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Frontline Leadership in Action: Redefining the Role of EMS Leaders in 2025

Frontline Leadership in Action: Redefining the Role of EMS Leaders in 2025

By Rob Lawrence,

At the 2025 American Ambulance Association Conference, the theme of frontline leadership resonated far beyond the breakout room walls. For the third year running, I joined my Aussie mate and Acadian Ambulance President, Justin Back, to co-lead a session that continues to spark powerful dialogue—not lecture—on what it means to lead from the front in today’s EMS.

As with previous years, it was an open and evolving conversation. Justin and I, as always, invited our colleagues in the audience to shape the session with us. Because, frankly, the best insights often come not from the podium, but from the room. And when it comes to defining effective leadership in our profession, EMS is undergoing a long-overdue cultural shift: from top-down command to servant leadership that starts at street level.

“People Don’t Work For Me—They Work With Me”

One of the key themes we tackled was how EMS leaders must embed themselves in the environments they expect their teams to thrive in. At Acadian, Justin holds his leadership team accountable to the “10-day rule”: no one in leadership should go more than 10 days without being back in the field. That means riding in the truck, answering calls, and walking in the same boots as the crews they support.

This is more than symbolic. It’s about closing the gap between policy and practice, between planning meetings and actual patient care. Justin puts it plainly: “The frontline is the top line. Ours is an upside-down pyramid—and it’s our job as leaders to support and serve from the bottom.” That philosophy doesn’t just build respect—it builds real-time understanding of what’s working, what’s broken, and where change needs to happen.

Replacing Preaching with Listening

What makes this leadership conversation different is that it acknowledges a hard truth: EMS doesn’t have the luxury of theoretical leadership anymore. Workforce shortages, recruitment battles, and retention challenges demand that we act fast—and with humility.

In our session, we didn’t preach solutions. We facilitated the sharing of them. Attendees contributed more than we did, offering cross-agency insights on how they’re addressing fatigue, field safety, and the evolving expectations of the workforce. We all walked away with five or more takeaways we could implement immediately.

For example, Justin shared Acadian’s surprising findings from a fatigue study: most preventable incidents were not happening during long night shifts, but during early daytime hours, among well-rested providers. That shifted their focus from assumptions about burnout to a broader concept of “shift readiness”—a term that now anchors their safety culture.

Accountability and Just Culture Can Coexist

Another hallmark of modern EMS leadership is knowing how to hold teams accountable without defaulting to blame. At Acadian, every preventable vehicle incident is reviewed by a centralized safety committee. Team members attend with their local supervisors, and the review process is rooted in a just culture model—one that aims to learn, not punish.

But this doesn’t mean going soft. As Justin said, “The pandemic forced us to bend without breaking, but now we must return to high standards. And we’re unapologetically doing that.” That blend of accountability and fairness is helping Acadian retain high performers and set a consistent tone of professionalism.

Leading the Next Generation

In 2025, leadership must also mean preparing for the workforce of the future. We discussed what today’s EMS recruit looks like—and how to welcome them into the profession even if their journey with us is short-term. “It’s not a stepping stone—it’s a building block,” Justin said. “If we can be part of someone’s broader journey and they leave as advocates for EMS, we all win.”

Leadership today means recruiting not just based on certification, but on mindset. Justin emphasized that Acadian looks for leaders with more will than skill—because skill can be taught, but heart and courage can’t. It also means being intentional about diversity, especially in areas like bilingual hiring, where language skills are becoming as vital as clinical ones.

From the Room to the Road

What struck me most about our session—and indeed the AAA conference as a whole—was the shared sense that the real solutions live not in leadership offices, but in the shared experiences of the EMS community. When we listen, when we ride, when we engage—true leadership takes shape.

Frontline leadership in 2025 isn’t about commanding from a distance. It’s about showing up, staying connected, and doing the hard, human work of leading with empathy, accountability, and consistency. As we say every year when we wrap this session: we’re not done yet. There’s more to learn, more to improve, and more to share.

Triple-A, we’re ready for round four.

 

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A Message from AAA President Jamie Pafford-Gresham

Happy New Year from Our New Association President

 

Dear Fellow Members,

I am saddened to begin the New Year with such grim and shocking news from Louisiana and New York. I am sickened and heartbroken—as I know you are—by the terror attack that struck New Orleans this weekend as well as the mass shooting in the Bronx. Our hearts ache for the victims and all those whose lives have been shattered by these senseless acts of violence. We also offer our deepest gratitude to our fellow first responders who selflessly rushed toward danger to provide skilled care and comfort in the midst of these tragedies. May their example galvanize us as we work in concert in support of EMS.

