A physician who acts as an off-line medical director for an EMS service in the state of Texas is required to register as such with both the Texas Medical Board and the Texas Department of State Health Services (DSHS). As of July 2014, the TMB registration is part of the physician biennial registration process.
Information on registration with the DSHS as an EMS off-line medical director is available through the Office of EMS/Trauma Systems Coordination at the following link: http://www.dshs.state.tx.us/emstraumasystems/provfro.shtm
An EMS Medical Director is defined in Board rule 197 as “A physician licensed by the board who is responsible for all aspects of the operation of an EMS system concerning provision of medical care. This physician may also be referred to as the off-line medical director.”
In addition, TMB board rule states that an EMS off-line medical director shall be:
- a physician licensed to practice in Texas and who is registered as an EMS medical director with the Texas Department of State Health Services;
- familiar with the design and operation of EMS systems;
- experienced in prehospital emergency care and emergency management of ill and injured patients;
- actively involved in:
o the training and/or continuing education of EMS personnel, under his or her direct supervision, at their respective levels of certification;
o the medical audit, review, and critique of the performance of EMS personnel under his or her direct supervision;
o the administrative and legislative environments affecting regional and/or state prehospital EMS organizations;
- knowledgeable about local multi-casualty plans;
- familiar with dispatch and communications operations of prehospital emergency units; and
- knowledgeable about laws and regulations affecting local, regional, and state EMS operations.
Please see Board rule 197, available on our website at: https://www.tmb.state.tx.us/page/board-rules for a complete listed of EMS off-line medical director requirements.
To register with the TMB as an EMS off-line medical director, you can either submit the information as part of the physician biennial registration process, or you can complete the EMS Off-line Medical Director off-cycle registration form.
At this time a physician may not hold the position of off-line medical director for more than 20 EMS providers unless the physician obtains a waiver.
The TMB may grant a waiver to allow a physician to serve as an off-line medical director for more than 20 EMS providers, if the physician provides evidence that:
- the Department of State Health Services has reviewed the waiver request and has determined that the waiver in the best interest of the public;
- the physician is in compliance with Board rule, by submitting documentation of protocols and standing orders upon request; and
- appropriate safeguards exist for patient care and adequate supervision of all EMS personnel under the physician's supervision.
To request a waiver to hold the position of off-line medical director for more than 20 EMS providers, please submit a completed EMS Waiver Request Form for each individual EMS provider you need a waiver for.
If you have any questions, please contact the Registration Department at Registrations@tmb.state.tx.us.
For each EMS medical director there are additional continuing education requirements.
Per Board rule 197.3(b)(17) each EMS off-line medical director is required to meet the following requirements:
- within two years, either before or after initial notification to the board of holding the position as off-line medical director:
o 12 hours of formal continuing medical education (CME) in the area of EMS medical direction;
o board certification in Emergency Medical Services by the American Board of Medical Specialties or a Certificate of Added Qualification in EMS by the
American Osteopathic Association Bureau of Osteopathic Specialists; or
o a DSHS approved EMS medical director course; and
- every two years after meeting the above requirements, one hour of formal CME in the area of EMS medical direction.
Please see Board rule 197, available on our website at: https://www.tmb.state.tx.us/page/board-rules for a complete listed of EMS off-line medical director requirements.