> Apparently most of these pilots are trying to build 1500 hrs to be eligible to fly for the airlines, so they are feeling pressured from that angle too.

Fixed wing, maybe, I'm not familiar, but around here, I know most of the pilots for the two HEMS agencies (I used to be a paramedic). HEMS is considered the most lucrative of the post-military pilot careers for rotary. You fly high end machines, in all sorts of scenarios, and see all manner of things.

And as it is, often times fixed-wing EMS doesn't actually fly that often. Long range transport that can't go ground (and providers and insurers will go to some lengths, depending on the patient - one employer of mine was contracted for a ground transport from Seattle to Las Vegas).