About Us

We exist to provide Native Americans high quality and dependable emergency medical care through dedicated physicians. We are committed to making this a reality across the country.

Our Mission

To partner with rural and Tribal communities to provide excellent emergency care, delivered with purpose, to the communities who need it the most.

Our Vision

We envision a future where every community, especially those in resource poor areas, has access to high quality emergency care provided by dependable, compassionate, and qualified emergency medicine clinicians.

Our Goal

Pinnacle exists to provide Native Americans and hospitals with access to high quality and dependable emergency medical care through dedicated physicians. We are committed to making this a reality across the country.

Our Values


We believe that our goal of providing exceptional care to underserved communities cannot be undermined by massive corporate overhead or administrative roadblocks.


Our teamwork is evident from the moment we step foot in a new facility. Our partners communicate with site leaders and have boots on the ground from day one. The result is simple: a direct line of communication between our physicians and Tribal leaders, whether that be in a hospital or community setting.


As a group of physicians with decades of combined experience in Tribal health we understand the commitment to respectful cultural care.


In the time of greatest need we are able to deliver the results patients deserve in a manner that is respectful of their unique heritage.

Our Promise To Providers

We are first and foremost an Emergency Medicine staffing company.  We pride ourselves on providing 100% coverage to Tribal and IHS Emergency Departments with Emergency Medicine board certified and board eligible physicians AND experienced Advanced Practice Providers (APPs) that have the training and expertise to thrive in any environment.  Providing the kind of care that our patients deserve starts with hiring a team of excellent providers.

We are a mission driven company, and we exist to address health disparities in emergency care in Native American communities.  Recruiting and retaining the best physicians and APPs is the only way we can make this dream a reality.

Therefore we make a promise to you.  We are a different kind of locum tenens company.  Here are a few ways that we are changing the game:

  • Public Benefit Corporation
  • Transparency
  • Community Reinvestment
  • Physician owned
  • Social Enterprise Funding
  • W2 employment
  • Pipeline for IHS and Tribal Hospitals


Our rates do vary based on location, difficulty, and travel needs.   We have several types of employment models including Independent Contractor (IC), as well as both half-time and full-time W2 positions (with benefits) for physicians interested in making a bigger commitment and impact.  Please send us a message if you’re interested in learning more about our different employment models.


We cover malpractice with an indefinite tail.  Coverage is $1,000,000/$3,000,000 by claims made.


We pay an all-in rate that includes bonuses for holidays, “emergency coverage”, and total number of shifts worked.


Travel is not included but we do our very best to find & provide  housing at all of our sites.


We take a lot of pride in this one.  We will never charge a buyout fee for any employee that would like to work at an IHS site full-time.  We will also never prevent you from working at a site that wants you there, even in the event of losing a contract.  We believe this should be the standard in our industry.  Unfortunately it is more often an exception.

PEMG History

Pinnacle was established by a group of dedicated emergency physicians who believed that access to high-quality emergency care in Native American and rural communities is a right. For thousands of people in these communities this right is yet to be a reality, and we seek to offer a solution.

As leaders practicing in reservation emergency departments we saw first-hand the challenges faced by patients with limited access to high quality emergency care. The most important resource to combat inequities in health care – dependable, highly trained, and compassionate emergency medicine clinicians – was lacking. Multiple qualified physicians sought work at reservation hospitals but frequently met with bureaucratic barriers. We created Pinnacle to navigate these bureaucratic hurdles and facilitate the employment of quality physicians with the hospitals that need their services.

In 2017 we offered our staffing service to our first partner hospital. We provided them with high quality emergency physician services, successfully covered 100% of their scheduled emergency shifts, and shared documentation templates, order sets, and protocols. We even helped create a cloud scheduling system.

As of 2019 we’ve expanded coverage to four Indian Health Service (IHS) hospitals. As we grow, we keep the unmet need of reservation hospitals at the front of our mind, and we hope to include them in our planned expansion to the Great Plains.

In 2020 we partnered with Arc Health, the first public benefit staffing company seeking health equity through providing exceptional primary care and hospitalist services to traditionally underserved communities. Together we now offer a full suite of healthcare services including outpatient and inpatient services. We believe that our combined leadership, experience, and focus on serving underserved communities allow us to recruit and retain uniquely skilled and compassionate healthcare providers that provide unequaled care to the patients they serve.

Our Team

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James Galloway, MD
Chief Medical Officer & Chief Partnerships Officer

Dr. Galloway is a cardiologist, public health physician, and internationally recognized scientist and leader in public and healthcare policy. Early in his career, Dr. Galloway was a cardiologist on the Hopi, Whiteriver, Fort Apache, and San Carlos Indian Reservations, where he gained recognition for his research on the major increase in cardiovascular disease among Native Americans. He subsequently founded the Native American Cardiology Program at the University of Arizona and was appointed as the national senior cardiologist for the Indian Health Service. Dr. Galloway has served the federal government in numerous capacities, including Assistant U.S. Surgeon General under the Bush and Obama administrations; senior health official for the Deepwater Horizon response and the Department of Homeland Security’s Pandemic Influenza and Bioterrorism response; and director of the Office of Health System Collaboration at the Centers for Disease Control and Prevention, where he led the integration of clinical care and public health nationwide. He now lives in Southwest Washington.

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Dave Shaffer

Dave is a social entrepreneur who believes in the true value of each individual. Building on his management and accounting education from Purdue University and his CPA certification, he has spent the last 20 years leading and growing social enterprises that serve individuals who traditionally are left behind. His core belief that with appropriate focus and alignment, healthy businesses should play an important role in the overall ecosystem.
Prior to Arc Health and Pinnacle, Dave led two not-for-profit employment agencies. First Step Staffing focused on employment for persons experiencing homelessness and before that DePaul Industries which served those with disabilities. Prior to DePaul, Dave Co-Founded and led Moonstruck Chocolatier, a successful high end chocolate company. Dave has won numerous awards during his career, among those the Ernst and Young Entrepreneur of the Year accolade in 2012.

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Niki Simoneaux
Chief Talent and Development Officer

Niki's has spent the past 25 years in startup and turnaround organizations. She has a passion for leading organizations where she can have significant impact and setting them up to scale and grow. She brings management experience that spans finance, mergers, operations, marketing and client management. At Arc Health, she is accountable for culture, HR and marketing. She oversees recruiting and our client and practitioner relationships. She brings an ``outside the staffing world`` perspective to Pinnacle and Arc Health and is inspired by the idea of sharing our story and mission more broadly to improve health care for those most in need.

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Candie Moran
Operations Manager

Candie joined the Pinnacle EMG team in 2020 and now serves as Arc Health’s Operations Manager. Prior to joining the Arc Health and Pinnacle teams, she worked in various healthcare settings including large urban community hospitals and trauma centers where she gained 15+ years’ experience in healthcare management and operations. Candie is avidly dedicated to empowering organizations through effective, collaborative, and meaningful leadership processes. Candie was born and raised in northern New Jersey and currently resides in Florida with her partner, two sons and their dog.

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Cathay Garcia-Lauzurique
Operations Manager

Cathay is currently pursuing her second graduate degree, a Master's of Healthcare Administration, at the University of Wisconsin. She is a Lead Histotechnologist at Mayo Clinic. Her interests include advances in anatomic pathology, healthcare operations, accessibility, and community-based healthcare education. Cathay was born and raised in Puerto Rico and now lives in Minnesota.

Join the Mission

Let’s work together to provide the quality emergency care that our Native American communities deserve.