Why are Paramedics Leaving the Streets

John M. Dabbs

Joshua Hoehne/Unsplash
Photo by Joshua Hoehne on Unsplash

Our streets are busy as ever with police, fire, and EMS (emergency medical services) responding to calls. In many locations, ambulance service providers have seen a significant uptick in the number of calls. Patients are routinely transferred to other facilities for care instead of receiving it in their local hospital. A large percentage of the U.S. is experiencing stagnation in the number of paramedics and EMTs (emergency medical technicians), even as the need for services has grown. The number of EMS providers is not keeping up with the volume of calls, or rise in population.

Is EMS dying as a profession

Is it a sign of the times, blending into the background, or indifference to the profession that has lessened the numbers in the grand public service ratio. It could be a combination of factors. Even before the dangers of infectious and communicable diseases like COVID-19 rose to prominence, more people were leaving the profession than entering. Most new paramedics and EMTs are choosing alternate career paths, moving into hospitals, industry, and support services. There are many new EMTs and paramedics who just aren't interested in riding in an ambulance.

Leaving the streets

How many 9-1-1 paramedics have made the transition over the years, from “trauma junkie” and “squad dawgs”, into a more refined and sophisticated provider with less passion for the profession. Whether burned-out or seeing the profession as maturing, there is a big difference in the pride exuded by EMS professionals. You may remember when a Star of Life or EMT decal could be found on their car when they received their license. Many would even wear their EMS or rescue squad jackets when off duty. We don’t see it anymore. There is less pride associated with the profession.

More EMS personnel choose to go about their private lives anonymously. Many have left the role of EMS provider, running 9-1-1 calls and taking transports to doctor's appointments or taking people home from the hospital, or to dialysis. They have moved on... working in hospitals, physician's offices, industrial settings, theme parks, and sports venues.

They choose to blend into society and not stand out in the crowd. Have we regarded those once proud ideals and professional symbols as juvenile and silly? Maybe we have. But is it also affecting the profession and those who would be drawn into the profession?


As a stepchild in the public safety arena, EMS is not a true public safety agency as are fire departments and law enforcement agencies. EMS is a healthcare service, with roots in public health, public service, public safety, and transportation. Obvious to anyone who can see them in polo shirts or a scrub top with BDU pants, boots, duty belt, a taser, fire helmet, penlight, scissors, and a pen.

They once had uniforms like their public safety brethren, of polyester uniform pants and button-up uniform shirts, or coveralls. From the initial milk-man white, they transitioned to uniforms similar to fire and police departments… some still wear the paramilitary uniform. Other agencies transitioned to T-shirts or Polo Shirts with most agencies adopting “EMT pants” with lots of pockets to hold all of the gear once kept in holsters.

They didn't want people thinking they wore holsters like the police with a gun, handcuffs, mace, and extra ammunition accompanying their radios. They put all of their stuff into pockets… and downsized. The penlight or Mini-Maglight, EMT shears, and a couple of pairs of gloves fit into their pockets with room for pens, guidebooks, and the like, along with their cell phones.

Appearances can be leading

I can’t help but wonder if they have become too enamored with comfort and utility. EMS employees look less like professionals today than in the past. Many studies emphasize the impact of physicians wearing sport shirts, compared to those with a dress shirt and tie and a white lab coat. The same with nurses and scrub-suits compared with traditional nursing whites. Have they over-valued comfort? The look of a professional has an impact on the perceived value - of the profession, and the competence of the professional.

Studies reinforce that properly uniformed professionals give the best first impression and put the public at ease more so than those dressed just for comfort or utility.

Should we adopt the old world influence with everyone wearing “put your eyes-out yellow” or bright green? Adopting Battenburg patterns on ambulances and reflective wear? Personally, I think that’s a bit overboard, but then I’m only speculating and pondering. It is not meant as advice, on to serve as some food for thought.

Some of our European and other foreign EMS personnel abide by strict uniforms that contain retro-reflective materials and safety-color materials that help them stand out when in the roadway… or a blinding snowstorm. It’s quite an impact compared to where we are in the scheme of things.

Considerations of Safety

As we consider the causes of injury and death to most EMS providers in the united states, most of the injuries are due to slips, strains, and falls. Proper stretching and joint strengthening exercises combined with a continuous reinforcement of proper lifting and moving techniques and proper footwear could address a majority of these issues. Most EMS involved fatalities are transportation-related and could benefit from proper vehicle design, requiring providers to remain seated and buckled in while attending patients during transit.

Have you seen a NASCAR driver promoting a product? Have you seen one promoting a product while still wearing his helmet and racing suit? Me too. It’s because we identify people and their groups by their uniforms. If we do not recognize the person, we can still identify them as one within a group by how they dress.

Lasting impressions

Maybe it's time to revisit a more traditional uniform. A shirt with a few patches can be of a material that is comfortable and professional in appearance if pressed. Uniform pants can be dressy with patch-pockets on the thighs for scissors and gloves. Excessive pockets are sloppy and catch on too many things. They also interfere with a proper crease in the pants.

Lastly, let’s clean up and shine those boots or shoes! Good grief I’ve seen a lot of EMTs who have probably never even been shown how to properly shine their boots. Watch a YouTube video if you have to! It’s not that hard! Being a professional requires you to look and act professionally. Emphasize this point and take pride in the profession and organizations. Promote the profession and do not be afraid.

Do not go gently into the night, there is no need to blend into the background. EMTs and Paramedics are really needed in this day and age. The profession is still evolving, and there are growing opportunities for people to become involved. These heroes and heroines in the streets deserve our respect, our support, and to be recognized - now more than ever. We need a lot more of them.

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An outdoor enthusiast with a passion for travel and adventure. John is a professional consultant and photojournalist.

Johnson City, TN

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