to our survey this year as a potential option for the question: Rank the following critical issues facing EMS today.
Respondents overwhelmingly highlighted burnout as the No. 1 top concern facing EMS:
— 76% responded burnout is a critical issue
— 51% of respondents ranked burnout in the top 3 critical issues
— 25% of respondents ranked it their No. 1 critical concern
Ranked above retention of quality personnel, funding and reimbursement, and career advancement, burnout is linked to the long shifts, high stress and emotionally demanding nature of the work.
Burnout can lead to high turnover rates, decreased job satisfaction and compromised quality of care. The emotional toll, combined with physical demands, contributes to a significant portion of EMS personnel either considering leaving the field or struggling with the demands of the job. This surge in burnout is compounded by other factors, including:
- Inadequate staffing (25% ranked staffing the most stressful aspect of their job)
- Inadequate leadership support (22% ranked the most stressful aspect of their job)
- The growing prevalence of complex patient populations
- Those affected by opioids (29% report having a high impact on EMS in their communities)
- Those affected by homelessness (31% report having a high impact on EMS in their communities)
- Those affected by mental health crises (54% report having a high impact on EMS in their communities)
Inadequate staffing and its impact
Staffing shortages remain a long-standing challenge, with 59% of respondents indicating that their agency does not have enough personnel to respond effectively to 911 emergency calls. This is nearly identical to the 57% reported in 2024, demonstrating the persistent nature of the issue. Staffing problems are ranked as the most stressful aspect of EMS work, reflecting both the physical strain on providers and the emotional toll of managing overwhelming caseloads with insufficient support.
Inadequate staffing is not just an operational issue, but a key driver of burnout. When agencies struggle to fill shifts or meet the demands of an expanding service area, providers are forced to work longer hours under increased pressure. The resulting stress contributes to the cycle of burnout, where personnel feel undervalued and overburdened.
EMS leaders must prioritize effective staffing strategies, including attracting and retaining qualified personnel, improving job satisfaction and fostering a work environment where employees feel supported. Addressing staffing issues can alleviate many of the stressors that lead to burnout, improving both employee retention and patient care.
Provider health: A growing concern
EMS providers’ physical and mental health continues to be an area of significant concern. While nearly half (46%) of respondents feel confident in their own physical fitness, only 27% feel confident that their partners are fit enough to handle the rigors of the job. Alarmingly, 40% of respondents report they rarely or never achieve the CDC-recommended 150 minutes of moderate-intensity physical activity per week, and 52% do not perform muscle-strengthening activities twice a week.
The physical wellbeing of EMS providers is critical for their safety and the quality of care they can provide to patients. Unfortunately, agency-level support for physical and mental wellness is lacking. Many respondents report dissatisfaction with their agency’s physical wellness services, with 50% disagreeing that their agency provides adequate wellness support.
EMS agencies are also struggling to support mental health, with 40% of respondents expressing dissatisfaction with mental health services offered by their employers. These statistics highlight a systemic issue within the EMS field: a lack of comprehensive support for the health and well-being of those on the front lines. If agencies do not prioritize both physical and mental wellness programs, the long-term impacts on workforce morale, retention and patient care will continue to escalate.
|More: On demand webinar: Unlock functional fitness. Exercises, techniques and routines designed to maximize readiness, prevent injuries and boost resilience
Leadership challenges in EMS
Leadership remains a critical issue, though it ranks lower than burnout and staffing in terms of priority. However, dissatisfaction with leadership remains high, with 33% of respondents reporting dissatisfaction with leadership at their agency. This dissatisfaction often manifests in a lack of recognition, support and communication from leaders. For example, over 50% of EMS personnel report that their supervisor rarely or never provides regular recognition, praise, or constructive feedback.
Poor leadership directly impacts employee satisfaction, leading to burnout and a lack of engagement. Leadership’s failure to recognize the stressors faced by staff and provide adequate support can lead to a disengaged workforce and diminished job satisfaction. As one respondent said, “Be more directly supportive of employees, make changes when employees express concerns.”
Effective leadership is crucial in creating a supportive work environment:
- Leaders who listen to their staff, recognize their contributions, and support their physical and mental health are more likely to foster a positive and productive work culture.
- Agencies must invest in leadership development to ensure that their leaders are equipped to support their teams through the challenges they face.
The impact of opioids, homeless populations, and mental health crises
The opioid epidemic, the growing homeless population and patients in mental health crises have an undeniable impact on EMS operations. The opioid crisis continues to place a significant burden on EMS, with 27% of respondents reporting that opioid overdoses have a high impact on their community. Similarly, 54% of EMS workers report that mental health crises are a high-impact issue, with many EMS providers feeling ill-prepared to handle these complex situations.
Other studies have shown that continual exposure to these patients in crisis, with limited options for improvement or resolution of the causal situation, can lead to compassion fatigue, patient mismanagement and caregiver burnout.
Agencies are beginning to implement specialized response teams to address these growing challenges, with 17% reporting the use of such teams for mental health crises. However, more needs to be done. Increasing the adoption of specialized teams and training EMS personnel to respond effectively to opioid overdoses, homelessness, and mental health crises will be essential in reducing the strain on EMS resources and improving patient outcomes.
Emerging technologies in EMS
While many emerging technologies hold promise for EMS, their adoption is still in its early stages. Only 6% of agencies are currently using AI tools for clinical care or documentation, and 14% are using whole blood in the field (although at the time of writing this article, this appears to be more rapidly expanding in some major metropolitan areas, such as Fort Worth, Texas).
|More: Tracking the whole blood landscape
These technologies could enhance operational efficiency and improve patient care, but their widespread adoption requires significant investment and training.
In the coming years, EMS agencies must embrace innovative technologies that can streamline operations, improve care quality, and lessen the burden on their staff. This includes the potential of AI tools, advanced medical equipment, and telemedicine to enhance service delivery and patient outcomes.
An opportunity for growth
The real trend here is, most importantly, identifying the myriad challenges the profession continues to face. This year, burnout and inadequate staffing are at the forefront. Addressing these issues requires a comprehensive approach that includes improving leadership, investing in workforce wellness, supporting physical and mental health, and leveraging emerging technologies.
EMS agencies that prioritize these areas will not only improve their quality of care but also foster a healthier, more resilient workforce capable of meeting the demands of this essential service. Reaction to or lack thereof will determine whether this is a crisis dooming our future or a challenging opportunity to be accepted, poising this noble profession for continued success. The time to act is now!
ABOUT THE AUTHOR
Anthony W. Minge is senior partner, Fitch & Associates, coordinating the firm’s educational offerings and responsible for reimbursement, compliance and membership consulting services. He serves as the program co-chair for the Pinnacle Leadership Forum and as the partner responsible for the Ambulance Service Manager and Communications Center Managers certification programs. He has a Bachelor of Business Administration degree, an MBA in Strategic Leadership and a Doctorate of Education in Organizational Leadership.
