Many of you will recall using protocols, procedures and pharmacology (the three Ps). The three Ps should be a reminder of the optimal focus for providers of paramedic care and the leaders of the paramedicine sector – namely patients, paramedics and advancing the profession. Organisations providing paramedical services need to keep their focus on the optimal care of patients, on the welfare and well-being of their paramedics and on advancing the profession. All too often however, the focus is on power, politics and process. This unfortunately comes at the cost of the things that really matter.