I recently went one-on-one with Josh Klein, CEO of Emerest, Royal Care, and U@ PERKS.
Adam: What does good leadership look like in the middle of a medical emergency?
Josh: In a crisis, clear and confident leadership is everything. High-pressure moments demand not just quick decisions, but the ability to both give and receive orders – depending on your role in the chain of command. I’m fortunate to be part of a volunteer organization where many of us are trained to respond to emergencies. As a paramedic, I often work alongside doctors with more advanced training, and in those moments, good leadership sometimes means knowing when to step back, listen, and follow.
Chaos doesn’t always require command – it often requires composure. Being able to stay receptive, follow directions, and contribute to the team dynamic is just as important as leading from the front. And when it’s your moment to take the baton, it’s not about control – it’s about how clearly you communicate, how calmly you guide, and how much trust you inspire. The best leaders speak firmly but respectfully. They stay grounded so others can find their footing. In the end, leadership in an emergency is about presence. It’s about mastering your craft, managing your energy, and using communication not just to direct others – but to steady them.
Adam: How can you, as a leader, prepare yourself for a medical emergency, and how can you prepare the people you lead so that they’re ready when the medical emergency hits?
Josh: I’ll start with the second part, because before you can prepare anyone else, you have to be prepared yourself. That means being confident in your own ability to lead. You can’t expect others to follow you in a crisis if you haven’t done the work to lead calmly and clearly when things get tough. The truth is, chaos affects everyone – even the smartest, most experienced people. Emergencies have a way of shaking you, and that’s why I think self-awareness and ongoing learning are key. For me, that means constantly training, reflecting on what’s worked and what hasn’t in the past, and learning how to manage both the situation and the people in it. A big part of leadership in these moments isn’t just about taking charge; it’s about staying composed and listening. People react differently when they’re scared or unsure. Some might shut down, others might panic. As a leader, you need to stay steady so they have something to hold on to. As an example, I always think back to the early days of COVID: that was a real test. What got us through was communication – a lot of it – and taking the time to really understand the needs of the people we were responsible for. In home care, you can’t treat everyone the same. Some patients are completely immobile. Others rely on oxygen or machines. We had to quickly categorize them based on urgency- who needed help right away, and who could wait. That structure helped us move efficiently and gave our team a clear plan in the middle of the chaos. So when I think about preparing others, it really comes down to a few things: know your people, be clear in your communication, and lead with calm confidence. Also, always remember to treat people well. Encourage them, give credit where it’s due, and create a culture where they feel supported. Leadership isn’t just about giving orders – it’s about listening, staying grounded, and creating an environment where others can stay grounded too.
Adam: What are the keys to staying calm during the high-stress moments? How can leaders empower the people they lead to stay calm and ultimately act quickly and decisively during the high-stress moments?
Josh: It all starts with empathy. When you approach a crisis with empathy – when you truly understand that some things are simply out of our control – it helps you stay grounded. You begin to realize that no matter how overwhelming a situation feels, no matter how bleak the outcome may seem, there’s always a next step. And that mindset creates calm. The truth is, not everything ends the way we hope. And as a leader, you have to be honest with yourself about that. The question becomes: What is within my control right now? What example can I set for others? You may not be able to solve the entire problem, but if you can address even part of it, that matters. In emergency situations, even small wins make a big difference. People can sense when you truly care. And that’s what leadership in a crisis really comes down to – leading with heart, not ego. If you approach others with empathy, if you’re genuine, people feel that. It builds trust. And that trust helps the team stay steady and act decisively, even under pressure.
In our industry, it’s not about selling a product. Healthcare – especially in moments of crisis – is a calling. If you treat it as such, and others see that you care deeply about the people you serve, they’ll follow your lead. Lastly, remember that you really can’t fake caring. You have to mean it. And for me, that sense of purpose has come through volunteering. Every time I go out into the field – see the homebound, hear their stories, witness their challenges – it reminds me why this work matters. It makes me a better human, and I believe that being a better person makes you a better leader. And being a better leader means you can give more back to the people you’re privileged to serve.
Adam: What protocols and training practices should leaders have in place to prepare for medical emergencies?
