EMS World Q&A: Jamie Pafford-Gresham

Jamie Pafford-Gresham
Title: CEO, Pafford Medical Services
Hometown: Hope, Ark.

Starting 55 years ago with one station wagon ambulance, Pafford Medical Services has grown to become a sophisticated EMS powerhouse with 80 operations in five states and a special-operations deployment in the U.S. Virgin Islands for natural disasters and multicasualty events. Through it all the company’s 1,400 EMS employees continue to respond to thousands of 9-1-1 calls in the midst of a once-in-a-century global pandemic.  

Pafford provides BLS, ALS, critical care transport, special-event medical standby services, and cutting-edge EMS operations to multiple states in the U.S., as well as the U.S. Virgin Islands. Pafford’s fleet of more than 200 ambulances, four fixed-wing aircraft, and three medical helicopters supports the company’s lifesaving mission. 

EMS World spoke with company CEO Jamie Pafford-Gresham to learn more about the service and her role as a tireless advocate for consequential EMS issues.

EMS World: How did the company get its start?

Pafford-Gresham: My parents, James and Carol Pafford, started Pafford Ambulance Service in Magnolia, Ark. in 1967. At that time a Magnolia Hospital nurse contacted my dad, who was a police officer, and told him they had a critical patient who needed to be transported to Little Rock. At that time the ambulance was operated by the local funeral home, and they were busy with a funeral. Fred Lewis, the owner of the funeral home, allowed my dad to grab the station wagon and make the emergency call with a doctor and nurse on board. When my dad returned, Fred decided it was a good time to exit the business and put my parents in the ambulance business.

My father was only 23 years old, and with the help of my mom’s paycheck from the phone company and the support of city leaders, they were able to accept Fred’s offer of a 1964 Chevy Biscayne station wagon for a year’s lease of one dollar. The city fixed up an apartment by the fire station, and my parents started their ambulance service there. Within a year they were able to provide not one, but two station wagon ambulances. Now that was big time!

As new opportunities and service areas became available, they would place their trust in company associates to advance their skills and grow along with the company.

How did you get your start in EMS?

Pafford-Gresham: It was such a different time. I didn’t think I had a chance to do anything different with my life. I've heard the word ambulance every day of my life. That being said, I actually ran my very first call with my mother and dad while I was in junior high school. My mom was pregnant with my brother (who is also in the business today), and Dad said she shouldn’t lift a stretcher. Seeing there was nobody else to respond, I was put on the call to help her. I was about 13 years old. 

It was that first day on the ambulance and on my very first actual call that I performed CPR on a gentleman who was in cardiac arrest. It was a call I can’t forget because I was on the call with my mom and my dad, and I did CPR. Luckily I had sat through numerous classes in my parents' home—as that was our station—for the other medics and had a really good idea what I was doing.

We talk about our mom and dad and how they raised us while running the ambulance service, but I cannot forget all the crew members who made me peanut butter and jelly sandwiches and took care of me because my parents were out on calls. It was fun growing up in the middle of an EMS family.

What is a typical day like for you?

Pafford-Gresham: I joke that I manage emergencies for a living, but that really is what I do. It seems there is always something that needs immediate attention. All joking aside, most do not realize all the moving parts involved with not just operating but owning an ambulance service and being responsible for every one of those people and payrolls. I spend an enormous amount of time advocating for EMS on the state and national levels. That could include stopping hurtful legislation or regulation or promoting our services to be expanded and recognized for services they perform without payment. Between those calls I have a great management team that briefs me on our different divisions and will ask for my input when needed. They are a true blessing.

What do you do in your downtime?

Pafford-Gresham: My friends will tell you I don’t know what that is, because I am connected by phone 24/7/365. But I do believe in the motto "work hard, play hard," and we do. I love the outdoors. My husband Ben and our two grown kids, who all work for the company, love water sports and snow-ski every chance we get—I have only lost about five phones in the lake and on the slopes!

Can you discuss your current advocacy and volunteer responsibilities?

Pafford-Gresham: I’m one of the longest-serving chairs of the American Ambulance Association’s Government Affairs Committee. I was honored to receive the American Ambulance Association President’s Award, and I have served on the AAA board of directors as a member of numerous committees and ad hoc groups for more than 20 years. Currently I am the secretary of this national association as well as a board member of the Arkansas and Mississippi Ambulance Associations.

