Viral NREMT screenshot supports EMS staffing doom and gloom … but it was wrong

Data, even when it’s inaccurate or represented out of context, can confirm our biases. Answer five questions about how your agency’s data is being shared and interpreted

The National Registry of Emergency Medical Technicians responded to a widely circulated social media post on Thursday about the number of currently certified EMTs and paramedics in the United States. Earlier in the week, many of the Facebook and Twitter sharers of the screenshot from the NREMT website interpreted the data as year-to-date new certifications and renewal certifications. The NREMT’s statement clarified that their website had been displaying numbers that were current as of mid-January 2021 and not year-to-date.   

Nearly every EMS agency is facing challenges to retaining their current staff. The combination of burnout, rising call volume and hospital bed delays, along with poor pay in many areas, in the midst of a pandemic has proven catastrophic for EMS agencies, regardless of their service model. Meanwhile, industry leaders are reporting that it’s more difficult than ever to recruit applicants, as they dial up signing bonuses and launch earn-while-you-learn programs.  

Data is often used in storytelling. EMS providers and employers have been fortunate in the last two years to have more opportunities than ever before to describe EMS successes, threats and challenges to media outlets, from the “New York Times,” to NBC, to hometown newspapers and television stations. As we’ve told the story of EMS, we’ve weaved together anecdotes and data to illustrate our reality. The stark contrast of 2020 to 2021 certifications, using inaccurate data and without context, fit a narrative we’ve been telling ourselves and our communities that EMS is in crisis.  

Confirmation bias is using observations to reinforce or affirm existing beliefs. We have a lot of reasons to believe an EMS staffing shortage exists. We regularly post news items about staffing shortages and innovative recruiting strategies. Most of you are working for employers that are understaffed. You’ve seen your coworkers leave as you soldier on, overworked and underpaid. The viral post of NREMT certification numbers confirmed a belief that many of us have about the gloomy state of EMS staffing.  

It took the NREMT about a day to respond to the internet’s gasping and hand wringing. This incident, along with the NREMT response, offers lessons for your organization. Here are five questions for every EMS agency to answer:  

  1. How is your organization’s data – staffing levels, response times, cardiac arrest survival, ketamine usage, immunization rates, etc. – being interpreted and shared by employees, competitors, regulators, policy makers, elected officials and the media?  
  2. What stories is your organization telling about its successes, challenges and threats?  
  3. How are you enriching those stories about your organization with organization-specific data and national EMS data?  
  4. How are you monitoring the social conversation about your organization, the organization’s data and the organization’s performance?  
  5. What processes and staff are in place to respond to misinformation quickly and effectively?  

Finally, the NREMT’s statement noted 2021 certifications have been removed from their website and won’t be released until the end of year in the organization’s annual report. Instead of waiting until the end of the year to release numbers on first-time certifications and renewals, I’d like to encourage the NREMT update the profession every month. I think the seasonal fluctuations, as well as month-over-month and year-over-year trends, will provide important data for EMS leaders and educators, as well as help us all continue to tell the stories of EMS success, challenges and threats.  

Visit for national registry data, including the number of NREMT personnel by state and past year annual reports.

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