Despite these tragedies, as we ring in 2025, I am excited to begin my two-year term as the president of the AAA. I am deeply honored and humbled by the outpouring of support I have received as we begin this 24-month journey together.

I say TOGETHER because this is about US and OUR profession, and I don’t plan to do this alone. I need your participation as we move forward to ensure the best outcomes for all of us in emergency medical services.

Decades ago, when I began working in the business office (which was the kitchen) of what was then my parents’ small Arkansas ambulance service, I never imagined that one day our family of Pafford companies would care for communities in four states, nor that I would have the opportunity to serve my EMS colleagues on the American Ambulance Association board.

I’d like to thank the outgoing AAA President, my friend, Randy Strozyk, for his hard work and leadership. Randy’s dedication over the past two years has enhanced unity and camaraderie among our leaders, members, and fellow EMS stakeholder organizations. I applaud his efforts and those of the larger board, committee chairs, and vice chairs. I am privileged to continue working with this extraordinary group of mobile healthcare professionals.

Too often, EMS—especially private EMS—feels like an unappreciated and misunderstood underdog. 2025 presents an opportunity to change that narrative. One of my cardinal rules at Pafford EMS is, “no whining allowed,” and another is if you complain about a challenge, be prepared to bring forth a proposed solution at the same time. We each know the incredible value we bring to our communities and patients. Together, our voices will be heard in Washington as we share data and stories highlighting the impact of the 24/7 on-demand mobile healthcare we provide.

I hope to approach my AAA presidency with the same sense of urgency with which we treat our patients. As a profession, we can work side-by-side to quickly and effectively secure the extension of the Medicare add-ons beyond the current March 31 expiration date, then collaborate on advancing additional key priorities including sustainable reimbursement, innovative payment models, and solutions to EMS’s challenging workforce shortage.

To accomplish these shared goals, we ask that AAA members treat our advocacy efforts with the same care, grit, and tenacity we demonstrate in our communities every day. On behalf of the board, I ask that you please respond quickly to requests from our government affairs team to write letters or to set meetings with members of Congress. AAA’s grasstops relationships are sterling and have helped the association punch above its weight for decades. However, I believe all politics are local and you are the secret sauce in our success!  Grassroots efforts rule the day in transitional times like these when every interest group is competing for dollars and attention. Nothing is guaranteed—we quite literally cannot advance ambulance advocacy without the active cooperation of every AAA member organization.

In addition to supporting you through lobbying, AAA proudly offers outstanding member educational opportunities. Learning and networking abound at the 2025 AAA Annual Conference & Trade Show. We can’t wait to see you—and a thousand of our mutual colleagues—in beautiful Lexington, Kentucky June 22–24. Speaker proposals are due January 31, and the full agenda will be announced in February. However, please don’t hesitate to register for the conference and book your hotel room today. From reimbursement to operations to human resources, AAA 2025 will offer informative, engaging executive-level content to help you keep service rolling. Additionally, thanks to the support of our exhibitors and sponsors, this year’s event will have fun extras including a welcome reception the night before the conference, trade show special events, and entertaining optional outings to visit Lexington’s famous racehorses and distilleries. You don’t want to miss it as we will roll out our southern hospitality and have a great time!

We also look forward to honoring the 2025 class of Stars of Life in Washington, DC November 3–5. Nominations will open in late summer for this year’s cohort of exemplary EMS professionals. We hope that your ambulance service will join AAA in celebrating your hometown heroes in our nation’s capital.

If you have not yet renewed your AAA membership for 2025, I encourage you to do so immediately—your dues power our ability to drive the policy that sustains EMS. As a friendly reminder, your membership includes complimentary access to dozens of webinars and e-books—log in to our website any time for on-demand education from Scott Moore, Brian Werfel, and countless volunteer leaders. Members also receive deep discounts on everything from medical supplies to uniforms to ambulances through Savvik Buying Group. Additionally, we are proud to support your team with counselor matching services and on-site critical incident stress management should the need arise. New for this year, the AAA mentorship match program will offer an exciting career development opportunity for staff of all levels. AAA delivers these resources and many others as part of a comprehensive member benefits package that we are confident pays for itself many times over. (If you need help updating your contact details or accessing your benefits, please contact hello@ambulance.org for assistance.)

Those of you I’ve had the pleasure of meeting in person know that state ambulance advocacy is a personal passion of mine. In the course of operating Pafford Medical Services, I have seen firsthand many times how strong state associations drive enhanced revenue for EMS as well as add might to state and federal lobbying efforts. If you are not yet connected to your state ambulance association, I encourage you to reach out today. For our part, AAA will continue to support state-level boards with resources, research, events, and connection opportunities through our State Association Forum network and State Association Leadership Excellence conference.

