EMS Insider, Expert Advice

We Just Won the Lottery, We’re Out of Here!

The unfortunate situation exists today that if you were to go out into any crew room and ask the average paramedic whether they would ever aspire to be a supervisor or an officer one day, they would probably laugh out loud. We have to ask ourselves why that is. Although most, if not all, paramedics entered the profession to treat the sick and injured in a pre-hospital setting, why is it that many very qualified paramedics, who are also great leaders in their own right, do not want to get promoted?

Let me ask you this: What would happen if the senior leaders in your agency all bought into a lottery ticket and won big? While some might stay for the thrill of the job or the dedication to their sworn duties, my guess is that most of them would be off to St. Somewhere Hot. So this begs the question: Who would step into their boots? One tragic real world example of this was 9/11, when FDNY lost a large amount of its senior command structure in one major incident.


It is important for EMS agencies to develop a culture in which employees want to move up into leadership ranks. Employees need to see the short- and long-term rewards of preparing themselves for advancement. Employees need to know that they will be rewarded for their actions in developing their agency.


Leaders today have to plan for their organization’s tomorrow. While there are some EMS agencies that have great succession plans already in place, many still have work to do in this area. When it comes to developing a strong succession strategy, EMS is not isolated in its lack of planning; succession planning is something many professions have difficulty with.


Unfortunately, succession planning is either not a priority in many EMS organizations or it occurs too late, after key people have already left.1 Many agencies have too many contingency plans to count, yet they do not have a plan in place to replace leadership ranks. It is incumbent on current leaders to prepare their successors for when they move on. If you are in a management or leadership position, you owe it to your organization, your community and our industry to develop a succession plan for your role, but day-to-day operational commitments often keep organizations focused on the present with little thought toward the future.2


The National EMS Management Association (NEMSMA) has suggested that, as the current generation of EMS managers ages, there is growing concern about how the experience and knowledge of leaders will be passed on to the next generation. The concept of succession planning is foreign to many EMS organizations. One key informant said, “We have no idea where the next generation will come from. We’re not developing them. We’re not passing on our knowledge. Are they going to have to start all over again?”3


In EMS, I have found the topic of succession difficult to research due to the fact that there appears to be little in the way of literature on the specific subject. Part of the reason for this is that, as a profession, EMS is relatively young. Modern-day EMS as we know it has only been around since the late 1960s or early 1970s. This means that many organizations are hitting their first major loss of staff, which includes a number of current leaders as well as those who are in a position to be promoted.



Building a strong succession plan in EMS is difficult for a number of reasons, including the fact that staff members who started in this profession when it was in its infancy are retiring or resigning due to their age and the toll the job has taken on their bodies.5 Indeed, NEMSMA research has found that, over the last decade, EMS leaders have expressed concerns about EMS manager development with growing urgency. That urgency is being fueled by the aging of the first generation of EMS managers, a lack of uniform management development and succession planning, the need to manage growing system complexity and the general lack of attention, coordination and leadership in the area of management development.6


Another issue is the fact that continued education has not been effectively pushed in EMS. EMS is a young industry lacking formal education programs for EMS management. EMS professionals who wish to pursue an actual degree in EMS have very limited choices, and programs with Bachelor’s or Master’s level programs are still quite difficult to find.7


Another reason that has been suggested for the lack of qualified managers and leaders is the fact that, traditionally, promotions have been based on street experience or clinical skills, rather than management skills or business acumen. Due to the fact that many of today’s senior managers were promoted in such a way, or merely belonged to the “old boys club,” a number of them do not believe that formal education is important and therefore do not encourage their junior staff to take courses other than those technical ones required for their licence or certificate levels.


Many of those who started their careers in the ’70s have begun leaving the profession in recent years, creating a brain drain that is sure to affect the future of EMS. In order to sustain organizational performance, EMS agencies should start planning now for the need to systemically replace key management positions.8 Agencies can no longer simply wait until there is a vacancy, put out a posting or an expression of interest, and fill it with the best out of those who applied. We must develop potential leaders from day one of their careers to ensure that members of the next generation are adequately prepared to step into these new roles as they become available.


Developing staff from day one allows organizations to prepare the next generation. Career development and succession planning go hand-in-hand, and when they are linked to the organization’s vision, employees can align their personal aspirations to the organization’s current and future needs, creating a mutually beneficial environment.9 Through inclusion in the organization’s planning and development means, staff members are part of the organization and have a sense of ownership as opposed to simply following the corporate direction. When employees understand what the organization needs and how their personal career aspirations ft into the overall plan, they become personally invested in the long-term health of the agency. And as employees grow within the organization, they continue to contribute to its evolution. When a strategy of grooming employees for future roles is implemented, the company can keep the people it needs to succeed.


Succession planning not only is a way of sustaining an organization, but it also decreases the amount of external recruitment that will be required in the future, allowing organizations to deal with staffing levels by looking in a broader fashion at what they currently have. Succession planning initiatives can help organizations address the seemingly separate issues of recruitment, retention and planning an organization’s future.10 In these tough financial times, it would appear that after investing in an employee for several years, an organization would want to keep him or her for as long as possible.


It is incumbent on the current leaders of today to prepare their successors for when they move on; thus protecting their agency, their stakeholders and ultimately their communities. With this in mind, my hope is that one day staff will be coming to us to ask how they might move up within their agency as opposed to the crew room full of laughter when we pose the question to them.

PASCAL RODIER has more than 25 years of service in Canadian EMS. He has worked as a front-line paramedic in Metro Vancouver, B.C., and has held various leadership ranks over the last 12 years. Pascal’s focus in recent years has been on the national development and expansion of responder interoperability. He holds a Master of Arts degree, with a focus on health leadership, from Royal Roads University. Reach him at [email protected].



1. Ludwig G. Follow the leader. JEMS. 2005;30(5):16.
2. Zavadsky M. Bench strength in the Ambulance Industry? Ambulance Service Journal. 2007;Spring:7–9.
3. NEMSMA. (Oct. 2008) Emergency medical services management and leadership development in America: An agenda for the future. Retrieved on July 13, 2015, from www.rwhc.com/mediasite/NEMSMA_Future_Oct2008.pdf.
4. Jaklevic M. Planning for day after tomorrow. Modern Healthcare. 2004; 34(26): 48–50.
5. Zavadsky M. ibid.
6. NEMSMA. ibid.
7. Zavadsky M. ibid.
8. Ludwig G. ibid.
9. Gaffney S. (2005) Career development as a retention and succession planning tool. The Journal for Quality & Participation via ASQ. Retrieved July 9, 2015, from asq.org/qic/displayitem/index.html?item=20242.
10. McDonald P. Succession planning as a retention tool. Financial Executive. 2008;24(6):18–21.