EMS Medical Director

The EMS Medical Director provides clinical medical direction and physician oversight for Bondurant Emergency Services (BES), an advanced life support fire/EMS transport service. The Medical Director supports safe, evidence-based prehospital care through protocol development and approval, provider credentialing, continuous quality improvement, medical audit, clinical consultation, education, and regulatory compliance. The Medical Director works closely with the Emergency Services Director, Assistant Fire Chief - EMS Coordinator, department officers, and credentialed EMS personnel while maintaining independent clinical judgment. City and BES management retain responsibility for administrative, employment, labor-relations, budgetary, and operational decisions except where Iowa law assigns authority to the Medical Director.

The following duties are illustrative of this position and are not intended to be all-inclusive. The Medical Director must also perform duties required by applicable Iowa law, Iowa Department of Health and Human Services (Iowa HHS) requirements, and the City’s authorized EMS service level.

Medical Direction and Coverage:

• Provides or coordinates timely physician consultation for clinically significant incidents, unusual cases, protocol questions, and patient-care concerns.

• Maintains reasonable availability to BES leadership by telephone, secure electronic communication, and in-person or virtual meeting as appropriate.

• Maintains continuity of medical direction and cooperates in any transition so Medical Director duties are not relinquished before a new or temporary replacement is functioning in that capacity.

Protocols and Clinical Practice:

• Develops, approves, maintains, and updates BES service protocols so they meet or exceed Iowa HHS minimum EMS clinical guidelines and remain within the City’s authorized EMS service level and provider scopes of practice.

• Reviews changes in state guidance, evidence-based prehospital practice, and local system needs and recommends or approves protocol changes when appropriate.

• Participates in implementation of significant protocol changes, including communication and education necessary for safe adoption.

• Assists with physician, physician assistant, registered nurse, or other exception or authorization processes when applicable to BES.

Provider Credentialing and Clinical Authority:

• Clinically credentials EMS providers rostered with BES for the emergency medical skills they are authorized to perform.

• Ensures clinical duties assigned to EMS providers do not exceed individual provider scope of practice or the City’s authorized EMS service level.

• Provides individual evaluation and consultation regarding clinical performance, competency, remediation, and return-to-practice considerations.

• Exercises the Medical Director’s lawful authority to restrict the City’s functional EMS service level or an individual provider’s scope of practice when clinically necessary for patient safety, coordinating implementation with BES leadership.

Continuous Quality Improvement and Medical Audit:

• Approves and actively supports the BES Continuous Quality Improvement (CQI) program and written CQI policy.

• Performs or completes medical audits required by the BES CQI program, or appoints a qualified designee when permitted.

• Personally conducts random audits of patient-care documentation at least quarterly and randomly reviews audits completed by a qualified appointee or designee, as required by Iowa Administrative Code.

• Participates in review of high-risk, high-acuity, unusual, adverse, sentinel, complaint-related, or protocol-variance cases as reasonably requested.

• Participates in at least quarterly CQI/clinical oversight meetings with BES leadership and assists in identifying trends, closing quality gaps, and documenting clinical remediation or improvement actions.

• Provides an annual summary of major medical-direction activities, including protocol updates, credentialing activity, CQI participation, significant system recommendations, and training completed.

Education, Training, and Clinical Development:

• Advises BES regarding clinical continuing-education priorities based on CQI findings, protocol changes, emerging practice, and service needs.

• Provides, arranges, or participates in periodic case review, physician-led education, skills review, or other clinical education when reasonably requested and mutually scheduled.

• Supports clinical remediation plans when provider performance indicates a need for additional education, supervised practice, testing, or reassessment.

• Assists BES with evidence-based clinical expectations for new or expanded services within the City’s authorized level.

Regulatory and System Support:

• Maintains compliance with applicable requirements of Iowa Code Chapter 147A, Iowa Code Chapter 148, Iowa Administrative Code 641-Chapters 131 and 132, Iowa HHS requirements, and other applicable EMS, pharmacy, patient-privacy, and professional-licensure requirements.

