This project was funded by the federal Office of Rural Health Policy, Health Resources and Services Administration, US Department of Health and Human Services, through cooperative agreement #5-U1CRH03714-03-00. The authors thank Indira Richardson, MPA, and Stephanie Poley, BA, for their help in the production of this article. For further information, contact: Rebecca T. Slifkin, PhD, North Carolina Rural Health Research & Policy Analysis Center, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, CB 7590, Chapel Hill, NC 27599-7590; e-mail firstname.lastname@example.org.
Designated Medical Directors for Emergency Medical Services: Recruitment and Roles
Article first published online: 23 SEP 2009
© 2009 National Rural Health Association
The Journal of Rural Health
Volume 25, Issue 4, pages 392–398, Fall 2009
How to Cite
Slifkin, R. T., Freeman, V. A. and Patterson, P. D. (2009), Designated Medical Directors for Emergency Medical Services: Recruitment and Roles. The Journal of Rural Health, 25: 392–398. doi: 10.1111/j.1748-0361.2009.00250.x
- Issue published online: 23 SEP 2009
- Article first published online: 23 SEP 2009
ABSTRACT: Context:Emergency medical services (EMS) agencies rely on medical oversight to support Emergency Medical Technicians (EMTs) in the provision of prehospital care. Most states require EMS agencies to have a designated medical director (DMD), who typically is responsible for the many activities of medical oversight. Purpose: To assess rural-urban differences in obtaining a DMD and in their responsibilities. Methods: A national survey of 1,425 local EMS directors, conducted in 2007. Findings: Rural EMS directors were more likely than urban ones to report DMD recruitment problems, but recruitment barriers were similar, with the most commonly reported barrier being an unwillingness of local physicians to serve. Rural EMS directors reported that their DMDs were less likely to be trained in Emergency Medicine, and were less likely to provide educational support functions such as continuing education. Rural agencies were more likely to get on-line medical direction from their DMD, but were less likely to always get the on-line support they needed. Common barriers to on-line support were typical of rural communication barriers. Conclusions: Existing recommendations for DMD qualifications may be difficult to attain in rural communities. To develop programs that will support medical direction for rural EMS agencies, it is important to learn what physicians identify as the barriers to serving as DMDs, and whether there are alternative and innovative ways to provide an optimal level of medical oversight. Solutions will likely be multi-faceted, as EMS activities and organizational structures are diverse and the responsibilities of the DMD are broad.