From Pinnacle: What Keeps You Up at Night?

Dia Gainor, executive director of NASEMSO, moderated a panel discussion of EMS association leaders at Pinnacle July 17, 2025 that included Roxanne Peek, executive director of the Association of Critical Care Transport, Doug Kupas, president of NAEMSP, Jamie Pafford-Gresham, director of operations for Pafford EMS, and Chris Way, president of NAEMT.

Gainor began the session by asking each panel member, “what keeps you up at night?” Below are just a few of the panel members’ replies.

Kupas: Falls in the elderly. “We have an epidemic,” Kupas said. Home assessments by EMS clinicians are critical to keep people safe as they age, as well as cut down on EMS calls. Also, anxiety rates among EMS professionals are skyrocketing, Kupas said. Finally, EMS professionals are not viewed as health care clinicians among the majority of the public.

Pafford-Gresham: Who is going to answer the call for service at 2 a.m.? The cost of readiness to keep ambulances running amid staffing and reimbursement shortages is a constant challenge, said Pafford-Gresham.

Way: “We as an industry don’t change as well as we should,” said Way. Agencies can be stuck in a “we’ve always done it this way” cycle. In addition, payment structures in EMS need to change. “We are health care clinicians: and not merely a transportation provider,” though that’s still the primary means of reimbursement for the industry, Way said.

Peek: Staff turnover and attrition of EMS leaders. The days of people staying committed to an organization for 10 years and more are largely gone, said Peek. Institutional and industry knowledge are being lost. “What’s going to happen when our generation retires?” she asked.

Targeted toward EMS leaders, Pinnacle is an annual conference that facilitates networking, learning and discussion among public safety and EMS leadership. The 2025 conference is being held July 14-18 at the JW Marriott Desert Ridge Resort & Spa in Phoenix. This is the conference’s 20th year.

EMS World is a media sponsor of Pinnacle.