A study by the American Ambulance Association in 2022 found the national employee turnover rate for emergency medical services is at an all-time high, reaching a range of 20%-36%, depending on the position.
Campbell said the MCHD’s turnover rate has been below the national average for the past three years, but numbers still remain high. In 2020, the turnover rate in Montgomery County for EMTs and paramedics was approximately 8%, doubling in 2021 to 16% before increasing in 2022 to 19%. As of May 2023, the turnover rate for this year is at 15%. Campbell said the goal is to be at or below 15%.
“One of the biggest contributing factors that is leading to the paramedic shortage is burnout—we’re busier now than we’ve ever been,” he said. “If you look at having more calls but fewer paramedics and fewer trucks on the road, it’s causing people to leave the industry.”
To address the high turnover rate, Campbell said his first step was to focus on employee retention. In January, the MCHD implemented a schedule change to allow paramedics and EMTs an additional day off—five in total—to help restore work-life balance. The new schedule is now one 24-hour shift, one day off, another 24-hour shift and then five consecutive days off.
Sarah Cuccia, captain of professional development at the MCHD, said hiring is another priority for the district.
The Texas Workforce Commission projects the emergency medical technicians and paramedic occupation in the Gulf Coast, which includes Harris and Montgomery counties, among others, is expected to grow 22% in 10 years. Despite seeing a shortage of workers, Campbell said the MCHD is 99% staffed.
In 2024-25, he said the hospital district anticipates opening more new stations in the county to accommodate growth, which will create more open positions. There are currently six open EMT positions and 14 paramedic positions.
Thinking ahead, Cuccia said the district is offering to pay tuition for EMTs to attend paramedic school at Lone Star College. In exchange, new graduates commit to working at the MCHD for at least three years.
“It’s a good opportunity if you’re an EMT and you want to be a paramedic,” she said. “You can go to school full time and get paid to work full time.”
Michael Furrh, a board member of Texas EMS Alliance, which serves as the state's public policy voice for EMS providers, listed pay as another major contributing factor to the shortage.
According to the U.S. Bureau of Labor Statistics, the annual median wage for paramedics as of May 2021 was $46,770. The average salary for EMTs was $35,470.
The average median wage for paramedics at MCHD, according to Campbell, is $67,505, while an EMT’s median salary is $48,100.
Furrh said the salary for first responders is paid through a city or county budget, causing challenges in upping pay.
“I really want the general public to understand that we aren’t just ambulance drivers,” Furrh said. “Paramedics are essentially a rolling ER room, and we are doing things in the ditch that they are doing in the hospital. All of us want to pay our employees more. Most of us can’t, but somebody will always be there to answer the call; it just depends on where you are in the state on how the shortage is being addressed.”
