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Montgomery County medical director Dr. Steven Kent reflects on 40-year career, protocol changes and rising call volume
Summary
In an inaugural Montgomery County EMS podcast, Medical Director and county medical examiner Dr. Steven Kent discussed his nearly 40-year career, a recent statewide award, proposed protocol changes to expand paramedic procedures (including surgical-airway training), a projected 8–10% rise in calls for 2026, and a request for budget funding for a death investigator.
Dr. Steven Kent, Montgomery County’s medical director and the county’s medical examiner, reflected on a nearly 40-year career in emergency medicine during the department’s inaugural "Chatting with the Chief" podcast. "I got here in '85 and, uh, it's pretty much been almost 40 years," Kent said, describing his move to Clarksville and long service in the local emergency system.
The interview with Chief Proctor covered professional history and recent recognition. Kent said he was surprised and honored to receive an award as the state’s top medical director at a Tennessee EMS conference: "They called my name and it totally floored me ... I was totally unprepared. Uh but quite honored, yes." Chief Proctor noted that, until this year, Kent provided medical-director services to the county at no cost.
Kent described changes in prehospital care since the 1950s, contrasting earlier "scoop and run" practices with today’s emphasis on on-scene interventions and training. He said the department is rewriting protocols, intends to broaden some paramedic authorities and is strengthening quality-assurance oversight. "We're looking to liberalize that. So that I mean, seconds count, you know, when you're dealing with an airway and so they don't have time to call medical control and wait ... 5 10 minutes for an approval to do a surgical airway, that's got to be done immediately," Kent said, discussing why the department is training paramedics on advanced airway procedures including surgical-airway techniques.
The department also discussed system capacity and near-term demand. Kent said the county is seeing hospital expansion locally and expects continued growth in service needs: "We're on tap to again be around a 8 to 10% increase in call volume for 2026," he said, adding that higher call volume will require more people, equipment and training.
Kent also described his role as the county medical examiner: coordinating forensic autopsies, working with families and managing jurisdictional issues that arise when incidents involve travelers or federal jurisdictions such as Fort Campbell. He and Chief Proctor noted the advantage of having a morgue at the EMS administration facility and said they have requested county funding for a dedicated death investigator. "Let's just hope we're able to successfully get that into our budget this upcoming fiscal year," Kent said.
Why this matters: Montgomery County EMS is preparing to expand paramedic scope and update protocols as local healthcare capacity grows. Those changes could affect how quickly advanced procedures are performed in the field, and the department is asking county leaders for resources to support increasing caseloads and forensic needs.
The podcast closed with plans to publish the episode on the department’s YouTube channel and on Spotify. Chief Proctor and Dr. Kent said they will continue to collaborate on training, protocol rollout and staffing as the county’s call volume increases.
