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The fact that utility work may take different skill sets, for example vertical reference, or simply rigging and hauling external loads, doesn't mean it is "better", or "harder".

The thing that makes EMS and normal utility work different is the fact that in utility work the pilot is required to problem solve, plan, and take independent action. EMS work requires skill, particularly SPIFR, and judgement. It has it's challenges.

My experience is that in true utility work you are left much more to your own planning and execution. I like this, every day is different aspect of utility work. If canned scenarios are your thing, EMS is probably a better fit.