The Role of State Medical Direction in the Comprehensive Emergency Medical Services System: A Resource Document

Figures & data

Table 1.  Barriers to the Creation of a State EMS Medical Director Position in 2003

Barrier	Frequency Reported (%)
Inadequate funding	17
Lack of statutory authority	12
Inadequate support from department administration	9
Needs are met in other ways	8
Other priorities take precedence	6
Other political considerations	5
Legal liability issues	3
Inadequate support from medical community	2
Inadequate support from EMS community	2
No need for such a position	1
Other	1

EMS = emergency medical services.

Table 2.  Components of the State EMS Medical Director Job Description in 2007

Component	Percentage of Responses
Contractual relationship with state EMS office	45
Position based within statutory language	47
Stable funding source provided for position	39
Compensation	74
Clearly delineated roles and responsibilities	66
Credentials for the position	79
Clearly delineated accountability and benchmarks	42

EMS = emergency medical services.

Table 3.  State Medical Director Qualifications/Prerequisites in 2007

Qualification/Prerequisite	Percentage of Responses
Valid state medical license	76
Valid Drug Enforcement Administration license	29
Board certification in any specialty	10
Board certification in emergency medicine	89
Residency trained in emergency medicine	3
Completion of EMS fellowship	0
Number of years of active EMS medical direction	21
Active practice of medicine	29
Other	13

EMS = emergency medical services

Table 4.  Profile of the State EMS Medical Directors’ Experience in EMS Medical Direction in 2007

Years as an Active EMS Medical Director of an EMS System	Percentage of State EMS Medical Directors in 2007
0 years	6
1–5 years	9
6–10 years	14
11–15 years	24
16–20 years	12
21–25 years	26
26–30 years	9

EMS = emergency medical services.

Table 5.  Scope of State EMS Medical Director Activities in 2007

Scope of Activities	Percentage of Responses
Patient care protocol approval/review/development	89
State policy approval/review/development	89
Legislative statute/rule approval/review/development	87
Investigation/mediation	74
Disaster/HAZMAT/terrorism preparedness	76
Hospital/emergency department preparedness	66
Emergency telecommunications issues	55
Service operational plan review/approval	42
Trauma system oversight/development/participation	11
Public health/prevention	74
Training and education standards/policy development	79
Tactical or law enforcement oversight	29
Professional organization liaison activities	84
No response	3

EMS = emergency medical services; HAZMAT = hazardous materials.

Table 6.  State EMS Medical Director Relationship with the State EMS Office in 2007

Relationship with State EMS Office	Percentage of Responses
Employee	29
Independent contractor	45
Volunteer	11
Appointed	7
Full-time	13
Not full-time	87
Written contract or agreement	45
No written contract or agreement	53
Agreement/contract with state EMS medical director	50
Agreement/contract with practice	0
Agreement/contract with employer	3
Agreement/contract with university	11
Agreement/contract with institution	3
Agreement/contract with other agency	3
Written job description	56
No written job description	39

EMS = emergency medical services.

Table 7.  Dedicated Hours of Work by the State EMS Medical Director in 2007

Requested/Contracted Hours per Month	Percentage of Responses	Actual Hours Committed in Last Calendar Year	Percentage of Responses
No response	13	No response	13
0–20	11	Less than 100	7
21–40	26	100–500	31
41–60	8	501–1,000	18
61–80	10	1,001–2,000	21
81–100	8	Greater than 2,000	10
101–120	3
121–140	5
141–160	16

EMS = emergency medical services.

Table 8.  Professional and Administrative Liability Protection Provided to the State EMS Medical Director by the State EMS Office in 2007

Insurance Product Provided	Percentage of Affirmative Responses
Professional liability including medical malpractice	24
Professional liability excluding medical malpractice	16
General liability (errors and omissions, slander, etc.)	29
Employee practice liability	5
Workers’ compensation	26
Disability insurance	14
Medical insurance	26
None of the above	45

EMS = emergency medical services.

Table 9.  Additional Provisions Provided to the State EMS Medical Director by the State EMS Office in 2007

Additional Provisions Provided	Percentage of Affirmative Responses
Vehicle	10
Equipment/radio	24
Cell phones	37
Travel expenses	60
Leave time	21
Professional organization dues	26
Health insurance	26
Workers’ compensation	24
Conferences	32
Continuing medical education	8
Retirement/pension	26
Books/subscriptions	11
Other	8
None	3

EMS = emergency medical services.