Insights

Notes from the Field

Practical thinking on EMS leadership, stakeholder relationships, and building agencies people trust — from more than two decades in the industry.

Why Ambulance Service Performance Declines: Looking Beyond Staffing Challenges

"We're short-staffed" is the explanation everyone reaches for — but staffing is usually a symptom, not the cause. The operational, financial, and leadership gaps behind ambulance service decline, and the questions customers should be asking.

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Why EMS Agencies Lose Municipal Contracts — and How to Keep Yours

Most EMS contract losses are predictable years in advance. Here are the warning signs municipalities watch for, and the governance habits that protect your renewal.

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How Hospital Discharge Teams Really Choose a Transport Partner

Referral volume doesn't drift to the cheapest ambulance service — it drifts to the one that makes a case manager's day easier. Inside the decisions that drive EMS referral volume.

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EMS Crew Retention: Why Your Best People Leave (and Why It's Rarely the Pay)

Sign-on bonuses recruit; culture retains. What more than two decades in EMS taught me about why medics actually quit — and the retention levers agencies overlook.

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