Editor’s Note: This article originally appeared in the EMS1 industry report, “What Paramedics Want in 2026: The provider roadmap for EMS leaders.” Explore our full coverage in the What Paramedics Want resource hub.
By Kerri Hatt and Anthony W. Minge, EdD
Despite widespread concerns about burnout, staffing shortages and compensation, a significant portion of EMS professionals still say they would recommend the profession to others.
The question is why.
The 2026 What Paramedics Want Survey found substantial differences between providers who would enthusiastically recommend EMS as a career and those who would discourage others from entering the field.
The divide was not simply about pay.
Instead, the data suggests providers are most optimistic when they work in systems that are predictable, adequately staffed and designed to give crews opportunities to recover between calls.
In many ways, the findings offer a roadmap for EMS leaders looking to improve retention and recruitment.
Predictability matters more than many leaders realize
The strongest relationship in the survey involved workload predictability.
Among providers who described their daily workload as highly predictable, 66% qualified as EMS career promoters, meaning they rated their likelihood of recommending EMS between 7 and 10 on a 10-point scale.
Among providers reporting low workload predictability, only 29% were promoters.
At the same time, detractor scores climbed dramatically among providers working in less predictable systems.
The findings suggest EMS professionals are not simply evaluating how busy they are. They are evaluating whether their work environment feels manageable.
Providers appear more likely to remain optimistic about the profession when they can anticipate workload demands, recover between calls and maintain some control over their schedules.
Recovery time separates promoters from detractors
Another defining characteristic of high-morale systems was recovery time.
Throughout the survey, providers repeatedly emphasized the importance of downtime between calls.
Many respondents described adequate recovery time as essential for:
- Physical health
- Mental health
- Family stability
- Patient care
- Long-term career sustainability
The operational data supports those concerns.
Providers working in deployment models associated with better recovery opportunities consistently reported stronger workforce sentiment.
By contrast, respondents working in environments where recovery time was rare reported lower levels of career satisfaction and were significantly less likely to recommend EMS to others.
The message from providers was clear.
Downtime is not a luxury. It is a workforce retention strategy.
Stable deployment systems appear to improve workforce outlook
The survey also identified differences between deployment models.
Static and hybrid deployment systems generally produced:
- More predictable workloads
- Better recovery time
- Fewer shift overruns
- Stronger career recommendation scores
Dynamic deployment systems, often referred to as system status management, showed the opposite pattern.
Providers working in those environments were more likely to report:
- Unpredictable workloads
- Inadequate downtime
- Frequent late calls
- Overtime-related fatigue
While deployment decisions are often driven by operational efficiency and response performance, the survey suggests leaders should also consider workforce implications.
The findings indicate deployment design may influence provider morale as much as many traditional retention initiatives.
Overtime remains a major dividing line
One theme appeared throughout both the quantitative and qualitative findings.
Providers want their scheduled shifts to end when they are supposed to end.
Respondents who reported frequent overtime, mandatory holdovers and routine late calls were substantially less optimistic about the profession.
Many described a cycle in which staffing shortages create overtime, overtime creates burnout and burnout further worsens staffing shortages.
Providers working in systems with lower overtime burdens consistently reported stronger career satisfaction.
The implication is straightforward.
Reducing overtime may improve retention not only by reducing fatigue, but by restoring predictability and work-life balance.
Balanced resource deployment may reduce provider fatigue
The survey also found slightly stronger career recommendation scores among providers working in agencies that use a combination ALS/BLS deployment strategy.
Many respondents expressed frustration with systems that place all workload responsibility on paramedics, regardless of call acuity.
Several providers specifically called for:
- Better use of BLS resources
- Expanded tiered response systems
- More appropriate matching of resources to patient needs
The findings suggest workforce optimism may improve when agencies distribute clinical workload more effectively across the system.
Innovation may signal organizational health
Technology adoption also emerged as a potential indicator of workforce optimism.
Respondents working in agencies adopting newer operational models often expressed greater confidence in the profession’s future.
Examples included:
- AI-assisted documentation
- Telemedicine
- Community paramedicine
- Alternative destination programs
- Mental health response teams
- Whole blood initiatives
While this correlation does not prove innovations directly improve morale, agencies pursuing operational innovation may also be demonstrating characteristics providers value, including adaptability, investment in improvement and willingness to address long-standing operational challenges.
Leadership still matters
Perhaps the most consistent theme throughout the survey involved leadership.
Providers who spoke positively about their agencies frequently referenced:
- Communication
- Transparency
- Accountability
- Leadership support
Those who expressed frustration often described feeling disconnected from decision-makers.
Many respondents noted leaders should spend more time understanding field conditions and listening to frontline concerns.
The findings reinforce a lesson that has appeared repeatedly throughout the What Paramedics Want survey series: culture matters.
Providers are more likely to recommend EMS when they believe leadership understands their challenges and is actively working to address them.
A roadmap hiding in plain sight
The survey results suggest the agencies most likely to generate workforce optimism are not necessarily the agencies with the highest budgets or the newest equipment.
Instead, they are often agencies that create operational environments where providers can succeed.
Predictable workloads. Adequate recovery time. Reasonable overtime expectations. Supportive leadership. Thoughtful deployment practices.
Taken together, those characteristics appear to define the systems where providers still believe EMS is a career worth recommending.
For leaders facing recruitment and retention challenges, that may be the most important finding in the entire survey.
The profession cannot eliminate difficult calls, staffing shortages or financial pressures overnight.
But the data suggests agencies can influence something equally important: whether providers believe the job is sustainable.
And increasingly, sustainability may be the difference between a provider who encourages others to join EMS and one who tells them to look elsewhere.
ABOUT THE AUTHORS
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.
