This Rob-Ed is informed by a recent Leadership Lab interview hosted by Asbel Montes, who sat down with the senior leadership of Pro EMS and its affiliated organizations. The conversation featured Bill Mergendahl, founder of Pro EMS; Dan Wagner, CEO of the Pro EMS family of companies; Gibson McCullagh, chief operating officer of Professional Ambulance; James DiClemente, chief operating officer of Prodigy EMS; and Larry DeFranco, operations manager for Professional Ambulance.
Together, they explored leadership philosophy, culture, innovation and what it truly means to build a nimble, mission-driven EMS organization grounded in trust and candor.
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Before I go any further, a full disclosure is appropriate. I am a director of Pro EMS, and Bill Mergendahl is, quite literally, my boss. That said, I have spent a career on both sides of the Atlantic, inside public, private, municipal and hybrid EMS systems. I have seen organizations that talk a good game and those that quietly live their values. What follows is not corporate flattery. It is an observation from someone who knows what functional culture looks like, and how rare it is.
Pro EMS is not built around slogans. It is built around behaviors.
At the center of that culture sits a deceptively simple mission, entrusted to everyone in the organization: Do the right thing. Not when it is easy. Not when it is cheap. Not when it is popular. But consistently, even when it is uncomfortable.
One of the most striking themes in Asbel’s conversation with the leadership team was candor. Real candor. Not the performative “open door” version, but the kind that invites challenge and expects dissent. Bill put it plainly: you can walk into his office and argue forcefully against an idea — but you had better bring the reasoning. He wants the why. Because in that back-and-forth, good ideas emerge, weak ideas get exposed, and the organization moves forward sharper than it was before.
Dissent feeds progress
That expectation of challenge is not limited to the C-suite. In fact, one phrase from the discussion deserves to be borrowed by every EMS leader reading this: duty to dissent. At Pro EMS, dissent is not tolerated, it is required. New hires are told on day one that feedback will be candid, sometimes raw and occasionally uncomfortable. They are also told that leadership expects the same candor in return.
That matters. Because organizations that do not invite dissent, calcify. They become slow, risk-averse and fragile. Pro EMS, by contrast, has built speed into its DNA, not reckless speed, but informed, deliberate agility rooted in trust.
Trust, in fact, is the quiet currency that makes the entire system work. Bill is explicit that he is no longer the smartest person in the room, and that is by design. The organization is intentionally surrounded by people who are smarter in their respective domains, whether that is operations, education, clinical practice or technology. Authority follows competence. Decisions are made close to the work.
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Shared history
That trust is reinforced by another unusual feature: everyone at the leadership table has worked on an ambulance together. They share lived field experience. This is not theoretical leadership. It is grounded in the reality of patient care, hallway medicine, bad weather, tight spaces and imperfect information. That shared history creates credibility, and a deep sense of responsibility to those still working the trucks.
Scalable solutions
The organization’s much-discussed nimbleness is not accidental. It is structural. Pro EMS has repeatedly built solutions internally because suitable ones did not exist. When no paramedic program met the standard, one was created. When learning management systems failed to keep pace with regulatory and educational needs, Prodigy EMS was born. When simulation was needed before it was fashionable, Pro invested early and figured it out.
The pattern is consistent: build for your own people first, then scale outward. That approach acts as a powerful quality filter. If your own clinicians and educators must live with the tool, you build differently. You build with urgency, humility and an intolerance for unnecessary friction.
None of this happens without sustainability. Bill’s phrase, “no money, no mission” — may sound blunt, but it is honest. Without financial viability, innovation stalls. Training suffers. Equipment lags. People burn out. Sustainability at Pro is not about profit for profit’s sake; it is about preserving the capacity to do the right thing tomorrow as well as today.
Culture and soul
What struck me most, however, was something Gibson McCullagh said almost in passing: Pro EMS is the only place he has worked that has a soul. That is not something you can fake. It emerges when values are consistent, leadership is authentic, and people are trusted to act in alignment with a shared compass.
So yes, I am proud to be part of this organization. Not because it is perfect it isn’t but because it is honest about what it is trying to be. In a profession facing relentless headwinds, reimbursement pressure, workforce strain, and increasing clinical complexity, Pro EMS offers a reminder that culture is not a soft concept. It is a strategic asset.
When culture is grounded in candor, humility, trust and an unwavering commitment to doing the right thing, it becomes more than a workplace philosophy — It becomes an operating system.
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