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3 ways you’re losing EMS providers and how to stop the revolving door

If providers don’t feel like part of a team, they’ll seek a connection elsewhere


Regardless of the size of your organization, if your crew members don’t know what you even look like – up front, in person – as an administrator, then your agency has a big employee engagement problem.


The cost of replacing a medic, both financially and in time invested, is steep. Finding and hiring promising candidates is only one piece of the staffing puzzle. In an EMS1 Special Coverage Series, “Year One: Creating a career path for new EMTs,” learn how to onboard team members to set them up for long-term success, through the first 90 days, the first 6 months and beyond.

Recruitment and retention: we hear about this often within our industry.

“We can’t recruit more volunteers.”

“There’s a paramedic shortage in our community.”

“These young kids only stick around for one paycheck and leave.”

Well, if this is your case, then you might have an employee engagement problem – and you need to address it now, before it’s too late.

If your agency wants to survive through the next decade, then employee engagement has got to be toward the top of your priority list. Likewise, if your agency is hemorrhaging over retention and recurrent onboarding costs, then employee engagement has got to be toward the top of your priority list.

So, where should you start to correct this course ... shift this paradigm?

Active contact and communication

Regardless of the size of your organization, if your crew members don’t know what you even look like – up front, in person – as an administrator, then your agency has a big employee engagement problem.

Now, I’m not saying that you have to take each and every employee out to lunch, or learn about their entire life story. But, if they can’t pick you out of a crowd as their leader, then they sure as heck won’t care about what you say as they exit your agency within the upcoming year or two!

Be active. Be seen. Be heard.

Investing in a communications platform – beyond Facebook – is a great way to create a controlled environment to foster intra-agency communications, provide direct feedback, and promote employee engagement at all levels within the organization.

As an administrator – a leader – it’s crucial that your employees feel engaged by your presence, mentored by your advice, and influenced by your actions. This applies to EMS directors, chiefs, managers and supervisors alike. Be active with your subordinates, otherwise, they’ll seek activity elsewhere.

Create a compatible environment

If your rendition of partnering individuals together as a crew encompasses drawing names out of a hat, or simply filling-in the empty spaces with the new EMT, then you likely have an employee engagement issue on your hands.

Either you need to change your agency’s practices to allow employees to choose their crews, stations, districts, or, you need to individually analyze your entire staff in order to baseline their behavioral and working habits, and then build teams based off of these findings.

Is partnering an analyzer with a maverick the best partner match? How about an ISTJ-A employee? Is that the most ideal candidate for your quality assurance manager position? Would an ENFP-T candidate be better suited?

Analyzing how your staff members interact, absorb, decide and organize can help to build teams, align project leaders, and foster positive working environments for crews. Indexing their performance can help to build teams proactively, rather than reactively. After all, we are a 24/7 operation – and aligning two differing personalities together may not promote the most compatible environment for whatever that 24/7 equates to for them.

Promote individual development

Referring to the quote, “What if we invest in our employees, and they leave? What if you don’t, and they stay?” How do you respond to this?

A lot of blame and hype surrounds our Millennial generation within our workforce, today. Well, as one of them (an older one), what’s your plan to keep us around? After all, we’re the next generation of leaders within our industry, and we’re going to be the ones mentoring the generation to follow.

Does your agency have a career ladder? Even if you’re a small agency, is there opportunity for internal growth, promotion, or individualized opportunities? Tuition reimbursement, training and conference attendance, credential sponsorship, and even incentive bonuses are all ways to promote individual development within your organization.

When employees feel informed and communicated with, then they feel like they’re a part of a team, like there’s a connection. When there’s a connection, there’s an ambition for development. When there’s development, there’s engagement. Moving into 2020, employee engagement needs to be at the forefront of every administrator’s mind. If it’s not, then you’re only going to continue on the same vicious path of having to oil that continuous, revolving door.

[Everyone has a breaking point; it’s important to understand the reasons why some EMS providers may decide to leave, and how to turn a potential problem into a solution. Read: 7 reasons why EMS providers flee, and how to combat them]

This article was originally posted Jan. 7, 2020. It has been updated.

Tim is the founder and CEO of Emergency Medical Solutions, LLC, an EMS training and consulting company that he developed in 2010. He has nearly two decades of experience in the emergency services industry, having worked as a career firefighter, paramedic and critical care paramedic in a variety of urban, suburban, rural and in-hospital environments. His background includes nearly a decade of company officer and chief officer level experience, in addition to training content delivery and program development spanning his entire career. He is experienced in EMS operations, community paramedicine, quality assurance, data management, training, special operations and administration disciplines, and holds credentials as both a supervising and managing paramedic officer.

Tim also has active experience as a columnist and content developer with over 200 published works and over 100 hours of education content available online, and is a social media influencer on LinkedIn within the EMS industry. Connect with him on LinkedIn or at