Finding Common Ground

Emergency Medical Service (EMS) delivery systems across our state are just as diverse as the amazing men and women that provide them. While we wrestle with high-level industry questions surrounding our identity as healthcare versus public safety one thing we all have in common is the need for a qualified workforce sufficient to the demands of respective call volumes. Public or private, fire or hospital based, air or ground; we all need well trained and competent personnel, and that is the common ground that can bring us together.


As a general rule, EMS is a nomadic culture and employees tend to move through employment with several different agencies throughout their career. In some instances providers may move out of the EMS profession altogether, as our research shows the average time an EMT or Paramedic in our state remains active in the field is around eight years. The South Carolina Department of Health and Environmental Control, Bureau of EMS (DHEC) along with the South Carolina EMS Association (SCEMSA) have published numerous research papers with supporting data to prove what we all anecdotally seem to know; as an industry, we are struggling to attract and retain new personnel. The questions then become why is this happening and what can we do to improve our position and image?

Be Ambassadors

The first answer is that we all need to be better ambassadors of our profession! EMS is our craft and we should all seek to not only improve ourselves but also empower those around us to do the same. Negativity breeds more negativity. We are not unlike many other professional industries with some of our concerns, however, we need to portray ourselves in a positive light. As EMS providers, we must be advocates for system improvement through meaningful engagement and stop being victims. If the public perception of our workforce is that of unhappy, disgruntled employees it not only serves to erode public trust but also affects our ability to recruit and retain good providers

Show Up

The second suggestion is to get involved. Change is determined by those who show up. Be a proactive advocate of your profession. Complaining without offering suggested improvements will not help us correct our industry concerns. Choose a path that is driven to make positive changes and do something to improve the industry. You don’t have to be an administrator or executive level leader to affect positive change. We need to understand all perspectives to make informed decisions.

Finally, I would suggest that EMS is evolving. We are the youngest of the allied services and as such we are still finding our place in the healthcare versus public safety world. Truth be told, EMS may also have a place in the public health arena making it difficult to truly assign the profession in a single setting. Which may be a strength and something that we as a profession can capitalize on.

I say all this simply to spur conversation across our state that the role of the EMT — referring to all certification levels — will likely change in the coming years. Innovative changes in payer alignment and reimbursement have already begun a transition with novel programs such as community paramedic and mobile integrated healthcare. It is only logical to think these trends will extend into traditional EMS as well. These changes could likely impact our ability to recruit into the profession.

I have the opportunity to engage with EMS professionals across the nation as well as across our state and we all have our troubles. Surprisingly, or not depending on your personal view of things, the issues are almost always tied to workforce, recognition, call volume and financial constraints. The issues that face our state are not unique, but our approach to addressing them is. At a recent National EMS conference our state EMS association was recognized for the innovative work that we’re doing surrounding workforce and recruitment. While we still have a lot to do, and sometimes it can seem overwhelming, we should take time to reflect on the fact that our profession is at a crossroads and we have a unique opportunity to be part of these discussions on a national level and here in South Carolina.

The need for effective leadership and stewardship of our craft is needed now more than ever. I hope you’ll join me on December 12th (details on Facebook and our website) for our next association meeting or consider joining one of our subcommittees to help shape the future of EMS in our state. Take a stand and get involved, the future of our industry will be decided by those who show up for the discussions.

Henry Lewis has served in EMS in South Carolina for 18 years. Lewis is employed by Richland County Emergency Services as the Project Coordinator with responsibilities in EMS, logistics, oversight of the South Carolina’s only Mobile Integrated Healthcare Collaborative, and Emergency Management. His career began with the volunteer fire service in Fairfield County where he still serves as a volunteer today. Henry is former EMT and Fire Instructor, sits on numerous committees at the state and national level, and is serving his final year as the President of the South Carolina EMS Association. Contact:

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