Honorable But Broken: New EMS Documentary Explores the Impact of EMS Funding Challenges

Movies depicting EMS typically show EMTs and paramedics rushing to the scene of emergencies, sirens blaring.  

Bryony Gilbey, a former producer for ABC News and 60 Minutes, took a different approach. Her new documentary, “Honorable But Broken: EMS in Crisis,” explores how a critical workforce shortage and inadequate funding threatens the existence of EMS, particularly in rural areas.

Shot on location with EMS crews in Ossining, New York, and Montclair, New Jersey, the documentary covers the strain placed on EMS providers during the COVID-19 pandemic, and the need for many to work multiple jobs to make ends meet. 

The film crew also came to Washington, D.C., for EMS On The Hill Day, where they interviewed members of the NAEMT Board. The documentary even nabbed some star power when actress Sarah Jessica Parker signed on to narrate.

Gilbey hopes the film will raise awareness about the need to reform EMS funding and recognize EMS as an essential service, like fire and police. 

“The film tries to paint a full picture of what it is like to work in EMS,” Gilbey said. “The honorable part is that this is an incredible industry. It’s described in the film by a physician as a ‘noble profession’.”

“The broken part is it is still reliant on a reimbursement model based on EMS being exclusively a transportation mechanism from the 1970s. That fundamentally needs to be revamped. It doesn’t cover what EMS does today.”

Inspiration from family

Gilbey’s inspiration for the documentary came from her three kids. As high school students, they all served as EMTs for the Chappaqua (NY) Volunteer Ambulance Corps. 

Her eldest daughter went on to become a paramedic. In March 2020, her daughter shared a story about responding to a stabbing victim inside a home where the occupants were sick with COVID-19. PPE was scarce, which led law enforcement to question whether they could enter with them. 

Gilbey worried. Her daughter risked exposure to the virus and violence. At 19, she was responsible for making critical decisions about her patients. It seemed like a lot to take on, especially given the low pay. In EMS, “you are so unprotected in so many ways,” Gilbey said. But her daughter loved her job, and took the challenges in stride. “That’s EMS, Mom,” her daughter told her. 

Gilbey decided the story of EMS was one she wanted to tell.

Making the film

She teamed up with producer Richard Diefenbach, and funded the making of the documentary largely from her own pocket. Parker donated her time to narrate.

The film covers the history of the EMS, how it developed differently from fire and police, and why it’s not considered an essential service in many states.

As the EMS community learned more about the project, she gained some important support. “When people started to hear we weren’t making a film about the lights and sirens and the glory but about the economics of EMS, and exactly what happens in the back of the ambulance and what EMS does, they started opening doors to us,” she said. 

She interviewed Eileen Mondello, mother of John Mondello Jr., an FDNY EMT who committed suicide at age 23 in 2020. Mondello spoke about the toll the job had taken on her son’s mental health, and the need for more support for struggling responders. 

“Every story is heartbreaking and heartwarming. These people give so much of themselves because they want to, until they can’t anymore,” Gilbey said. 

Derek Hanley, a former U.S. Air Force medic and photographer, donated his time to build the honorablebutbroken.org website. Hanley also allowed filmmakers to use the images he shot during the year he spent documenting the lives of EMTs and paramedics in Alameda County, California, as they responded to the COVID-19 pandemic. 

“It’s the gravity of the material and the potential impact it could have that made me want to do whatever I could to support the mission in the film,” Hanley said. 

Knowing her children worked in EMS, also made him feel that “she understands. She hears the stories. She sees the mental health fallout this job has on folks,” he added. “That is really what got the buy-in from me.” 

NAEMT donated $10,000 to assist with distribution. “Honorable But Broken is an hour packed full of information on the issues facing EMS throughout the United States. NAEMT is a proud contributor, both financially and as participants, to this effort,” said NAEMT President Susan Bailey.

Screening on Capitol Hill

In November, NAEMT, in collaboration with the EMS Caucus and Bound Tree, hosted an “Honorable But Broken” screening on Capitol Hill. About 100 Congressional aides, members of Congress and federal agency representatives attended. 

“Honorable But Broken tells our story beyond our circles, which is imperative for change to occur,” said NAEMT Director Steven Kroll. “As EMS professionals we see the challenges and the opportunities in our daily activities. This film can help us raise awareness nationwide.”

 

One of the key changes that needs to happen: moving away from an outdated funding scheme that reimburses EMS solely for providing transportation to a new model that reimburses EMS for providing patient care, NAEMT Director Matt Zavadsky noted in the film.  

During the screening, some in the audience were moved to tears. They “realized the sacrifice, passion, and needs of our profession. There were moments of silence and awe as the credits rolled,” Kroll said. “I believe the emotions evoked by Honorable But Broken created a sense of urgency that I hope will magnify NAEMT’s federal advocacy activities.”

 

Gilbey agreed that it’s urgent to get the message out. She hosted a screening for elected officials in New York to advocate for a bill to establish EMS as an essential service there. The film is available to others in EMS who want to show it to their legislators to support their advocacy efforts.    

EMS practitioners “are hardworking, highly trained medical professionals who put themselves in just as much danger as police and fire do, and they deserve just as much compensation. I’d like this to be a mouthpiece. In whatever capacity I can help, I will.”

EMS agencies and other interested groups can apply to host a screening of the film in their local area. Priority will be given to applicants that have legislators committed to attending and a venue identified. Apply here.