Is 'brain drain' the threat we think it is?

Several sources contradict the assumption of a high attrition rate in EMS

Editor’s Note:

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?


  1. 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 20 September 2012)
  2. Williams DM. 2008 JEMS Salary and Workforce Survey. Retrieved 20 Sept 2012.

About the author

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook writer, author of "EMT Exam for Dummies," has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.

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