Physicians in prehospital care: A review of the clinical and economic evidence

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Daniel Kapustin
Sparsh Shah



Prehospital care delivery varies across different geographies. Among the starkest differences is the role of the physician in prehospital care and emergency medical services (EMS). In the ‘Anglo-American’ model, ambulances are primarily staffed by emergency medical technicians (EMTs), emergency medical responders (EMRs), and paramedics. In contrast, in the ‘Franco- German’ model, ambulances are commonly staffed by physicians. Physicians can theoretically provide superior prehospital care due to increased level of training, judgement, and competency. However, physician-staffed emergency medical services (PS-EMS) also increase the financial burden on the prehospital care system. This review paper aims to summarize, compare, and analyze the clinical and financial features of these two models in order to identify the best staffing model. The information presented in this paper can aid medical administrators in the decision-making process involved in optimizing their prehospital care delivery system.