title: State requirements for physician emergency medical services providers.
abstract: OBJECTIVE
  To describe requirements of physicians wishing to function as primary field emergency medical services (EMS) providers and variation of these requirements among states.
  
  
  METHODS
  A simple mailed survey was developed and distributed to all 50 U.S. state EMS directors. The survey gathered information about each state's regulations concerning physicians performing as a primary EMS crew member. Data were entered into a Microsoft Excel spreadsheet and reported using simple descriptive statistics, including proportions and 95% confidence intervals (CIs).
  
  
  RESULTS
  Forty-four (88%) of the states responded. In 32 states (73%), physicians can work as a primary member of either a basic life support (BLS) or an advanced life support (ALS) ambulance crew without any specific additional training. In 30 states (68%), physicians can work as a primary member of either a BLS or an ALS ambulance crew without any specific prehospital certification. All of the reporting states will allow a physician to become certified as an emergency medical technician (EMT) or paramedic and then work as a primary member of a BLS or ALS ambulance crew. Seventy-nine percent allow the provision of physician-level care on BLS ambulances, and 81% on ALS ambulances. There was no meaningful difference between the training requirements for becoming a certified BLS provider vs. a certified ALS provider. States were significantly less likely to require a skills examination of physicians wishing to become certified as a BLS provider (9%) compared with those wishing to become certified as an ALS provider (82%).
  
  
  CONCLUSIONS
  Most states allow physicians to become certified prehospital care providers, although few states require physicians wishing to work as a primary EMS provider to do so, or even to undergo any specific EMS training. There is no national standardization of the preparatory requirements of physicians wishing to provide in-field EMS.
authors.affiliation: Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, New York 13210, USA. fullagac@upstate.edu
authors.forename: Christopher Jason
authors.initials: CJ
authors.lastname: Fullagar
authors.forename: N Heramba
authors.initials: NH
authors.lastname: Prasad
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Brown
authors.forename: Nelson
authors.initials: N
authors.lastname: Anaya
mesh_terms: D002568:Certification; D004636:Emergency Service, Hospital; D033161:Government Regulation; D019538:Health Care Surveys; D006801:Humans; D010820:Physicians / Q000331:legislation & jurisprudence* / Q000592:standards; D013219:State Government; D014481:United States