Sometimes, when you’re busy running an EMS system, it’s easy to focus on operations while taking “the medicine” for granted. Remember the adage “If you set low expectations, they’ll be met every time?” Setting high expectations that are both achievable and measurable is a better approach.
Medical directors’ duties often include overseeing quality improvement, protocol development and verification of proficiency. But too often, time limitations and mismatched expectations conspire to significantly reduce the effectiveness of this core service component, leading to frustration for all parties.
So what can you expect? At the least, you have the right to expect your medical director to be truly interested in EMS and willing to commit the time required for your particular community. A physician specializing in emergency medicine is preferred, but not essential — motivation counts more.
Beyond that, getting the most from your medical director is largely up to you — probably more than you realize. Some helpful advice:
Encourage education.
The Critical Illness and Trauma Foundation, in collaboration with the National Association of EMS Physicians, the National Association of State EMS Officials and other institutions, offers a short online program for new EMS medical directors, available at http://www.medicaldirectoronline.org/. This program should be a minimum requirement for every medical director, no matter how small the community.
Be clear about responsibilities and time commitment.
Ensure that the EMS organization and the physician agree on the director’s time commitment and responsibilities, and that each understands how to support the other.
Provide support.
Make every effort to use the director’s time efficiently and effectively. This may include having other staff members responsible for data gathering and preparation, reporting and coordination.
Clarify protocols, policies and communication channels.
Establish clear guidelines for (1) what actions EMS workers may take within their scope of practice, (2) how management will handle clinical questions or errors, and (3) under what circumstances the director must be notified of an error or must address personnel issues.
Communicate early and often.
The more thoroughly the relationship between a physician and the EMS organization is discussed and understood in advance, the more effective the director’s oversight will be.
