Where Have All the Ambulances Gone…
As of 2023, New York State reported the loss of approximately 9% of EMS Agencies over ten years; along with those agencies went many trained EMS personnel. In comparison, our population of approximately 8-million people has significantly increased since 2020. With the number of ambulance agencies and EMS personnel decreasing balanced against the possibility of increased patient load, we are also looking at increased response times… or even NO available response. At best, neighboring agencies must travel into these areas and leave their districts with less coverage.
Training as a First Responder AT ANY LEVEL takes time and money (no matter who is footing the bill). The anxiety of emergency response with unknown outcomes combined with the high-risk situations a responder can find themselves in means a lot of stress; this stress can lead to burnout. Some EMS responders turn to alcohol or drugs as a coping mechanism, while others leave the profession altogether; suicide ranks high for on-the-job deaths. Add to the angst these responders already feel, the salaries for this highly trained position for those responsible for saving another person’s life are often comparable to those of convenience store clerks.
Although there are a substantial number of volunteer agencies throughout the state (EMTs, whether volunteer or paid, receive the same classroom training towards certification), more and more volunteer agencies are becoming hybrid (paid and volunteer) services out of a need for round-the-clock coverage. Many rural agencies have to travel longer distances to hospitals, while the more urban environment usually means faster transport access. Volunteer agencies must rely on local tax districts to fund their basic services. In addition, for both volunteer and paid agencies, reimbursements from insurance, Medicare, and Medicaid are often below actual costs.
Paid EMS have an average career longevity of less than a dozen years in the field; although a number far exceed that average. Volunteer EMS also traditionally averages a short span as some use the volunteer experience and go into paid positions. Many trained EMTs and Paramedics decide to pursue higher levels of “healthcare”; ironically, EMS providers are not officially considered “healthcare” and are not classed as ESSENTIAL workers. Most paid EMS providers work much longer than their standard shifts as a way to increase their income and pay their bills. It’s very hard to support a family on an EMS income.
The importance of being able to call 911 and have an ambulance respond promptly and trained personnel to administer the feasibly life-saving treatment and transport to a medical facility is obvious. However, little more than a dozen states recognize EMS as an essential service (New York is NOT one of them), and the Federal government has left this designation to the state governments to decide. Generally, a state that does recognize this essential service can substantially help with the funding of services.
We need to lobby our local and state governments to support our life-saving work by making all EMS essential and paying livable wages.
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