Over the past three years, healthcare staff shortages have periodically made their way into the headlines. But none of them may be as critical or urgent as the current lack of EMTs, paramedics, and ambulance personnel. According to the American Ambulance Association, 39% of all EMT positions and 55% of all part-time paramedic positions routinely go unfilled.
Recruitment and training for these positions have been steadily dwindling over the years – but over the last two years, the rigors of pandemic surges drove one in three EMTs to quit their job. Many will likely leave the profession permanently. As a result, many for-profit ambulance companies are turning to sign-on bonuses and travel contracts to fill this gap, with only modest results.
Why Recruiting More First Responders Matters
When patients request emergency transport, their chances of survival are dramatically affected by the time spent between the original emergency and the moment a professional can tend to them.
For an ambulance company, open positions and understaffed shifts will directly increase their response times. In turn, this will create delays in offloading patients at an Emergency Department (ED), worsening outcomes and increasing the risk of preventable deaths. At a time when average ED waiting times are already at an all-time high, these staff shortages may directly translate into lives lost.
Big Bonuses and Shiny Perks: FALCK USA’s example
The EMS shortage is expected to hit low-income areas and small agencies the worst, as they often don’t have the funds to compete with larger agencies in big cities. However, even large corporations in desirable areas fail to meet their recruitment targets.
Falck USA, one of San Diego’s largest ambulance providers, is a good example of how “cold, hard cash” may not be enough to keep paramedics on the job.
Where did Falck go wrong?
In 2021, the city of San Diego chose Falck to replace American Medical Response, a longstanding emergency provider. Falck entered the market offering lower response times, better patient outcomes, and at least 900 ambulance hours per day.
To meet these ambitious promises, they offered a $50,000 sign-on bonus for any new full-time paramedics. These bonuses are being paid out over three years as a $600 increase on each paycheck. And yet, over one year later, Falck still fails to meet its contract’s minimum requirements.
Why Isn’t FALCK Meeting its Target?
Few people would reject $50,000 without a second thought. However, once this bonus gets divided into monthly installments over three years, much of the attractiveness is lost.
But FALCK’s relative failure goes a step beyond that. First, using a sign-on bonus may have actually been detrimental to the company’s morale, as it failed to reward its existing employees appropriately.
According to Tony Sorci, a San Diego paramedic union leader, the bonus also doesn’t compensate for Falck’s below-average wages. California is well-known for its high cost of living, making $600 a month less impactful than it initially seems. Falck’s base hourly wage for paramedics is just $22.39, while American Medical Response pays $25 an hour.
In addition, the well-known staffing shortages at Falck are also jeopardizing its reputation among prospective recruits, who now have the power of choice. A company with insufficient staff is more likely to deny PTO or vacation requests and will likely be less accommodating when scheduling shifts. With low morale and overworked employees, the atmosphere is also likely to suffer, spurring more employees towards alternative careers.
Instead, more tangible long-term benefits – good health insurance, a solid pension plan, and room for professional growth – may be more effective at attracting new paramedics in San Diego. In addition, the company should care for and nurture its existing staff, acknowledging the tremendous emotional and physical strain of the job.
In a groundbreaking moment for the medical world, a Pennsylvania ground-based EMS unit has become the first to provide whole blood transfusions to a patient in the field.