Few topics generate stronger reactions from EMS professionals than how major cities structure their systems — and New York City’s ongoing debate over whether EMS should separate from FDNY hit a nerve.
| HOT TOPIC: Should NYC split EMS from FDNY? Pay, staffing and patient care are on the line
You’ve shared direct, candid reactions rooted in your own experience: pay gaps that undermine recruitment, system designs that limit clinical growth and long-standing frustrations over how EMS is valued compared with fire services.
Many of you echoed themes you see in your own departments, while others pointed out the operational realities a split would create.
Your comments shed light on a larger issue: how EMS identity, recognition and resourcing shape daily work and long-term careers.
EMS1 readers respond
“While many advocate for EMS salaries to match those of firefighters, parity is unlikely due to the distinct nature of their roles. EMS professionals are medical providers, akin to LPNs, RNs and PAs, and their compensation should reflect this. Rather than comparing themselves to firefighters, EMS pay should be aligned with industry standards for medical professionals in similar positions, ensuring fair compensation for their expertise and responsibilities. Pay parity with firefighters isn’t the right comparison; EMS roles are distinct and deserve compensation reflecting their medical expertise.”
“It’s time the city recognizes EMS value. We have been disgustingly underpaid, underfunded, unappreciated. Working 80 hours a week just to stay afloat is asinine. Numbers showed EMS only gets approximately 18% of budget but 70% of work is done by EMS. It’s time to stop funding million dollar kitchens for fire houses and start giving parity to EMS.”
“I don’t know anything about FDNY and FDNY EMS. I am a firefighter/EMT with 29 years in a large metro city. I worked for a surrounding county EMS for 15 years, 12 as a paramedic. The problem nationwide is a failure of imagination, period. Regardless of who runs EMS, they fail to understand the problem that they are up against. In my experience, one of the largest problems within the overall problem, is the EMS deployment model. A variation on the definition of insanity is to continue to do the same thing you have always done but expect different results. EMS problems are not going to fix themselves. It takes visionary leadership. Leadership with imagination.”
“Everything depends on cost, not what makes people happy or the delivery of goods/patient care; it’s what the savings is; sad but true.”
“I consider the issue moot. Folks, this issue is more than 25 years old. Personally, the unions screwed over the workers. Do the union representatives still get compensation by the unions as well as NYC?”
“Splitting the agency would create redundancies and additional costs. They would still lose personnel to fire regardless. Fixing the pay disparity gives them a fighting chance at retention.”
“Absolutely, EMS is the new frontier and the need is outpacing fire service needs.”
“EMS was used to keep FDNY intact by raising response numbers and increasing diversity. Medicine was never a consideration. If EMS can’t be its own agency, it should be a division of NYCDOHMH. EMS is an important part of public health. Our EMS practitioners must be financially compensated so they can work one job and live in NYC.”
“Fire and EMS are 2 different jobs and SHOULD NOT be under one umbrella!”
“A combination department makes sense if the resources, personnel, and demands are all reasonably limited. New York City is not the place for that. FDNY has left EMS to wither away while they spend money on everything else a fire department has to do.”
“No, I always wanted to be an EMT and for the fire department. I don’t want to be a firefighter and never had the desire to be one. All I ever wanted is to be an EMT but if I can’t be a part of FDNY then I won’t be one. To me FDNY is a part of me and I as a 6 year veteran will not be a part of it if I’m not part of the FDNY family.”
“Yes, we are the stepchildren of the FDNY, and they treat us like 2nd-class citizens. We need pay parity for EMS members to stay and not have to work multiple jobs. The cost of living in NYC is out of control and is only getting worse.”
“Definitely split and equal pay is a must. Most FDs started EMS because of revenue and being bored most of the time.”
“Yes it should and the fire budgets need to be cut back and the money from the cut back of the fire department budget goes to EMS to staff properly!”
“Absolutely! Fire wants to play with hoses; that is their thing, not patient care and that often shows as less-than-optimal care from fire-based medics. For FDNY, they used EMS increased bargaining power for fire and threw EMS under the bus from the beginning.”
“The majority of hospital-based EMS agencies are running in the red! Partly because Medicaid and Medicare don’t pay the cost of prehospital care, the cost of medical equipment is outrageous and the cost and maintenance of vehicles is unsustainable! So what is going to change? The only thing that will change is the ease at which FDNY Fire was ‘promoting’ EMTs and paramedics, 300 at a time! This is what devastated FDNY EMS, poor leadership on both sides!”
“I think EMS should definitely be its own entity. Double the budget for EMS!”
“I think it’s much better for EMS to be with fire. I’ve worked in two agencies, one with fire and one in a separate location. Being in the same location, fire support is incredible and amazing and always there! When you’re separated sometimes you have fire support and sometimes you don’t.”
It’s an age-old constant question — should EMS be its own agency, separate from fire? Why or why not?
EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.
