Today’s Biggest EMS Department Challenges

Author: Lauren Cantley

In February 2023, PCG sponsored a webinar with NAEMT & ICMA-CPSM titled, “EMS in Critical Condition – Analysis of National Survey on EMS Economics and Operations”, which was attended by over 350 EMS leaders, as well as municipal and county officials. The webinar explored the scope of the staffing and economic crisis facing EMS agencies and predictions for changes coming in the near future. The recording of the webinar is available and free to NAEMT members on the member portal which can be accessed using the following link: Member Login (

Prior to the webinar, NAEMT asked EMS and Fire agencies across the country to reveal pressing challenges their EMS systems face in their respective communities. This webinar revealed major findings from the survey and discussed how agencies are changing. After the webinar, attendees were asked to answer a survey for PCG, identifying the biggest challenges their departments face, along with any major operational or structural changes being implemented in 2023.

The webinar’s survey results show the top 5 biggest challenges being:

  • Staffing
  • Recruitment and retention
  • Funding
  • Reimbursement
  • Finding/Keeping Volunteers


The top 5 major operational or structural changes being made this year are:

  • Hiring
  • Increasing training and education (for both internal staff and local communities)
  • Creating a tiered response model
  • Increasing funding
  • Creating additional advanced life support (ALS)


It should come as no surprise that staffing is the biggest challenge, as this has been a nationwide issue for several years now. The survey showed how numerous agencies are increasing the number of personnel they hire in order to alleviate staffing shortages. Although there are many intricacies behind the hiring process, agencies are working to address the staffing shortage.

If you can think of a challenge your agency is facing that is not on our list, leave us a comment below, or reach out! Our team is always here to help.



Posted by PCG

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