Volunteerism has been around as long as humans. They help communities survive and thrive.

However, some service industries and nonprofits cannot stock a healthy roster of active volunteers — a problem with far-reaching consequences for many communities. With more agencies and fire departments hard hit by low volunteer EMS turnout, we asked leaders in the field to weigh in on the challenges of volunteer EMS.

First, we spoke with Dave Johnson, BS, CP-C, a Relias-based lead instructor in community medicine.

What is the importance of having a strong volunteer EMS base?

When you leave the urban bubble, the necessity for volunteers is huge in EMS, especially given the reimbursement structure of American EMS, Johnson said.

Due to operating margins being the way they are, you need committed volunteers who are willing to share their time with their municipality.

What is the risk of not having volunteer EMS?

Not having a strong volunteer community will result in more services closing shop, which reduces access, increases costs and impacts quality of care, which is completely contrary to the Institute for Healthcare Improvement’s Triple Aim Initiative, Johnson said.

What needs to change so we can have more volunteers in the community?

Having started as a volunteer EMT for a university-based ambulance service, reducing entry barriers is huge, Johnson said.

Creating a pipeline for people to enter the field is important, like providing EMT training in the community or region, but also pairing that with recognition and enrichment.

Leaders need to make their volunteers know that their time donation is valued, and leaders need to be willing to send their volunteers to state and national conferences so they can learn more and bring back new ways of doing things from the larger community.

Next, we talked to Senior Editorial and Program Director Hilary Gates, NRP, MA Ed, of EMS World magazine.

Assuming there’s a problem attracting and retaining volunteer EMS, what are communities or municipalities doing wrong? What needs to change?

Firstly, increasing requirements to acquire and maintain certification, Gates said. The majority of volunteer EMS providers maintain the same level of certification as paid EMS providers.

Organizations where they volunteer adhere to the same state or local requirements as a paid service. The amount of time that providers must devote to continuing education requirements is increasing and coupled with the amount of time the local volunteer service requires makes it a difficult job on top of an existing career, she said.

For instance, a local volunteer agency may require a member to ride on the apparatus 12 hours a week. Typically these shifts are overnight or on the weekends (supplementing the paid day workers).

Also, there are meetings, administrative requirements, fundraising and training that take up time. In households with two working parents, this may be too demanding, Gates said.

There is a lack of marketing and recruitment training and awareness, Gates added. Many of these volunteer agencies rely on volunteers to do their marketing, recruiting, maintenance of training records, retention tactics, etc.

They likely do not have the training needed to know best practices in this area the way that a paid agency would. This, combined with the lack of time mentioned above, makes for branding and marketing that may not be as successful as it could be.

Additionally, those who have traditionally been in these positions may be stuck in the past and not willing to be creative, make change or improve recruitment and retention tactics.

Next, we caught up with Nancy Magee, a nationally registered EMT and licensed Louisiana instructor with expertise in volunteer EMS. She speaks at conferences and volunteer agencies around the country.

Why is there a problem attracting volunteer EMS?

There’s not a shortage of volunteers. There’s a shortage of people who want to volunteer in EMS and fire, Magee said. People volunteer in other places.

EMS organizations have not adapted to changes in social structures. They have not done anything different to attract people and are not accommodating to the volunteers’ needs. The world is not like it was in the 1970s when another volunteer at the fire department would watch your kids.

What do EMS agencies require of volunteers?

The demands required today for volunteer EMS are equal to or exceed what is expected of the National Guard.

EMS entities usually want a commitment to a schedule of 24-36 hours per month, plus meetings and training. Also, you have to pay for your uniform, and sometimes a parade uniform.

What you described doesn’t sound like a volunteer role. Are we misusing the word volunteer?

There’s a tremendous benefit to volunteering, Magee said. We need to change public perception of what it takes to be a volunteer EMS or firefighter.

Volunteer associations need to reclaim the culture of volunteerism instead of trying to change the culture.

Originally, volunteering was about taking care of each other. Now, it’s more about the organization than the mission.

Learn more with our Complete Paramedic Recertification Package today.


Elise Oberliesen has 15 years of combined media and marketing experience. Her work appears on corporate blogs and publications, such as the LA Times, Chicago Tribune and AARP. Her specialties include healthcare, high tech and finance. Elise is a member of the Association of Healthcare Journalists and founder of Big Mountain Media.