In my local community of Hope, Ark., I serve on the University of Arkansas Hope/TXK Foundation Board of Visitors, and I am a former governor-appointed chair for the Arkansas Rural Economic Development Commission. I’m proud that in 2021 Pafford Medical Services was named the Hope Chamber of Commerce Business of the Year, as well as the EMS World/NAEMT Career Service of the Year. I do believe everyone should volunteer to help their community in some capacity.

What EMS issues are you passionate about?

Pafford-Gresham: Hands down, rural EMS. I believe our rural ambulance services are the healthcare safety net in their respective communities and the glue that ensures the trauma system is functional across the states. 

When you think about it, many towns do not have hospitals, and the physician clinics close. Then the local EMS provider becomes the only healthcare provider in that community. And we are 24/7/365. This is an easy story to tell on Capitol Hill because I live it. But overall, I speak on behalf of all ambulance reimbursement issues and advocate and lobby Congress for proper reimbursement for the services [ambulance organizations] provide.  I am committed to helping agencies and providers receive fair compensation for their work.

What is the most critical issue facing EMS today, and what is the most important strategy to address it?

Pafford-Gresham: Workforce development. I am saddened by the exit of real street medics, yet I don’t blame them. I believe a good paramedic is like a Swiss Army knife—they can do just about anything! We can deliver a baby, save a life, administer vaccines, monitor patients, run circles around most—you get the idea. Our secret is out. Our workforce is our most valuable asset, and unfortunately we struggle to properly pay them for the awesome job they perform. The problem is only going to get worse until the time when both the federal and state governments, as well as insurance companies, properly reimburse providers for their skills and the front-end savings we provide the system. Ambulance providers will be well served to stay connected to the American Ambulance Association as we move forward with cost reporting required by CMS in the years to come. Strong data will help us change the course of our systems.

What are some charitable causes the company is involved with?

Pafford-Gresham: We feel it’s important to give back and have the people we serve know us personally and know we truly care about our communities. We offer numerous educational trainings, community support services, and industry partnerships. Some of our local outreach includes free Stop the Bleed and CPR classes to community groups, civic groups, schools, and churches; Camp Save-A-Life, a summer youth health camp to introduce kids to the medical industry; Explore Success, a career path expo benefiting junior high students; fundraisers to benefit the American Cancer Society, Relay for Life, Race for the Cure, and families that have been impacted in local communities; Heart Walk; Toys for Tots and “Pack the Ambulance” toy drives; and many more. And my personal favorite: We work with foster children and their families, and many more initiatives. 

It really is up to local crews to help decide what's important to them. Their involvement is key to the success, and they truly care for their communities. We may offer suggestions, but they run with the ball.

How does the company provide disaster relief?

Pafford-Gresham: We strive to position Pafford as a go-to support system for deploying EMS crews for weeks, sometimes months, at a time to weather disaster locations, fire-relief areas, and sites experiencing COVID infection and hospitalization surges, as well as for COVID testing and inoculations. The company is currently providing all EMS and emergency room services in St. Croix, U.S. Virgin Islands. Pafford offers EMS and medical clinic services aboard river barges on the Mississippi for the Army Corps of Engineers. In 2021 we also established our own freestanding medical clinic for employees, employees’ families, and members due to the COVID surge.

What message did you wish to convey when Pafford was awarded the EMS World Dick Ferneau Career Service of the Year Award for 2021?

Pafford-Gresham: From those to whom much is given, much is expected. I believe in a servant heart and to do our best to take care of folks and keep our word. I believe our medics are on loan to us from their families, and it is our job to take care of them. In return I feel if I can provide the best I can possibly offer in the way of a wage, great equipment, additional education, and a safe working environment, then they in return will do their best to pass that on to the communities and patients they serve. 

It is a group effort. More than 80 ground and air ambulance service areas’ elected officials, citizens, and visitors expect and receive reliable, prompt, and skilled ambulance services under our leadership team’s watch. I believe that is because we keep our word. The best thing about Pafford today is that we are still a group of people who love EMS, sitting around the table, looking to solve problems. What keeps me up at night is just the wish to see all our 1,400 crew members safe and returning home to their loved ones after every shift and for them to have the desire to continue to serve.  

Jonathan Bassett, MA, NREMT,  is editorial director of EMS World. Reach him at jon@emsworld.com.