Last, but not least, I wanted to share with you that the board has initiated a strategic planning process for the association to ensure that AAA is positioned for continued success. Our trusted consultants at Davidoff Mission-Driven Strategy will be gathering candid feedback from members of all types and sizes. Your insights are essential to charting a course for 2025 and beyond. I thank you in advance for your participation in surveys and/or virtual focus groups that will take place in the coming months.

I look forward to collaborating with you to move EMS forward in the coming 24 months. Thank you again for your support and participation, and happy New Year!

Now, let’s get to work!

Jamie

Jamie Pafford-Gresham
2025–2026 President
American Ambulance Association

2024 EMSNext Nominations Now Open!

EMSNext Nominations Due January 1, 2024!

Know a wonderful rising leader you’d like to recognize as the future of EMS? Nominations are open for EMSNext (formerly Mobile Healthcare 40 Under 40)!

Selection Process & Criteria

2023 EMSNext Honorees

Honorees will be selected based ONLY on the information provided in the nomination form below. Nominees should have contributed to their organization, state ambulance association, AAA, other professional associations, and/or the EMS profession in an extraordinary way beyond faithful completion of job duties. Please be sure to include detail about the nominee’s impact to date and future promise.

Please note that nominees must be under 40 in the year of nomination OR from a diverse background. No specific job role or title is required for consideration.

EMSNext Program Description

EMSNext is a recognition and development program of the American Ambulance Association. The goal of this program is to recognize up-and-coming leaders within EMS and support them in building their networks and leadership skills and encouraging them to get involved in the next level of EMS leadership. This program is a way for organizations to fully engage their rising leaders through company-sponsored travel and participation in additional learning and networking events throughout the year. Program participation includes:

    • Complimentary conference registration for the 2024 AAA Annual Conference & Tradeshow (April 22-24 in Nashville, Tennessee)
    • Recognition of the EMSNext recipients during the Conference
    • Mentor pairing and additional professional development opportunities
    • Encouraged to attend AAA Board Meetings throughout the year
    • Encouraged to attend another AAA event with our leaders in 2024

AAA’s Commitment to Diversity, Equity, and Inclusion

Updated in August 2022

Caring for People—Together.
The American Ambulance Association board and its members are committed to providing high-quality healthcare to every patient regardless of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and/or on the basis of differing ability. We dedicate time, thought, and resources to fostering diversity, equity, inclusion, and mutual respect within the Emergency Medical Services workforce and leadership. Together, we save and sustain the lives of community members.

2024 Vanguard Nominations Open Through January 1

Nominations Are Due January 1, 2024!

Recognize woman leaders with at least 35 years of service in EMS! Nominations are open for the second annual American Ambulance Association Vanguard Awards! The Vanguards honor those who blazed the trail for fellow women EMS professionals.

The Vanguards are presented in collaboration with our colleagues from Women in Emergency Services (WiES), a newly-founded organization dedicated to supporting and advancing women’s careers in the emergency services industry through empowerment, networking, mentorship, and education.

2023 American Ambulance Association Vanguard Awards

Selection Process & Criteria

To submit a 2024 Vanguard nomination, please complete the form below before January 1, 2024.

Honorees will be selected based ONLY on the information provided in their nomination form. Nominees should have contributed to their organization, state ambulance association, AAA, other professional associations, and/or the EMS profession in an extraordinary way beyond faithful completion of job duties. Please be sure to include detail about the nominee’s impact to date.

Please note that nominees must be women with 35+ years of service in the EMS industry. No specific job role or title is required for consideration.

Recognition

Honorees will be recognized at the American Ambulance Association President’s Reception award ceremony, and will be recognized on the AAA and WiEMS websites and social media platforms. Winners will also receive complimentary registration to the AAA Annual Conference & Trade Show.

2024 AAA Annual Conference & Trade Show
Gaylord Opryland
April 22–24, 2024
Nashville, TN

2023 Vanguard Award Winners Announced

FOR IMMEDIATE RELEASE

Contact:
Amanda Riordan
Vice President, Membership
ariordan@ambulance.org

American Ambulance Association Announces Inaugural Vanguard Award Winners

Washington D.C. – The American Ambulance Association (AAA) is proud to announce the winners of the inaugural Vanguard Awards. The Vanguards honor those who blazed the trail for fellow women EMS professionals, and the 23 winners represent a diverse group of dedicated individuals who have made significant contributions to mobile healthcare.

“We are thrilled to recognize these trailblazers who have paved the way for women in EMS,” said Randy Strozyk, President of AAA. “Their dedication, perseverance, and commitment to excellence have not only elevated their own careers but have also helped to advance the entire profession.”

