The Growing EMS Retention and Recruitment Gap

Author: Lauren Cantley

When thinking of what EMTs or paramedics do for a living and knowing their national average salaries are $36,000 and $46,000 per year respectively, it comes as no surprise that income was the leading factor for EMS agency turnover in 2022 . In the article “Flattening the Turnover Curve,” author Rob Lawrence discusses the latest American Ambulance Association and Newton 360 Industry Turnover Survey results, focusing on the turnover rates for EMTs and paramedics nationwide, along with the cost and effort needed to fill those gaps.

According to the survey results, “Voluntary and overall turnover increased for 2022, with the turnover rate being in the 20-36% range for EMTs and paramedics, a 6% increase over the prior year–meaning that EMS agencies are experiencing a full turnover of all staff every 3-4 years.” Surveyed personnel mentioned increased benefits, wages, and a better work/life balance as their top two needs.

Recruitment has also significantly impacted by turnover causes. If EMTs and paramedics are leaving the industry due to low wages and poor work/life balance, qualified candidates will walk away from applying to open positions that desperately need to be filled. Looking at the timeline and cost of filling these positions, Lawrence notes, “…it takes one day to two weeks to lose or part with a staff member…but, under normal, non-pandemic, circumstances, it could take three months and beyond to advertise, interview, onboard and precept to a street-cleared standard.” Along with the extensive time to hire, the survey estimates it costs roughly $6,000 to replace an EMT, and $8,600 to replace a paramedic, excluding the cost of paying current EMTs and paramedics overtime to cover the gaps.

This is not a new issue, but the voices of EMTs and paramedics have grown louder over the past five years, forcing EMS agencies to look at internal policies, salaries, and funding options. On this topic, Lawrence states: “The survey notes that 85% of HR leaders believe that ongoing feedback and check-ins are key for successful outcomes. Organizations that employ a regular and ongoing feedback model have turnover rates that are 15% lower than those that do not.” This survey shows that listening to EMTs and paramedics makes a difference. Hearing their concerns and working towards a change is necessary to take on this issue of retention and recruitment before the gap in service grows too large.

If you have noticed lower retention and recruitment in your own EMS agency, Public Consulting Group (PCG) is here to help. No matter what your needs are, we have teams specializing in many factors of Fire and EMS who can help you determine what changes need to be realized, and how to implement them in a step-by-step manner.


Turnover Rates by Year by Occupational Category

(2021 Results Appear in Parentheses Below the 2022 Results)

Table/Courtesy American Ambulance Association

Posted by Nora Culeton

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