A lack of care by NYC for its EMS: EMTs and paramedics save many lives, but are treated poorly by the city

By Oren Barzilay | May 26, 2023

New York would be in deep trouble without the lifesaving work of its brave first responders, most especially our city’s “Street Doctors” of the FDNY EMS. In 2022, FDNY EMS responded to 1,580,871 medical emergencies — a 100,000 increase over the prior year.

This is National EMS Week, an annual observance started by President Gerald Ford in 1974 and continued by the American College of Emergency Physicians, but the significant contributions our workforce makes to public health and safety are continually disregarded.

EMS members are frequently put in harm’s way, with the number of assaults more than doubling between 2018 and 2021. Forced into overcrowded and ramshackle worksites, significant stress of the job, coupled with a corresponding lack of support or proper mental health services, has resulted in record numbers of paramedics dying by suicide.

New York’s is undoubtedly the busiest Emergency Medical Service in the world and yet our EMTs and paramedics are horribly underpaid. To put it more bluntly, FDNY EMS members are fed up with being treated like crap by city leaders.

Despite their pivotal role administering urgent medical care and safely transporting patients to hospitals, EMTs and paramedics are continually being starved of resources.

It’s a saga as old as the merger of FDNY with EMS, which took place on March 17, 1996. Promises made then were never upheld.

In that merger, EMS was promised new stationhouses and more of them, but decades later most of the locations we have are falling apart and jammed with multiple EMS units.

As recently as 2017, after seeing the overcrowded EMS worksites, even Mayor Bill de Blasio promised a fix. Years later, we are still waiting. When an FDNY building is deemed too old and dilapidated for firefighting needs, like the little sister or brother, we get the hand-me-downs. It is a nightmare for members.

Several stations in the Bronx intended to have 10 to 11 EMS units working from them, have 20 crammed in. There are stations that house 150 members and are so overcrowded, members do not have sufficient space to have lockers where they can change before and after their shifts.

There has been a consistent lack of reinvestment in our people, tools, and the places needed to do our job effectively.

Along with saving countless lives, EMS is a significant revenue generator for the City Hall treasury, bringing in some $300 million over the last two fiscal years and nearly $167 million last year alone. How many city agencies can say that?

At the end of March, the city announced that the cost for treatment and transportation to a hospital will increase by 54%. It blamed this on not only inflation but also EMS salaries.

To blame a contract settled almost two years ago is illogical. Especially when wages for this difficult, dangerous job start at about $18.94 per hour. Try raising a family on that.

In April, new NYPD officers received a $12,000 bump in starting salaries to combat decreasing recruitment. This brings rookie cop’s salaries to $55,000, roughly $5,000 less than a five-year EMT veteran.

The City of New York spends tens of thousands of dollars training each EMS professional but compensates them more like teenagers on a weekly allowance. It’s why so many FDNY EMS members must have second jobs and can’t afford to live in the city we love and protect. And why our force is constantly experiencing massive job turnover.

EMS loses on average 30% of new hires within three years; and 50% in five years! They leave in droves for other cities or even jobs with private companies, where they can easily make $20,000 to $30,000 more per year.

Rather than pointing blame at a woefully underpaid workforce for recent cost increases, let’s do something proactive to slow that brain drain from our medical first responder force. The needs of our city’s FDNY Street Doctors are truly dire and much investment is needed to even make a dent in the many problems in the FDNY EMS.

It’s time to make the FDNY EMS more central to the strategic planning and budgeting of one of the greatest fire departments in the world. The dedicated women and men of EMS — and the citizens we are sworn to protect — deserve better than we have been subjected to.

It shouldn’t have to take the governor and Legislature authorizing a $2 increase to minimum wage for all others, to make the city take responsibility for treating its medical first responders with dignity for the difficult job they perform.

Barzilay is the president of FDNY EMS Local 2507, representing New York’s 4,000 uniformed EMTs, paramedics & fire inspectors.