During my more than five decades in EMS I have focused the majority of my career on helping make things better. As a street paramedic in Denver I honed his clinical skills caring for patients and helping new paramedics learn to provide solid clinical care with kindness and compassion. As a popular conference educator, and author of more than 600 articles in professional journals. As an Associate Professor in the Master of Science in Healthcare Administration and Interprofessional Leadership at the University of California San Francisco UCSF I help healthcare leaders develop the ability to make meaningful and measurable improvements. As a consultant I've have worked with EMS, Fire, and Public Health in 48 of the 50 states, most of the Canadian Provinces, Israel, Palestine, Australia, and throughout Europe. My expertise includes EMS Street Survival, Patient Centered Leadership, and Effective Quality/Performance Improvement. I hold a Masters Degree in Organizational Systems. I facilitated the development of EMS Agenda 2050 www.emsagenda2050.org. I serve as the Improvement Guide at FirstWatch in Encinitas, CA. www.firstwatch.net