• Completes Iowa HHS-sponsored Medical Director training within one year after assuming the role if not already current and completes required refresher training at least once every three years thereafter.

• Supports medication, controlled-substance, and pharmacy policies and agreements to the extent Medical Director participation is required.

• Cooperates with Iowa HHS inspections, investigations, data-quality reviews, or clinical-compliance inquiries involving medical direction.

• Provides clinical input, when reasonably requested, related to EMS complaints, claims, regulatory reviews, public-safety investigations, or other clinical matters.

To perform this role successfully, an individual must be able to perform each essential duty satisfactorily and meet all legal requirements to serve as an EMS Medical Director in Iowa. Reasonable accommodations may be made when applicable to enable a qualified individual to perform the essential functions.

Education and Experience:

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited medical school.

• Current physician license to practice medicine in Iowa under Iowa Code Chapter 148, in good standing and without restrictions that would materially impair the ability to perform the role.

• Demonstrated knowledge of contemporary prehospital emergency care and the clinical practice of EMTs, AEMTs, and paramedics.

• Professional judgment, availability, and organizational capacity sufficient to provide required medical direction and reliable alternate coverage.

Preferred Education and Experience:

• Board certification or substantial clinical experience in Emergency Medicine, EMS, Family Medicine with significant emergency-care practice, trauma/critical care, or another specialty directly relevant to prehospital care.

• Prior experience serving as Medical Director for an Iowa EMS service or system.

• Experience with ALS transport services, combination fire/EMS departments, suburban or rapidly growing communities, and multi-agency mutual-aid systems.

• Experience with EMS quality improvement, provider credentialing, protocol development, simulation, education, and performance remediation.

• Established working relationships with regional hospitals, emergency departments, EMS systems, physician groups, or medical-control resources that can support continuity of care and alternate medical direction.

Knowledge, Skills, and Abilities:

• Knowledge of Iowa EMS service authorization, provider scope-of-practice requirements, Iowa HHS clinical guidelines, CQI requirements, and applicable medical-director responsibilities.

• Ability to interpret clinical evidence, regulations, protocols, patient-care documentation, and quality-improvement data and translate findings into practical clinical direction.

• Strong written and verbal communication skills and the ability to provide timely, clear, and professional consultation to EMS personnel and City leadership.

• Ability to collaborate effectively with public-sector leadership while maintaining independent clinical judgment and appropriate patient-safety authority.

• Ability to handle confidential patient, personnel, and quality-improvement information in accordance with HIPAA, Iowa law, and applicable professional standards.

CERTIFICATES, LICENSES, REGISTRATIONS

• Active Iowa physician license (MD or DO) in good standing is required.

• Must be legally eligible to serve as an EMS Medical Director under Iowa Code Chapter 147A and Iowa Administrative Code 641-Chapter 132.

• Must have completed the Iowa HHS Medical Director workshop within the required period or complete it within one year after assuming Medical Director duties, with refresher training at least once every three years thereafter.

• Must maintain professional liability/malpractice insurance acceptable to the City throughout service in the position.

PHYSICAL DEMANDS

The physical demands described here are representative of those ordinarily associated with performance of this role. Reasonable accommodations may be made when applicable.

• Primarily sedentary professional work involving review of electronic or written records, telephone or electronic consultation, meetings, and clinical decision-making.

• Occasional standing and walking during in-person meetings, training, quality-review activities, or visits to BES facilities.

• Ability to communicate effectively by telephone, video conference, secure electronic communication, and in person and to review patient-care documentation, protocols, and related clinical materials.

VOLUNTEER APPOINTMENT AND STIPEND

This is a volunteer Medical Director position and is not a regular City employment position. The City anticipates an annual stipend of $600. The stipend is negotiable based on qualifications, experience, availability, and the final agreed scope of service. Appointment is subject to completion of the City’s selection process, verification of required licensure and qualifications, and approval of any required appointment or agreement documentation.

The City of Bondurant is an Equal Opportunity Employer. The City will provide reasonable accommodations to qualified individuals with disabilities in accordance with applicable law.