Background: Emergency medical service providers are ideally positioned to help reduce unnecessary use of emergency department care. Purpose: To report a qualitative analysis conducted on a “treatment in place” pilot program designed to treat low-acuity medical patients on-scene that was operated by an academic medical center and a city fire department. Methods: We conducted focus groups with fire department personnel to identify program benefits, implementation challenges, and suggestions for improvement. We reviewed 911 call notes to identify barriers and facilitators to providing on-scene care. Discussion: Poor communication and training caused uncertainty about team members’ roles and how to provide care on-scene. A barrier to program success was not having an Emergency Medical Dispatch system that could identify low-acuity patients. Program benefits were its potential to save patients and insurance companies money and to educate the community about the purpose of emergency medical care. Conclusion: Differences in culture, communication, and resources create challenges and opportunities to interprofessional treatment in place programs.