Revitalizing Emergency Medical Services in the United States: A perspective from frontline workers

Emergency Medical Services (EMS) stands at a critical juncture in the United States. Despite its indispensable role in the healthcare continuum—providing vital acute care and transportation during emergencies—EMS is confronted with significant challenges. Underfunding, personnel shortages, and an outdated financing model collectively undermine the sustainability and efficacy of EMS agencies nationwide. Urgent action is required to address these issues and prevent the collapse of EMS. In this article, we present recommendations from frontline EMS workers to revitalize the current EMS system. These recommendations include restructuring the financial framework to improve workforce compensation and retention; fostering professional development pathways within the EMS sector; and implementing community paramedicine initiatives while fully utilizing advanced Emergency Medical Technicians to enhance service value.