Lori Burns | National Vice President of Learning, Global Medical Response | Denver, Colorado
Denise Carson | President, Med-Tech EMS | Morrilton, Arkansas
Sherry Carson | President, Monticello Ambulance Service, Inc. | Monticello, Arkansas
Diana Cataldo | Founder/Treasurer, Cataldo Ambulance Service, Inc | Middleton, Massachusetts
Cindy Elbert | President, Cindy Elbert Insurance Services, Inc. | Peoria, Arizona
Linda Frederiksen | Executive Director, MEDIC EMS | Davenport, Iowa
Dia Gainor | Executive Director, National Association of EMS Officials (NASEMSO) | Falls Church, Virginia
Debby Gault | Retired/Consultant, AMR | Waterford, Wisconsin
Dr. Marianne Gausche-Hill | Medical Director, Los Angeles County EMS Agency | Santa Fe Springs, California
Blanche Hill | Co-Founder, Superior Air-Ground Ambulance Service, Inc. | Elmhurst, Illinois
Kristine Kern | Paramedic Professor, San Jacinto College | San Jacinto, Texas
Susan Long | Vice President, Emergency Medical Services, Allina Health EMS | St. Paul, Minnesota
Tracey Loscar | Deputy Director, MatSu Borough EMS | Palmer, Alaska
Pam McBeath | President/ CEO, Balentine Ambulance Service Inc. | Shreveport, Louisiana
Susan McHenry | EMS Director (Retired), State of Virginia | Highlands Ranch, Colorado (Honored Posthumously)
Carol Meyer | Director, Government Relations, McCormick Ambulance | Compton, California
Carol Pafford | Vice President Emeritus, Pafford Medical Services | Hope, Arkansas
Jamie Pafford-Gresham | President/CEO, Pafford Medical Services | Hope, Arkansas
Helen Pierson | Chief Executive Officer, Medic Ambulance | Vallejo, California
Julie Rose | Director of Policy & Advocacy, Superior Air-Ground Ambulance Service, Inc. | Ashtabula, Ohio
Lauren Rubinson | Founder and CEO, MedEx Ambulance Service | Skokie, Illinois
Janet Smith | Owner and President, On Assignment | San Diego, California
Debbie Vass | Chief Administrative Officer, Sunstar Paramedics | Largo, Florida

The Vanguard Awards are presented in collaboration with Women in Emergency Services (WiES), a newly-founded organization dedicated to supporting and advancing women’s careers in the emergency services industry through empowerment, networking, mentorship, and education.

The winners will receive complimentary registration to the American Ambulance Association Annual Conference & Trade Show in Las Vegas on June 26-28, 2023. They will also be recognized at the President’s Reception on the evening of June 27, and their profiles will be featured on the AAA website and social media.

“The Vanguard Awards celebrate the accomplishments of women who have broken down barriers and opened doors for future generations,” said Strozyk. “We are proud to honor their legacy.”

About the American Ambulance Association

The American Ambulance Association safeguards the future of mobile healthcare through advocacy, thought leadership, and education. AAA advances sustainable EMS policy, empowering its members to serve their communities with high-quality on-demand healthcare. For more than 40 years, AAA has proudly represented those who care for people first.

2022 AAA Board of Directors Election Results

The winners of the 2022 AAA Board of Directors election are listed below. The term for each position will begin on January 1, 2023. For regions 1 and 3, two directors were chosen due to vacant positions. Please join us in thanking all candidates for their service to the American Ambulance Association.

President-Elect

Jamie Pafford-Gresham
Pafford EMS
Hope, AR

 


Treasurer

Julie Rose
Superior Air-Ground Ambulance Service, Inc.
Ashtabula, OH

 

 


Secretary

Wayne Jurecki
Bell Ambulance Service, Inc.
Milwaukee, WI

 

 


Region 1 Director – 3 Year Term

Dennis Cataldo
Cataldo Ambulance Service
Somerville, MA

 

 

 

Region 1 Director – 1 Year Term

Mike Addario
Global Medical Response
Baldwinsville, NY

 

 


Region 2 Director – 3 Year Term

Chuck Kearns
Mercy Ambulance Service, Inc
Savannah, GA

 

 


Region 3 Director – 3 Year Term

Tom Tornstrom
Gundersen Health System-Tri-State Ambulance
La Crosse, WI

 

 

Region 3 Director – 1 Year Term

Kyle Wolber
Superior Air-Ground Ambulance Service, Inc.
Winfield, IL

 

 


Region 4 Director – 3 Year Term

Allyson Pharr
Acadian Ambulance
Lafayette, LA

 

 


Region 5 Director – 3 Year Term

J.D. Fuiten
Metro West Ambulance
Hillsboro, OR

 

 

 

 


Ethics Committee

Hanan Cohen
Empress EMS
Region 1

 

 

 

Ron Quaranto
Acadian Ambulance
Region 4

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