Why EMS Leaders Fail: Executive Coaching, Burnout, and the Leadership Gap | David DiNapoli
Jason Falvey sits down with Dave DiNapoli (former EMT/paramedic, police officer, police chief; now an executive coach) to unpack why strong clinicians often struggle once they step into leadership. Coaching isn’t about giving answers — it’s about creating clarity, pressure-testing decisions, and forcing leaders to confront unintended consequences. Dave breaks down the hardest transition in EMS: moving from line staff to formal leader, where identity, language, and expectations change overnight. They explore why effective leadership requires one eye on the current problem and one eye downrange, how the “broken window” effect applies to EMS culture—where ignoring small behaviors quietly rots the organization—why toxic high performers are unsustainable, and how burnout, emotional reactivity, and imposter syndrome undermine executive presence. The episode also draws a hard line between management and leadership: managers run the playbook, leaders write it.
Memorable moment: Dave shares an early-career MVC where a medevac helicopter is talked into the scene without GPS — and why that decision changed regional practice.
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Executive Coach
David DiNapoli is an executive coach and risk leader whose career has ranged from the back of an ambulance to the boardroom, giving him a rare, ground-level understanding of how frontline pressure shapes leadership.
In 2024, David founded Smokerise Partnership, an executive coaching and leadership development practice, where he serves as Principal. He works with leaders navigating new roles, career transitions, and crises, helping them find their voice and build more effective organizations. The practice reflects a throughline in his career: a consistent focus on leading people through high-stakes, high-pressure environments, whether in an ambulance, a police department, or the C-suite.
He began his career in emergency medical services in the early 1990s, working as an EMT and paramedic, before moving into law enforcement as a police officer in both municipal and campus police departments. That operational foundation led him into executive roles, first as Chief of Police at a college campus, where he modernized the department around community policing and risk reduction.
Over the two decades that followed, David built a career at the intersection of safety, security, and organizational risk. He served as Chief Security Officer and Senior Director of Environmental Operations in a multicampus healthcare organization. He went on to lead safety and security for New England's largest day shelter and later served as Risk Manager for a state forensic hospital, where he also managed the institution's response to the COVID-19 pandemic. He subseq… Read More