Medical Direction Where You Need It

When an EMS agency contracts with International Medical Direction (IMD), IMD assigns a Board-Certified Emergency Medicine (EM) physician to serve as the agency’s Lead EMS Medical Director and direct, state-licensed physician of medical control.

IMD’s model is built around an active physician-agency relationship—not simply physician availability. This relationship includes direct physician access, quarterly live interaction, and an in-person physician presence at least annually. The Lead EMS Medical Director is supported by IMD’s experienced EMS support team, which provides ongoing day-to-day administrative and operational assistance.

Austere, Wildland & Disaster Medical Direction

IMD’s medical direction model is uniquely designed to support austere, wildland, disaster, and other remote EMS operations, where EMS teams may operate far outside their normal service area and under circumstances that require additional medical-direction planning and coordination.

When an EMS agency deploys to an incident without a declared state of emergency, IMD may provide an additional Board-Certified Emergency Medicine physician licensed in the incident state to serve as an Incident Location Medical Director (ILMD), where permitted and applicable.

A critical component of this model is IMD’s contractually required pre-deployment notification process. Before deployment, the EMS agency notifies IMD of the proposed assignment and provides the information necessary for IMD to evaluate the deployment and establish the appropriate medical-direction structure. IMD then provides the agency with applicable deployment paperwork documenting and supporting the medical-direction arrangements for that assignment.

This process is important because deployment outside an agency’s normal operating environment may involve different state requirements, medical-control arrangements, operational considerations, and controlled-substance requirements. Pre-notification gives IMD an opportunity to address these issues before personnel and resources are deployed, rather than attempting to establish the appropriate medical-direction structure after operations have begun.

Through this coordinated process, IMD can determine whether an Incident Location Medical Director (ILMD) or other medical-direction arrangement is appropriate, provide the agency with its deployment paperwork, and help ensure continuity of Direct Medical Oversight throughout the assignment.

The process also allows IMD physicians to maintain ongoing surveillance of remote EMS operations, including patient care, clinical practices, operational medical issues, and DEA-controlled substance activities.

Declared Emergencies & EMAC Deployments

When an incident involves a declared state of emergency, agency pre-notification remains an essential part of the process. Early notification allows IMD to review the proposed deployment, coordinate the appropriate physician oversight, and provide the agency with applicable deployment paperwork before the assignment begins.

For deployments conducted through the Emergency Management Assistance Compact (EMAC) or similar emergency-response mechanisms, the agency’s Lead EMS Medical Director may serve as the Point-of-Origin EMS Medical Director, providing Direct Medical Oversight for these highly specialized deployments in accordance with applicable laws, regulations, compact provisions, and emergency authorities.

In both declared and non-declared events, the objective is the same: medical direction should be established before deployment—not after the EMS team arrives at the incident. IMD’s pre-notification and deployment-documentation process helps preserve a continuous and clearly defined physician medical-oversight relationship from the agency’s point of origin through field operations and return from deployment.

24/7/365 Physician Access

Regardless of location, IMD-supported EMS teams have access to 24/7/365 Online EMS Medical Consultation through IMD’s cloud-based communications platform, helping maintain direct physician connectivity during remote, austere, and complex operations.

Have a Unique EMS Program?

IMD’s medical direction model can support many specialty and nontraditional EMS programs. Depending on the type of program, operational environment, and applicable state laws and regulations, IMD can develop a medical-direction structure tailored to the agency’s needs.

The following are states in which IMD physicians are licensed as of August 1, 2026.

  Southwestern USA

• California
• Arizona
• New Mexico
• Texas
• Nevada
• Utah
• Colorado

   Northwestern USA

• Oregon
• Washington
• Montana
• Wyoming
• Idaho

  
  Southern USA

• Louisiana
• Mississippi
• Alabama
• Oklahoma
• Arkansas
• Nebraska

  Southeastern USA

• North Carolina
• Georgia
• Florida