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6 common competencies of highly effective EMS leaders

From technical and decision-making proficiency to humility and ambition, these characteristics help leaders propel EMS agencies to a future of success


Organizations with effective leaders consistently outperform those with poor leaders.


Leadership is the underlying critical element in the success of an EMS agency. Organizations with effective leaders consistently outperform those with poor leaders. What competencies are required to be an effective leader?

The systemic and scientific study of leadership effectiveness has identified six common competencies of highly effective leaders:

  1. Integrity. Integrity builds trust. Trust is fundamental to building all relationships. Think back to your time in the field. If you didn’t trust your medic or EMT partner, you probably couldn’t wait until the next shift bid. The word integrity has deep meaning and is often intermingled with words like honesty and truthfulness. In EMS, it connotes a deep commitment to do the right thing for the right reason, regardless of the circumstances. Effective EMS leaders build trust by keeping their word, not playing favorites.
  2. Vision. Effective EMS leaders provide a vision for the future. Team members want to know where the agency is headed and how we are going to get there. Providing a vision and showing team members how the agency is pursuing that vision facilitates buy-in. All other things being equal, teams that understand their sense of purpose and the pathway to achieve it will be more motivated and productive. Sharing your vision helps others focus on the 20% that is important instead of the remaining 80% that is mundane.
  3. Technical competence. Effective EMS leaders have technical competence in one or more aspects of the organization. Nobody expects their director to know everything, but they expect you have some technical knowledge; whether that’s clinical or administrative experience. The same is true in other professions. The CEO of an accounting firm usually has been an accountant. Most football players want their coach to have had experience playing football. Most choir members expect the conductor to be able to read music. The same is true in EMS.
  4. Solid decision making. Effective EMS leaders make good decisions in a timely fashion. This does not mean they always make the right decision. It means that they base their decisions on the best data available and don’t spend unnecessary time and energy overthinking those decisions. Making these kinds of calls doesn’t always mean you will be well-loved, but when you use good judgment to make decisions, it will earn you the respect of others. Ineffective leaders tend to make decisions that are irrational or illogical and/or make decisions very slowly. Both drive caregivers crazy, and lead to dissatisfaction and disengagement.
  5. Humility. Effective EMS leaders are humble. They give credit to their team, listen to feedback from others, and accept responsibility for their team’s failures, instead of blaming others. People want to work -- and will work -- for humble leaders who create environments where their accomplishments are recognized and appreciated. Humble leaders have more influence, they attract better people, and they earn more confidence, respect and loyalty than those who rely upon ego and power.
  6. Ambition. Effective EMS leaders tend to be both competitive and persistent. Don’t be fooled into thinking humility means a lack of passion. The most effective EMS leaders are competitive. But their competitiveness is centered in their team’s success. They want their team to succeed above all else, and they are willing to sacrifice personal glory, accolades, and rewards if it results in their team’s success.

There are multiple other leadership competencies that need to be developed and expanded throughout your career. But these six are foundational elements of your success and the success of your service.

About the author

Dr. Fitch is an EMS thought leader and consultant. He is the founding partner of the EMS/public safety consulting firm Fitch & Associates. He serves as the co-chair of the Pinnacle EMS leadership conference and is a founding commissioner of the American College of Paramedic Executives. Contact him directly at

For more than three decades, the Fitch & Associates team of consultants has provided customized solutions to the complex challenges faced by public safety organizations of all types and sizes. From system design and competitive procurements to technology upgrades and comprehensive consulting services, Fitch & Associates helps communities ensure their emergency services are both effective and sustainable. For ideas to help your agency improve performance in the face of rising costs, call 888-431-2600 or visit