Patient Care

The Malcontent Medic: How to control persistent pessimism

Say you just finished talking with a certain employee who wanted a pay increase or just wanted to complain about the old recliners in the break room. You_re thinking, ˙They never seem happy, no matter how I try to accommodate them.Ó As a colleague of mine once said, if you give them a raise, they_ll complain about having to pay more taxes.

I_m not talking about the medic who occasionally complains about a policy or their schedule; we all have parts of our jobs we_re unhappy about and may even do a little bit of complaining at times. I_m talking about the medics who complain about everythingƒthe malcontents! Even their partners dread working with them, because they can suck the energy right out of you. But partners who stick around and listen to the malcontent medic long enough might start believing some of the rhetoric and turn negative themselves. Worse yet, the malcontent_s attitude can become infectious and spread to others throughout the organization.„

Seeds of Discontent

I_ve had plenty of experience with malcontent medics. I_ve seen how they can disrupt a successful organization, preying upon the weak. After having witnessed the process from beginning to end, I_ve given plenty of thought to how negative attitudes can impact an organization and how to deal with them effectively.„

Let_s first discuss the reasons why people are discontent and yet remain in your workforce. Based on anecdotes from other EMS managers, I_ve learned that malcontent medics exist in every department. It_s rare when you hear about a department that doesn_t have at least one. It_s a commonality that reaches across fire-based, county, third-service, PUMs and every other delivery model.„

So, we should realize that negative people would probably be unhappy wherever they worked because they enjoy creating discord and conflict. Take them out of EMS and put them to work at a large financial institution, and their negative attitude would probably be pervasive there as well. They_d likely complain about the corporate structure, the management, the pay and benefits, plus a host of other issues.

If it_s not the environment, it_s something internal that drives them to be negative. Further, their behavior is based on years of a negative perspective, so a change for the better has to come from within. You, as the EMS manager, can_t force the malcontent medic to change their attitude. Also, the change will take years, and your patience might be tested.„

Some malcontent medics are just burned out. Some can_t recover and move into other professions. Others stick it out, never to be happy, and reach what I call the ˙let_s get your shoesÓ phase. This phase is when a medic shows up on a low-priority call and doesn_t question the patient about why they called. They just tell them, ˙Get your shoes and let_s go to the hospital.Ó Previously, the provider might have discussed why a patient should call 9-1-1 only in an emergency and whether going to the hospital was necessary for them.

Homegrown Remedies

To get malcontents back on track, first assess how much of the problem might be external. Although being discontented is primarily internal, you invite the malcontent medic to constantly voice negative opinions if your organization isn_t run efficiently. The more mismanagement, the more opportunity they have to point their finger at you.

If it_s not the management, you need to deal with the employee directly, which isn_t an easy task. We_re not trained psychologists; we may not have insight into the human mind, how it ticks and how to change what people think. But one theory we can borrow from parenting and teaching is that misbehavior is often a sign of not being challenged.

If your dissatisfied employee hasn_t reached the stage of being unhappy no matter what, posing a new challenge will sometimes redirect them in a positive way. Try giving them a role that puts them into the decision-making tree. They_ll move from ˙outside the circle,Ó where it_s easy to throw stones at the administration, to ˙inside the circle,Ó where they have ownership of the decisions handed down.„

If they have the aptitude, try including them in management meetings. I know it_s hard to bring the malcontent medic closer to the inner workings of the department when you fear they_ll gripe about petty issues, but it gets rid of the ˙us versus themÓ attitude. Formal involvement with your department leaders will force your employee to put aside their personal complaints and focus their energy on productive tasks related to agenda items. You might even realize that some of their complaints are valid and learn that they have great ideas on how to improve the organization.


Dealing with the malcontent medic isn_t an easy chore for the EMS manager. However, it_s a responsibility we should undertake to maintain the morale of our employees. Left unchecked, the discontented employee can spread their negativity like a cancer among your entire workforce.„

Gary Ludwig, MS, EMT-P, is a deputy fire chief with the Memphis (Tenn.) Fire Department. He has 29 years’ experience and previously served 25 years with the city of St. Louis. He is chair of the EMS Section for the International Association of Fire Chiefs and can be reached online at„

Presented by the„IAFC EMS Section