From Pinnacle: What Keeps You Up at Night?
A popular session each year at the Pinnacle EMS conference is “What Keeps You Up at Night? A National EMS Leadership Roundtable.” Senior leaders across EMS discuss their most pressing challenges and strategies to resolve them.
Panelists for the 2026 session, held the afternoon of July 15, 2026, included:
- Dia Gainor, Executive Director of NASEMSO
- Scott Gilmore, President of NREMT
- Douglas Kupas, MD, President of NAEMSP
- Jerry Overton, President of the International Academies of Emergency Dispatch
- Shawn Baird, Vice President of State Affairs for American Ambulance Association
- Chris Way, President of NAEMT
Below are paraphrased excerpts of their replies to the question, What keeps you up at night?
Way: Who will replace experienced EMS leaders? Who will be the next battalion chief or clinical educator? Way encouraged every clinician and leader to get involved in association-led advocacy efforts.
Kupas: Long-range concerns such as not having EMS viewed as healthcare delivery. EMS helps people with lots of problems but we have not advertised ourselves sufficiently as healthcare clinicians, said Kupas. “We need to get to a place where we are respected by the other parts of healthcare,” Kupas said. If we stay on the current path, the future is bleak.
Gilmore: What technologies are coming that can help us meet patients where they are and deliver proper care? How can we train incoming providers on these new tools? Also, don’t make the perfect the enemy of the good when it comes to legislative efforts and advocacy. Take smaller steps to improve rather than striving for consensus that makes all stakeholders happy.
Gainor: Accountability. Your state legislature created its EMS office to protect the public, and they may not have the resources—human, capital, technology—to fulfill that mission. Utilize your state governor's office as a sounding board—go beyond just your state EMS office.
Baird: A federal financial system that is cracking at its core, and the fear that we will not be bold enough to take data-driven steps to truly change the reimbursement system. Also, we should be tying clinical outcome data to educational initiatives for frontline providers. EMS needs a “win” that galvanizes the profession and demonstrates that the industry can move forward.
Overton: The extreme pressure being faced by telecommunicators in our control rooms. Chronic fatigue, mental burnout, caffeine overuse, and other coping strategies by overworked 9-1-1 operators in chaotic rooms for long shifts is not sustainable. “We’ve got to be able to find ways to help that situation,” said Overton.
Overton summed up the session with lyrics from Tom Petty that represent the resolve of EMS champions and advocates: "[We] won't back down."
Presented by Fitch & Associates, the 21st Pinnacle EMS conference is taking place July 13-17 at the Sheraton Resort San Diego.
