The paramedic profession is growing rapidly in Israel. The study examines whether there will be a balance between the supply and demand for paramedics in the future by looking at the supply of paramedics; the nature of the profession; the expected demand for paramedics; and whether the supply forecasts are commensurate with the demand forecasts. To gather information on supply, we conducted a national telephone survey between November 2005 and February 2006 of a random sample of over 50% of graduates of paramedic courses and we examined administrative data on the paramedic training courses. We also conducted interviews with key people in the field of emergency medical services (EMS) in order to develop scenarios of the demand for paramedics.
Key Findings
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64% of course graduates are working in the civilian market. The rate of those leaving the profession is 18% over a five-year period. The likelihood of newcomers remaining in the profession after one year is 96%, after five years, 79%, and after 10 years, 68%, with variations based on gender and the type of course taken. Older paramedics, those with children, and the more highly educated among them are more likely to remain.
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The factors that attract people are strongly tied to the nature of the work. For many, lack of administrative support, paperwork, long hours, imbalance between work and family life, and the salary, are harder to cope with than the serious nature of the job, the responsibility, or difficult incidents. Dissatisfaction is connected to burnout, overwork, and poor health.
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From the structured interviews it emerges that the boundaries that define the profession are expected to remain as they are, commensurate with the training given today. However, it is possible that paramedics will be employed in new settings both within the health system and outside of it.
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If demand does not increase beyond the natural growth rate of two intensive-care ambulances (ICAs) per year, there could be a surplus of paramedics by 2010 (and perhaps even before). If paramedics are employed outside of the EMS (such as in factories and at large public gatherings), it will slightly increase the demand for paramedics, but a surplus will remain. However, if the ambulance fleet is upgraded to ALS (whether each ICA has one or two paramedics), the demand will increase substantially, and a significant shortage of paramedics will be produced unless more paramedics graduate every year.
The findings of the study make it possible to better plan the required complement of paramedics for a range of time periods and scale the scope of the training programs according to a variety of scenarios in their labor market. The findings could help long-term strategic planning of this workforce. The study was funded with the aid of a research grant from the Israel National Institute for Health Services and Health Policy Research.