Why diversity matters in EMS

David Page, Pinnacle EMS Leadership Award winner, discusses diversity in EMS, why we don’t want to talk about it and what we can do to make things better


When I started in EMS more than four decades ago, just about everyone I worked with was a white male. All these years later, that has changed a little, but not nearly enough. Our profession still struggles to recruit and retain a diverse workforce.

Why does diversity matter in EMS?

An EMS workforce that reflects the people it serves will be more empathetic, better able to treat its patients and receive the respect and support of the community. We don’t need to look much further than what’s happening between police and residents of cities across the country to understand that.

David Page at the Pinnacle EMS awards.
David Page at the Pinnacle EMS awards.

Unfortunately, many of us struggle to talk about diversity, afraid of offending someone or convinced that it isn’t a problem. One leader in EMS who isn’t afraid to talk about the issue or do something to improve it is David Page, which is why I was honored to present him with the 2016 Pinnacle EMS Leadership Award.

For years, Dave has proven that leadership doesn’t come with a title — he isn’t a chief, but he has made as much of a difference in the profession as anyone else in the last few decades. As an educator, he has inspired hundreds to make a difference. As a lecturer and author, he has changed how thousands of us practice in the field and train our successors. And as an advocate, he has encouraged us to be safer and shown us the critical importance of research and evidence in everything we do.

But what has truly inspired me is Page's unwavering efforts to bring more diversity to the workforce and encourage young people, many of whom had been written off by the rest of the community, to strive for greatness.

Creating an opportunity for low-income youth to thrive

Page is the driving force behind St. Paul (Minn.) EMS Academy and Freedom House Ambulance Service, which trains low-income youth and helps them enter the EMS workforce. Although the news reports make it look like a no-brainer, behind the scenes Page has had to fight for the program and his students against pressure from people in our profession and in his community who would rather see things stay the way they are.

"They don’t want to talk to me," Page says. "They’re flat-out very upset that somehow we are giving a 'handout.'"

It takes true leadership to stay the course and do what’s right despite opposition, threats and a difficult path. But what Page recognizes is that his struggle pales in comparison to the struggles faced by many of his students, including assumptions that poor, inner-city kids are destined to fail.

"The attitude that 'these people' won’t be able to perform at a level that everybody else does is still very, very prevalent," Page explains. "They call it a 'reach down,' because you’re reaching down the list for diversity that is not as qualified."

His students also face a double-standard.

"You’re going to have to rise to a higher standard to prove that you can be a part of us," Page reminds them. "You’re going to have to speak not only for yourself, but for your race."

And that’s just the start. Fire department personnel, the potential future colleagues of the EMS Academy students, have followed and filmed Freedom House ambulances in the city, Page says. They are hoping to catch his graduates rolling through a stop sign or screwing up in some other way.

But what Page has shown is that his students, who might not score as highly on department entrance exams — many of which emphasize physical strength over other factors — can thrive in EMT class and eventually work as EMTs or go on to paramedic training. Proudly, he’s seen many of his students hired by hospitals and nursing homes, but sadly struggle to get jobs in fire departments and EMS agencies. The rest of the health care community, it seems, is ahead of EMS — they see the value in having a workforce that reflects the patients and community they serve.

Benefits of a diverse workforce

Page points out that naysayers argue you can’t ensure the "right" provider will end up with the "right" patient. The paramedic who is Hispanic might be on a call with another patient, and not available to help translate when a patient who speaks Spanish is having a heart attack on the other side of town.

But Page says that is just an excuse for keeping the status quo. Having a more diverse workforce means having more resources available — and a smart EMS system will go out of its way to get the right resources to the patient if necessary.

But he’s not arguing that individual caregivers have to look and sound like each patient they treat. It’s the indirect impact of diversity that can truly make a difference in an agency and in the profession. Learning during training sessions and in the station from colleagues who have different backgrounds will help each of us when we treat our patients. Think how much more we’ll learn from a diverse group of coworkers, rather than hearing the annual lecture on diversity taught by someone who looks, sounds and thinks like we do.

"That we’re not ready for this conversation in EMS is an understatement," Page says. "There are factions within our profession who would like to make sure this doesn’t happen. There’s a reason we don’t have diversity."

At the same time, programs like St. Paul’s EMS Academy (and the similar academy held by nearby AllinaHealth EMS) and Freedom House Ambulance Service, and people like Page and his colleagues, inspire me. It was encouraging to hear that after his great talk on professionalism at Pinnacle, Page was approached by other EMS leaders who wanted to know how they can bring the lessons Page has learned to their communities. They give me hope that we are finally becoming less afraid to openly discuss issues like diversity in our workforce.

Page and each of his students, people who aren’t afraid to stand up and do what’s right in the face of adversity, inspire me and assure me that our profession will continue to grow and better serve our communities and our patients, no matter what they look like or where they come from.

About the author
Jay Fitch, PhD, is the founding partner and president of public safety consulting firm Fitch & Associates. In addition to consulting, Fitch frequently speaks at conferences and serves as the program chair for the Pinnacle Leadership Forum. Contact Jay directly at jfitch@emprize.net.

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