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Lunar leadership: 5 EMS leadership lessons from the Apollo program

Establish a concrete but flexible mission and communicate the vision with EMS providers and the community to chart a course for success


Apollo 8 was a bold and risky mission that demonstrated flexibility in the face of changing circumstances as the lunar landing module was not ready to be tested and the Soviet Union was believed to be readying a mission to the moon.



Steve Wirth, Esq., EMT-P, is an EMS attorney and founding partner of Page, Wolfberg & Wirth, which represents EMS agencies throughout the United States.

By Steve Wirth, Esq., EMT-P

July 20, 2019, marked the 50th anniversary of Apollo 11 – the first time humans landed on another celestial body. The greatest feat in the history of exploration was achieved through the intensely focused efforts of over 400,000 dedicated Americans who were part of NASA’s Apollo program in the 1960s. Every person connected with the Apollo program – from the astronauts in the spacecraft to the engineers who designed them, to the janitors at mission control – all made important contributions to the success of the mission.

Doing the seemingly impossible came about only with forward-thinking leadership and the strong personal commitment of everyone involved, from the top down. There are many examples of how that commitment – demonstrated throughout the Apollo program – can apply to your EMS agency.

Here are five practical approaches that today’s EMS leader can adopt from Apollo to help launch your agency onto a trajectory for success.

1. Establish a simple concrete vision that everyone understands

In 1961, President John F. Kennedy committed America to “the greatest adventure on which man has ever embarked.” He kept the vision big, clear and simple:

  • What? The Moon.
  • When? By the end of the decade.
  • How? On a rocket that has not yet been invented.

And America got to work! Most people associated with Apollo, regardless of their position, when asked what their job was all about, would reply: “I’m putting humans on the moon.”

The fundamental changes happening in EMS during this era of healthcare reform may cause stress and strife, especially if the vision of where the organization is headed is not clearly developed and communicated by leadership. Everyone needs to know the fundamentals of any new direction:

  • Where are we going?
  • Why we are going?
  • How are we going to get there?

Only then can the entire team support the vision.

The vision should be:

  • Simple and clear (everyone understands what it means)
  • Concrete (it has an objective)
  • Meaningful (relating to a higher purpose)
  • Easy for everyone to adopt
  • Motivational

Do your staff uniformly know the vision of your EMS agency? If the answer is yes, you are doing an effective job of communicating it.

2. Be flexible and adapt to changing circumstances

Progress on the lunar module was slow, so the Apollo 8 mission to test it in earth’s orbit had to be delayed. To keep on track to a lunar landing by the end of the 1960s, a bold decision was made: Send Apollo 8 directly to the moon instead. At the end of the turbulent year of 1968, Apollo 8 gave us the famous “earthrise” photo from lunar orbit as humans left our planet for the first time.

It was a risky decision (the huge Saturn 5 rocket had only been tested unmanned). But the rewards would be great – we beat the Soviets, who were believed to be readying their own mission to the moon. This audacious decision demonstrated how original plans may need to be scrapped or drastically modified based on changing circumstances.

EMS is in constant flux with major shifts in reimbursement, community healthcare needs, and new delivery models – challenging our established thinking. Our circumstances have changed drastically in recent years and will continue to change as we fully evolve into mobile integrated healthcare.

EMS leaders must be prepared to move their agency into new services or territory that may not have been anticipated. The successful EMS leaders are those who are nimble and agile, and not mired in bureaucratic decision-making or red tape. They are the ones who see change as an opportunity for progress (even when that change is not always welcome!) rather than see it as an obstacle.


John F. Kennedy awards Alan B. Shepard, Jr. the first American in space, the NASA Distinguished Service Award on May 8, 1961.


3. Give credit to the back room

The astronauts and the controllers at mission control were the face of Apollo, but behind the scenes were thousands of people who really made it all happen. At mission control, several hundred engineers and scientists literally worked in a back room at mission control, solving problems and giving guidance to the few dozen controllers that everyone saw on television behind the consoles. NASA leadership and the astronauts themselves frequently gave credit to those behind-the-scenes individuals who were just as important to the success of the mission as the astronauts on that mission.

Paramedics and EMTs are on the visible front lines and often get the public accolades. But as we know, providing EMS involves teamwork with many people working to ensure that the patient receives the highest level of care – including call takers, dispatchers, educators, supervisors, billing staff, mechanics and others who support the EMS mission. Insightful EMS leaders believe that no one person in the organization has a job that is more important than any other person’s job. These enlightened leaders exercise humility and constantly recognize the critical efforts of those who support the caregivers on the street.

4. Learn from your setbacks – and move ahead

Before we ventured to the moon, we lost three astronauts on the launch pad during the Apollo 1 fire. That tragedy revealed major flaws in the command module that were identified and corrected for future missions. It set the program back over a year, but many say that had it not been for the Apollo 1 tragedy, we would have likely lost astronauts in space and may not have made it to the moon. But NASA didn’t sit on its laurels – it learned from its mistakes and pushed forward after a critical review of its processes.

EMS leaders can experience many setbacks, from loss of a competitive bid or a nursing home contract, to injury or death to a patient or team member from an ambulance crash. The resilient EMS leaders can get back up after being knocked down – they don’t let the bad situation control the future. Resilient EMS leaders set an example by encouraging others to stay focused and move forward to accomplish the mission of service to the community – even when the chips are down.

5. Make the public feel a part of it all

NASA was brilliant in bringing the lunar landings into the living rooms of millions around the world with live TV from space – a completely innovative idea at the time and one that was resisted by many, including some of the astronauts. NASA had a public relations machine that constantly educated America and the world about the program and the benefits it brought to humankind.

That mastery of marketing is best described in an excellent book by Richard Jurek and David Meerman Scott, “Marketing the Moon.” NASA needed public support to keep the money flowing into the program – just as we need adequate funds from the public to support the EMS mission and move forward.

Today’s reimbursement challenges, and media criticism of seemingly high ambulance bills can put leadership on the defensive. EMS leaders must be out in the community every day, communicating with all stakeholders from citizens to elected officials to hospital administrators. Effective EMS leaders are constantly beating the drums about why EMS is so important and why high-quality mobile healthcare is not cheap. They make the public feel that it has a vested interest in the success of the program.

We must constantly counter the notion that ambulance service is not just an expensive ride to the hospital. One EMS agency, EmergyCare in Erie, Pennsylvania, says it well on their website: “Education and community outreach activities are at the heart of our lifesaving mission!”

The Apollo program brought a nation – and the world – together with a shared, positive vision during a very difficult time in our country. The Apollo lunar program fostered worldwide pride in the good things that people can accomplish when they work together toward a common goal.

The many technological developments that emerged from the Apollo program helped advance our world in many ways. Those advancements could only happen with forward-thinking leadership. Apollo provides many examples of these positive principles of leadership in action that can have similar applications in today’s world of EMS – half a century later.

Read next: 6 common competencies of highly effective EMS leaders

About the author

Steve Wirth is a founding partner of Page, Wolfberg & Wirth, LLC, and is an avid space exploration enthusiast. He can be reached at

This article was originally posted July 20, 2019. It has been updated.

For over 20 years, PWW has been the nation’s leading EMS industry law firm. PWW attorneys and consultants have decades of hands-on experience providing EMS, managing ambulance services and advising public, private and non-profit clients across the U.S.

PWW helps EMS agencies with reimbursement, compliance, HR, privacy and business issues, and provides training on documentation, liability, leadership, reimbursement and more. Visit the firm’s website at