Josh: I think it starts with something as simple as a fire drill. When we were kids, those drills trained us to act without hesitation, and that same mindset applies in healthcare. Emergency preparedness can’t just live in a binder; it has to be lived and practiced. When a crisis hits, there’s no time to reference a manual. People need to know exactly what to do, and that only comes from repetition. I remember during the wildfires in Los Angeles, we asked ourselves: What if this happened in a crowded New York neighborhood? We didn’t just write a plan – we walked through it step by step. Who gets the first call? Who contacts the family? What’s the chain of response? Running real drills doesn’t just build competence – it builds confidence. It shows your team you’re serious, and it helps them visualize how they’d respond if it were their own loved one in need.
Nothing replaces real-life experience, but practice is the next best thing. When I started as a paramedic, I learned quickly that you don’t rise to the occasion – you fall back on your training. And that’s why drills matter. They give people the clarity to act instead of panic. But just as important as preparing your team is preparing yourself. You can’t lead others through a crisis if you haven’t figured out how to manage your own stress. Whether it’s reading, boxing, or volunteering, like I do, finding what grounds you is part of being ready. So yes, write the plan. But more importantly, live the plan. Run the drills. Refine it. Repeat. That’s how you build a team that’s ready when it matters most.
Adam: What are the most common mistakes that people make as they’re preparing for emergencies or during the emergencies themselves and how could those mistakes be avoided?
Josh: The most common mistakes in emergencies usually come down to three things: miscommunication, a breakdown in communication, and a lack of clear command. And what’s interesting is – those issues typically don’t start during the emergency. They’re usually signs of gaps in structure or leadership that existed well before anything went wrong. That’s why strong leadership and clear expectations on a regular day, when there is no emergency, are so important. Everyone needs to know who they report to, who they listen to, and what’s expected of them when the pressure is on.
Another big mistake I see often is the “blame game.” Emergencies are unpredictable. No matter how much you prepare, some things will catch people off guard, and sometimes even the most qualified person can freeze, panic, or make a mistake. In those moments, the worst thing a leader can do is criticize or shut someone down. That doesn’t help anyone. Instead, a good leader steps in with empathy. Maybe you gently grab that person’s arm, look them in the eye, call them by their name, and remind them: “You’ve got this.” Those small moments of reassurance can reset someone and help bring them back into focus.
Empathy isn’t just for the people receiving care – it has to extend to the people giving it. Your team is also experiencing trauma. They’re operating under intense pressure. Blaming someone during a crisis only shuts them down further. And in an emergency, you need everyone. You need every set of hands, every voice, every bit of focus. So if someone makes a mistake, the key is to refocus, not reprimand. Empower them, don’t diminish them. Because in those moments, how you treat your team can determine how well you all come through it together.
Adam: Do you have any other advice for leaders?
Josh: Be involved. Really get to know the people you’re serving, especially if you work in healthcare or medicine. Get out of the office and go see what a patient’s home looks like. Try to picture what it means for someone to be lying in a hospital bed in a sixth-floor walk-up apartment building. I’ve had the privilege of seeing that firsthand through my volunteer work, and it’s something I encourage everyone around me to do. Because healthcare isn’t always about sitting behind a desk or filling out forms – it’s about people. And that applies to all of us in this field, no matter your role. Whether you’re a physician, a nurse, a paramedic, a home health aide – go see the reality for yourself.
Immerse yourself in real life. When you see what patients are truly facing, it changes how you lead. It gives you perspective, builds empathy, and helps you stay calm when things feel out of control. Most importantly, it makes you better at your job because you’re leading from a place of understanding, not assumption.
Adam: What role does empathy play in healthcare?
Josh: Empathy is everything. It’s the foundation of good care, because healthcare isn’t just about treating a condition, it’s about caring for a person. That means showing compassion not only for the patient, but also for their entire support system – the family members, caregivers, and anyone walking that journey alongside them. But empathy also needs to extend to the people delivering that care. Your team – whether they’re doctors, nurses, home health aides, or administrators – deserves to feel seen and valued. I’ve learned that asking someone how they’re doing, truly listening, and remembering the small things can have a huge impact. It builds trust. It reminds people they matter, especially in high-stress environments. In home care, most of our aides are women, and many bring a deeply nurturing presence to the work. That emotional connection is powerful as it shapes the entire care experience.
Empathy isn’t just about grand gestures – it lives in the little moments. When you walk into a room and notice someone seems off, ask them how they’re doing. Be present. In emergencies, patients often don’t know who you are, but a simple introduction and a few kind words can completely change their experience. That’s what empathy does. It transforms healthcare from a task into something deeply human and meaningful.
Adam: How can anyone develop empathy?
