What's the best piece of advice you've received, and how have you changed since you received it?

When I completed my Advanced Firefighter/Squad Boss task book back in about 2003, my wildland fire crew superintendent told me to always “choose the difficult right over the easy wrong.”

Since that time, I’m certainly different physically. I look back at the things I did and was able to do as a 24 year-old wildland firefighter and wonder how that was even humanly possible. 

The advice, though, has stuck with me for over 20 years. I think this idea is particularly relevant to leaders across all industries and for society in general. I have encountered a huge number of decisions during my career where I could have “hit the easy button,” but this piece of advice has stuck with me and continues to guide a lot of the decisions I make.

And, with time and experience come changes in perspective and values. The excitement of attacking a fire or cutting open a car have changed into enthusiasm for affecting meaningful system improvement.

Also, I value attending my kids’ soccer, hockey and lacrosse games and sleeping in my own bed over the risks, excitement, and fraternal camaraderie of 48 hours at a fire station (although I do miss that sometimes).

What do you remember most clearly from your Haverford School days?

I have quite a few vivid memories of Haverford, including: chess tournaments in the common room, discussing “duality of man” after reading Lord of the Flies in Mr. Hallowell’s English class, playing whiffleball during breaks in Sixth Form, EA-Day pep rallies and ice skating on the football field. I remember shedding a tear when I watched the fundraising video of the Parker Gym being torn down. It felt a little bit like part of my childhood was destroyed. Progress is a good thing, though. 

One memory that really resonates with me now that I have two children is a teacher telling me that I may not love the school at the time, but down the road, I would look back and really appreciate the place and the experience. This perspective could not have been more true. In fact, almost 30 years later, I have found a school for my kids to attend here in Salt Lake City that is similar in many ways to Haverford. Coincidentally, in a conversation last year with the head of school, he told me that one of his early mentors was Don Healy, head of school at Haverford when I attended. Small world. 

How does your location in Salt Lake City, or Utah in general, influence your work?

Utah, is growing rapidly. As the EMS Division Chief for Unified Fire Authority, the state’s largest fire-based EMS organization, we are facing similar growth in service demand. I’m also seeing demographic shifts of 911-callers and changes in the reasons people call 911. This year, I helped to develop and implement a new, low-acuity EMS response unit. Our agency’s transport rate has consistently remained below 50 percent. What that tells me is that more often than not, people don’t necessarily want to go to the hospital. In a lot of cases, there is a need for help and nowhere to turn other than the 911 system. The cost of services, both from the perspective of a system administrator and a service user, is clearly a consideration. A new ambulance costs the tax-payers about a million dollars to put into service between equipment and staffing and so finding ways to provide service to the community in a more cost-effective manner is critically important. 

In addition to this rapid growth, our response area is hugely variable. The Salt Lake valley has pockets of high-density, urban housing 15 miles away from mountain ski towns and rural desert communities. Managing an EMS system with this amount of variability is challenging but exciting. 

What do you hope your legacy will be?

I hope that people will remember me for changing my organization’s culture from anxiety about being told that “you’re doing something wrong” to excitement about improving performance. While it’s true that a rising tide raises all ships, in healthcare, and particularly in emergency medicine, you want the best performance to occur on the exact day and time that you or your loved one calls 911. When someone is in cardiac arrest, there is no second chance to get it right, and it is this thought that motivates me to want our EMS system to focus resources on providing the best care all of the time, not just most of the time.