NEW YORK — A debate over whether New York City’s Emergency Medical Service should separate from the FDNY has reignited after a veteran FDNY EMS lieutenant and union leader is calling on the city to break its emergency medical service away from the fire department and create a stand-alone “third 911 service.”
In an article for The Chief Leader, FDNY EMS Lt. Anthony Almojera, vice president of Local 3621 and author of “Riding the Lightning: A Year in the Life of a NYC Paramedic,” argued that paramedics and EMTs “may show up to the same scene, risk the same dangers and respond to the same calls,” yet earn roughly half a firefighter’s salary and receive fewer benefits. The pay gap, he said, “leads to massive attrition” and tells young providers “they are second-class responders.”
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“We’re asking to be seen not as an appendage of the Fire Department, but as what we are,” Almojera said. “Healthcare professionals delivering critical services in some of the most dangerous and high-pressure situations imaginable.”
Almojera argues that EMS belongs firmly in the healthcare realm, not in fire suppression or policing. Its core job, he says, is to assess, treat, stabilize, and transport patients and to advocate for them both at the scene and in the hospital. But inside the FDNY, EMS still answers to fire-focused leaders trained in fire science, which limits medics’ career growth and suppresses new ideas in pre-hospital care.
Almojera says an independent EMS agency, run by medical professionals, could update care protocols, launch community paramedicine programs and tackle modern public-health needs.
A stand-alone EMS agency would be nimbler, more accountable, tightly linked to hospitals and mental health partners, and better equipped to deliver patient-centered care.
“We aren’t looking for special favors, only fair treatment,” Almojera said. “See us not as a fire department add-on but as healthcare professionals who provide critical care in the most dangerous, high-pressure situations.”
What’s your take? Should New York City spin EMS off into a third service, or does keeping it under the FDNY make more sense?
Share your frontline experiences, concerns about pay and staffing, or ideas for improving prehospital care.
EMS1 readers respond
“The city already has infrastructure in place with FDNY for unit placing and funding. I do think their pay needs to certainly be increased. I make more as a paramedic in NC then they do living in one of the most expensive cities in the country. Perhaps some supervisors or department head who actually has an interest in EMS would be appropriate as well.”
“Take a look at Austin. It works and the prehospital medicine is top notch. Austin-Travis County EMS.”
“EMS should ALWAYS be a separate organization especially in larger communities/cities.”
“EMS absolutely needs to cut the cord with Fire. Innovation and timely, relevant change requires a level of autonomy not possible when EMS exists under the auspice of FD leadership. EMS can coexist geographically with Fire and LE, but it needs to have its own leadership and accountability. This is, unfortunately, also true of EMS and enlisted healthcare in the military, as well.”
“Fire personnel should always be a separate entity as they are more responsive to fire scenes cutting cars and providing citizen assistance when asked. They are not medically oriented and often provide less care and inadequate care to medical emergencies they respond to.”
“There is a multitude of depts that operate like NYFD. With no negative consequences. Why can’t NYFD EMS also?”
“In a place like N.Y. this makes sense to me, and I’m glad to see an effort to identify EMS as a part of healthcare, even fire-based EMS. If you are from a fire department where cross-trained working both EMS and Fire that is a different situation where I wouldn’t support it as a third-service.”