Josh: Empathy starts with intention. Like any skill, it takes practice and a conscious effort to build. One habit I’ve developed, especially in emergency settings, is to always ask the patient’s name and use it throughout the interaction. If I’m speaking with a family member, I ask about their relationship and refer to their loved one personally, like saying, “Here’s what we’re doing for your mom.” Small things like that create connection. They show people you see them as human, not just another case. Communication matters too – speak clearly, simply, and calmly. Medical jargon can overwhelm people, especially in stressful situations, so slowing down and choosing your words carefully can make all the difference. But above all, empathy is about being present. Make eye contact. Listen closely. If a patient says, “I have a doctor’s appointment at 3,” remember that detail, and mention it before you leave. That tells them you were truly listening. You don’t always have time for deep conversation, but even noticing a family photo or asking a thoughtful question can build trust. Sometimes I’ll ask an elderly patient to repeat something – even if I already heard it – just to show I care about understanding them fully. Empathy isn’t a box you check; it’s something you live through small, consistent actions. The more you practice, the more natural and powerful it becomes.
Adam: What are common communication mistakes that healthcare professionals make, even when they’re made with good intentions?
Josh: Unfortunately, there are many. One I’ve seen often is asking well-meaning questions that lack situational awareness – like walking into a patient’s home and asking, ‘Where’s your family?‘ without knowing if they even have one. If that person is alone, that question can cut deep. Or asking, “Where are your kids?” not realizing they may have wanted children but couldn’t have them. These moments, while unintentional, can turn an already vulnerable situation into something even more painful. That’s why awareness matters – being thoughtful, observant, and sensitive to the things you don’t know about someone’s life. And on a similar note, it’s not just about what you ask – it’s how you ask it. Instead of assuming, ask gently: “Is there someone you’d like us to call?” or “Is there anyone you’d want us to notify?” That gives people the space to share on their own terms. Whether I’m working in home care or responding in the field as a paramedic, I’ve learned that tone and presence often leave a longer-lasting impression than the treatment itself. Some of the most technically skilled clinicians can fall short if their bedside manner is cold. Patients will remember how you made them feel. So I always ask myself: What kind of energy am I bringing into this room? In Yiddish, there’s a word – mensch – someone who does the right thing, with kindness and integrity. That’s what I try to be. That’s what I teach my kids to be. Because in moments that truly matter, it’s not just about being right, it’s about being human.
Adam: How have you seen empathy shift the outcome of patient care and lead to better performance?
Josh: Empathy can be the difference between a patient feeling dismissed or truly cared for – especially when something goes wrong. Whether it’s a procedure that didn’t go as expected or a medication error, how a healthcare professional communicates afterward matters deeply. Patients don’t just want solutions – they want to feel heard, respected, and reassured. That starts with listening and ends with action. We call it “bedside manner,” but really, it’s about showing genuine concern for the person behind the diagnosis. Empathy builds trust, even in the toughest moments. One example I often think of is my experience with Hatzolah, the Emergency Volunteer Ambulance Corps. We can arrive at an emergency in under 90 seconds, but to a terrified parent whose baby is choking, even that feels like forever. Their panic is valid. In those moments, empathy means understanding their fear and meeting it with calm, compassion, and clarity. Over the years, I’ve learned that every culture expresses care differently, and by watching others, I’ve become a better listener, a better responder, and ultimately, a better human. The biggest lesson has been realizing that true leadership in healthcare comes not just from teaching, but from staying open enough to learn.
Adam: Do you have any other tips on how to develop empathy?
Josh: Get involved. Volunteer. Give your time. There’s always time to give back – and you don’t need to be a medical professional to make an impact. Walk into a nursing home and spend time in the community room. Visit a hospital during visiting hours. Sit with people. Take in the environment – the smell of antiseptic, the sound of machines, the rhythm of a busy floor. Being present in those spaces, around people who are struggling, offers life experiences that shape and deepen your empathy in ways no textbook ever could. For me, volunteering is both a calling and a reminder. It’s running out of the house in the middle of the night, sleeping in scrubs, showing up when it’s inconvenient – because people need you. But giving back doesn’t always have to be dramatic. Visit an elderly person. Listen to a parent whose child is ill and whose entire life has been turned upside down. There are so many ways to serve, and each one opens your heart a little more. Personally, this conversation has reminded me to pause and reflect – and I’m walking away with a renewed commitment to push myself further, to explore new ways to give. I hope it inspires others to do the same – for their neighbors, their communities, and maybe most importantly, for themselves.
