TUSCALOOSA, Ala.– Across North Alabama, emergency medical service workers say the EMS system is under increasing strain as call volumes rise and staffing struggles persist.

EMTs and paramedics report long hours, low pay, burnout, and frequent non-emergency calls that tie up ambulances and delay response times for true medical emergencies.

EMS in North Alabama is delivered through a mix of municipal fire departments, private ambulance companies, county-based services, and hospital-affiliated providers. About 67 percent of EMS is fire-based, where firefighters are cross-trained as EMTs or paramedics. These positions typically offer higher pay, better benefits, and more stable staffing than private ambulance services.

Leaders at the Alabama Fire College in Tuscaloosa say burnout poses a serious threat to retention, noting that only a small percentage of EMTs advance through paramedic training. They also highlight available resources such as peer support programs and education reimbursement funds to help workers remain in the field.

Proposed solutions include increased funding, competitive wages, smarter tiered 911 responses, expanded training support, and greater public understanding of what constitutes a true emergency.

As population growth continues and emergency call volumes increase, EMS leaders say retaining trained professionals will be critical to ensuring timely, lifesaving care across North Alabama.