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Emergency Medical Services

Medical Direction

Medical Direction

EMS Medical Director

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Information for Medical Directors

The EMS Office contracts with a licensed physician as the State EMS Medical Director to provide medical consultation to the Office and EMS Board and the Office of General Counsel for investigations and contested case hearings. The state Medical Director also provides medical advice to training institutions and service medical directors plus acts as liaison with professional medical groups, facilities and individual practitioners.

This physician also serves as chair of the EMS Board’s Clinical Issues Committee, which processes all medically related issues before they are presented to the Board. In this capacity, the Medical Director has responsibility for the development and updating of treatment protocols, review of new procedures and drugs, quality assurance standards, and the clinical content of training programs.

Joe Holley, M.D. FACEP
Tennessee Department of Health
Office of Emergency Medical Service
665 Mainstream Drive, 2nd Floor
Nashville, TN  37243

Medical Directors

Roles and Responsibilities

The EMS Medical Director has the responsibility to provide oversight for the medical aspects related to planning, development, implementation, and evaluation of the EMS system.  This includes all medical components for systems of care supported by public policy that integrate or interface with the EMS system, such as those listed: .

  • Domestic preparedness
  • EMS for children / neonatal transport
  • Stroke plan
  • Cardiac plan
  • Other systems of specialized care through which EMS patient care is delivered

The EMS Medical Directors oversees the establishment of protocols, policies, and procedures for all patient care activities from dispatch through triage, treatment, and transport for all emergency responders (EMS, fire, hazmat, police, etc.).  He or she is involved in the EMS continuous quality improvement program involving all entities including First Responder Agency under the EMS Service providing patient care.

The EMS Medical Director also serves as an advocate for efficient and effective emergency medical services, ensuring delivery of medical care that is consistent with professionally recognized standards.  The EMS Medical Director assures quality care management to ensure professional and public accountability for medical care provided within the EMS system.

The EMS Medical Director recommends medical policies and procedures to be included in the treatment and transport protocols, ensuring appropriateness of training and certification of the EMS providers practicing under his or her guidance.   The EMS Medical Director recommends corrective action and disciplinary action when necessary for an EMS service or EMS provider when cause is related to a quality of care issue.
The EMS Medical Director assists the state EMS regulatory agency to assure compliance with applicable rules and regulations.

The EMS Medical Director provides education and promotes and participates in EMS System research.  He or she provides as a liaison with the medical community and professional medical organizations.  They interact with local, regional, state, and national EMS authorities to ensure that standards, needs, and requirements are met and resource utilization serves to optimize efficient and effective medical care.   They also ensure there is a coordinated effort of all medical activities for disaster planning and response.

The EMS Medical Director promotes public information and education on prevention of illness and injury.  The EMS Medical Director maintains  knowledge for all levels of medical response (in the context of not only traditional EMS but also for first responders involving police, fire, hazmat, and others) through ongoing professional and personal education in order to provide coordinated medical advice for interagency activities and disaster response.

Exerience and Education Requirements

The following are examples of knowledge, skills and abilities an EMS Medical Director should possess:

  • Thorough knowledge of state EMS laws
  • Thorough knowledge of system level data analysis
  • Considerable knowledge of EMS dispatch and communications
  • Considerable knowledge of mass casualty and disaster plans
  • Considerable knowledge of group dynamics relating to advisory committee structures
  • Significant knowledge of out-of-hospital care research
  • Significant knowledge of public health education, injury prevention, and health promotion
  • Considerable communication and interpersonal skills
  • Considerable technical writing skills in grant preparation, protocol and policy development and regulatory language
  • Ability to analyze and comprehend data
  • Ability to deal tactfully with the media, elected officials and others, on sensitive matters
  • Ability to make public presentations

Experience and Education Requirements

It is essential the EMS Medical Director possess significant experience and familiarity with the design and operation of the statewide EMS system (including any existing subset systems of trauma, peds, burn, cardiac, stroke, and other specialized components of the EMS system).  They should also have significant experience, leadership, and success in working with state EMS committees and experience with the EMS quality improvement / performance improvement process.  It is desirable that the EMS Medical Director be board certification in emergency medicine (ABEM or ABOEM), have continued involvement with the ED management of acutely ill and injured patients and have recent or current involvement in local, state and national EMS organizations.

Liability Insurance Information



The following medical protocols have been developed for use by emergency medical providers operating within the State of Tennessee as a GUIDELINE for preparation of pre-hospital treatment protocols and related administrative policies. Protocols are treatment guidelines that should only be carried out with direct medical control from a physician unless a "standing order" policy has been established for a particular protocol. Please keep in mind that the treatment sequences illustrated presume that the patient remains symptomatic or in a deteriorating state and covers a broad range of conditions and situations and may require changes in the plan of actions. At the time of development of the protocols, great care was taken to make certain that doses of medication and schedules of treatment were compatible with generally accepted standard of care. Anyone planning to use any or all of these protocols should review and study them carefully, satisfying themselves that they are accurate and appropriate at the time they are instituted.