Medical oversight refers to the formal relationship between the EMS providers and physician(s) responsible for the out-of-hospital emergency medical care provided in a community. All EMS systems are required to have medical oversight. The physician who provides the medical oversight is usually referred to as the medical director, and has two roles: indirect medical control and direct medical control.
Indirect Medical Control
Includes all activities that do not involve direct communication between the physician and care provider during patient care. Indirect medical control is also called offline, retrospective, and prospective medical control.
System elements of medical oversight involving indirect medical control include:
b. Protocol development (guidelines or standards of care to be given for specific situations). This is both prospective and off-line.
c. Education (recommendations for and participation in providers initial [prospective] and continuing [retrospective] education).
d. Quality management, often in the form of run reviews or audits. This is a form of retrospective medical control.
Direct Medical Control
Involves communication between a physician and care provider during a call. It may also be called online, base station, immediate, or concurrent medical control. In direct medical control, communication may take place via an on-scene physician medical director or by radio or telephone communication.