The Paramedic Shortage

My good friend (and I daresay mentor) Dr. Bryan Bledose recently opined on the paramedic “shortage” in the United States.

The good doctor mentions several ideas worthy of consideration, including limiting the number of paramedics, improving the scope of basic and intermediate level providers, and allowing for transport to alternate destination.  And like many of the current discussions, he advocates a college degree for paramedic level providers, which is a cause that I can support, given the requisite forethought and groundwork prior to a requirement being instituted.

I really don’t know if the numbers support the assertion that there is a shortage — or that there isn’t.  What I do believe is that a degree requirement is going to exacerbate a shortage.  There’s all the usual arguments that the fire service won’t embrace a degree and that rural EMS will suffer from a lack of access to educational programs.  And the truth is that those are valid concerns.


But here’s my real concern. Most all of us know and agree that a college education creates a more well-rounded provider and provides a core curriculum in English and the humanities.  (I’d also note that said core curriculum is one of the least recognized benefits of a college education from many of the loudest EMS degree advocates on social media.)


We also know that many EMS organizations are poorly managed and have a toxic organizational culture. How many degree educated paramedics are going to stick around this average EMS workplace with the toxic culture and idiotic management? There’s a lot better places to work much of the time and a degree educated provider is typically educated enough to recognize this. College educated folks are a bit less likely to want to drive a truck around town for twelve hour shifts and eat and perform their bodily functions at the nearest 7-11, depending on the whims of dispatch.  And a college educated professional is unlikely to respond well to unwritten policies and upper management dictating policy through email rants.

If we want to fix EMS and address the paramedic shortage, we need to address working conditions first. And that starts with expecting EMS managers and leaders to actually be competent to run a functional organization.  EMS needs more education, but that education needs to extend well beyond a better way to read an EKG.


  1. Jeff Brockman says:

    While I agree with most of what was said, I will say that if we are going to thrive as a profession we need the education first to be at the top level! I’ve experienced it first hand where leaders of departments have sacrificed education requirements / degrees for work experience to continue to promote from within and keep the “good ol boys club intact”. I’ve also in my career worked for people that haven’t even worked in the environment that they are in charge of leading ( and this is both from my EMS and my hospital work experience!)

    • This is why they have EMS classes. Yes I do agree one should have the correct education to “run with the ambulance.” Patient care is a must. Communities can corrupt Ambulance stations. We need to support our VOLUNTEERS FIRST, who are already established and continue to encourage communities to recruit new members. Give the interested people a reason to want to become EMS. If a person wants to do it as a “second” job, then he has to go where the money is. All Counties , Cities and States are different. It is a realistic job. I Pray that Ambulances doesn’t lose the strength to a point of not being able to provide for citizens in time of need.

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