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
“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.
