May 15, 2005
by John Dickens
Medical Direction
All EMS systems must have a Medical Director; this is a physician who assumes the ultimate responsibility for oversight or medical direction of the patient care aspects of the EMS system. The medical director also oversees training, develops protocols or standing orders, and oversees the quality improvement process by doing run reviews.
An EMT or health aide operates as a designated agent of the physician. This means as an EMT/health aide your authority to give medicine and provide emergency care is actually an extension of the Medical Director's license to practice medicine.
The Doctor cannot be everywhere at every emergency. This why EMS systems develop "standing orders." These are protocols or policies that allow responders to use certain skills or procedures in certain circumstances. This is an example of "off- line medical direction"
Often, responders may need to consult with medical direction via telephone or radio. This is an example of "on-line medical direction."
Medical Direction is a classic example of ensuring quality patient care, and is an essential component of an EMS system. The whole EMS system would not work without them. I have always felt that medical directors are very brave doctors who care so much about the patients that they take enormous risks with often little reward to make the EMS system work. I believe it is our duty as responders to ensure we do our part in respecting and honoring these brave doctors in the never- ending quest for good patient care.