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You're asking two very different questions here. Regarding who's "better," that's completely variable from area to area, service to service, and person to person. In some areas private ambulances, even if they do not respond to 911 calls, will have very motivated, well educated providers. In some areas the ambulances that respond to 911 calls, private or otherwise, will have dumb, lazy providers. And vice versa of course. There is to much variability across the country to say definatively which is more prevalent. Nor does it really matter all that much beyond what you are dealing with in your own area. Now, if you want to talk personal opinions, that's different. Based on my own experience, in MY opinion and in MY area, generally the non-private providers are better. Of course, this is only my opinion; doesn't make it right, and since I still recognize that and understand that it very well may not be accurate in a multitude of situations...it doesn't really matter that much. As far as what you should do...that is entirely dependant upon you. If you have the opportunity to move into management, and that's something that you want to do, then you just need to decide if it's a service you want to be in that position with. You can always move back to being a field provider, and having a supervisory position on your resume is always a good thing.

It varies from hospital to hospital. As mentioned, some have their own EMS, some have specialty transport like Neo-nate, Pedicatric, or helicopter service. Most use medics as "techs", which may be able to do a lot or very little. I have been in settings where I acted as "Charge Nurse" to settings where I could just take vital signs or draw labs. That would be a question to ask during interview, but with that being said, any ER job will give you a lot of good experience as a newbie.

I think the only reason I lasted 5 years at a transport company because we also did emergency transports out of our contracted facilities. I could go from a nursing home to doctor's office run one minute to an unresponsive, hypotensive sepsis patient the next. ...And then back to a transport over to the wound care clinic after that. But there was always the next one.... Don't get me wrong, eventually I did burn out. It didn't affect my patient care, just my sanity. But the burnout had way more to do with our management, the trucks and equipment, and some of the morons we hired (and promoted) than it was the types of calls we ran.