Embracing Challenges and Creating Impact as an EMS Leader

At this year's California Ambulance Association's Stars of Life celebration, a panel of EMS leaders shared their journeys, challenges, and perspectives on leadership. The group included Steve Grau, CEO and Founder of Royal Ambulance, Danielle Thomas, Chief Operating Officer at Lifeline EMS, Carly Strong, Chief Operating Officer of Riggs Ambulance Service, and Sean Sullivan, CEO of LIFEwest Ambulance. Each followed a different path into EMS, but all shared the same belief. Leadership isn't about a title or a degree. It's about grit, curiosity, and a relentless drive to make an impact.

In emergency medical services, leadership often emerges from real-world experience, hands-on problem solving, and the ability to inspire teams during high-pressure situations.

For the EMS professionals in attendance, the conversation offered valuable insights into what it takes to move forward in this field. The leaders didn't claim to have all the answers. Instead, they spoke about embracing challenges, pushing through obstacles, and taking action even when the path ahead isn't clear. These lessons are not only relevant for EMTs and paramedics but also for operations managers, dispatch supervisors, and anyone aiming to grow into an EMS leadership role.

Leadership Doesn't Follow a Straight Line

Steve Grau never planned on a career in EMS. He started in tech but found himself drawn to healthcare after caring for his grandfather. That experience showed him how powerful a provider's presence can be.

A stranger walks into a home and, through skill, compassion, and knowledge, completely transforms someone's life. That kind of impact pulled him into the field.

He didn't overthink his next steps. He jumped in.

"I had no idea what I was doing," he said. "But I had this feeling that I could do it better, so I bought a couple of ambulances and started a company."

Many EMS entrepreneurs share this same spirit of adaptability, moving from unrelated careers into ambulance operations because of a deep personal calling.

Curiosity and a willingness to take risks fueled his journey. He didn't wait for permission. He tested his ideas in real-time and adjusted as he went.

Curiosity and Drive Are Underrated Leadership Skills

The best EMS leaders aren't ones who accept things as they are. They ask how things could be better.

Grau sees curiosity as one of the most important traits in a leader.

"Every day, you should ask yourself how far you can push your impact. How can you serve better or differently? 

That mindset drives innovation in EMS. Leaders who keep asking questions instead of settling for the status quo push the industry forward.

Sean Sullivan emphasized the importance of continuous learning in leadership.

"The moment you think you know everything is the moment you stop growing," he said. "Great leaders remain students throughout their careers."

Grit Separates Ideas from Execution

Every EMS provider knows what exhaustion feels like. Long shifts, tough calls, and an unpredictable work environment wear down even the most dedicated people. But the panelists didn't talk about avoiding challenges. They talked about pushing through them.

Carly Strong has worked in EMS for over 20 years. She worked her way from a part-time EMT to Chief Operating Officer. Her approach to leadership comes down to persistence.

"If you aren't persistent, you won't make progress," she said. "Change happens through grit."

She pushed back on the traditional idea of power in leadership.

"I don't think of myself as anybody's boss," she said. "My job ensures 300 people still have jobs every day and that two communities still have ambulance service."

For her, leadership becomes a responsibility. It's about putting in the work to create a system that supports the people who make EMS possible.

Balancing Action with Strategic Planning

One of the biggest questions during the panel focused on decision-making. Should EMS leaders take a 'go for it' approach, or should they carefully plan each move?

Grau believes in both.

"Early in my career, I had no frameworks. I went for it," he said. "But now I see the value in structured improvement. You need both. You take action, but you also step back, analyze, and adjust."

Thomas added that leadership means reading the situation and adapting.

"I try to surround myself with people who are smarter than me," she said. "If they're planners, I'll be the one who takes action. If they're more action-oriented, I'll step in with strategy."

Sullivan shared his perspective on balancing urgency with careful planning.

"In emergency services, we make split-second decisions every day," he explained. "The skill is knowing when to move quickly and when to slow down and bring others into the conversation."

Effective EMS leadership requires agility, using data from response times, patient outcomes, and crew feedback to guide both immediate actions and long-term strategies.

Passion and Impact Matter More Than Titles

None of the panelists set out to become leaders. They took ownership of their work, kept asking questions, and didn't back down from challenges. That mindset moves people forward.

Strong put it simply.

"My passion is my people. If I take care of my employees, they'll take care of our patients."

Grau took it a step further.

"Passion isn't about loving what you do. It's about being willing to suffer for what you believe in," he said. "There are hard days in this job. But if you're still showing up, still fighting to make a difference, that's passion."

Thomas shared her thoughts on authentic leadership.

"Leadership isn't something you practice from 9 to 5," she said. "It's a commitment to showing up as your whole self and bringing others along with you."

Passion-driven EMS leadership fosters stronger patient care outcomes, higher employee morale, and a workplace culture built on trust and shared purpose.

Leadership Starts with Mindset

The EMS leaders on this panel had different career paths. Some started as EMTs. Some transitioned from other industries. Some had leadership aspirations from the beginning. Others stepped up when opportunities appeared.

What united them was a mindset of curiosity, persistence, and a commitment to making an impact.

Leadership in EMS isn't about waiting for the perfect opportunity. It's about doing the work, asking the right questions, and pushing yourself and your team to improve every day.

By adopting this mindset, EMS leaders can build resilient organizations that thrive in both routine operations and large-scale emergencies.

What will you do today to take ownership of your impact?