Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

OLMC for President!

The justification for OLMC (On Line Medical Command) requirements is usually “Well you wouldn’t want Medic X treating your mother (or daughter, or somebody who owes you money, . . .) without having to call for permission.”
Medic X is a menace, so any mention of this medic is viewed as an example of the problems with medics. Some doctors, especially medical directors, use this example. Some medics use this example, too.

The logic they employ is completely corrupt.

Medic X is a medic.

This is true.

Medic X is dangerous.

Whether this is true is not important to the argument.

Medic X is probably not the only dangerous medic out there.

This is true. Don’t lie, you know it is true.

Therefore, in order to protect patients from Medic X, we will require all medics to call OLMC to ask for permission to use any potentially dangerous treatment.

Before you get swept up in the fervor of the argument of these used car dealers of EMS . . .


You are calling medical directors the used car dealers of EMS?

Some of them.

Would you buy patient care from Medic X?



Medic X is dangerous! You’d have to be crazy to let Medic X take care of you!

What OLMC does is allow you to hire medics who should not be allowed to treat patients beyond the basic level – and that is being generous to some of these medics.

After you hire the medics, they need to receive authorization from the medical director to treat patients.

If the pool from which you hire is not particularly deep, you may have a problem convincing a medical director that these new hires should be allowed out in the world on their own.

Eureka – OLMC!

So, how does this protect the patients from Medic X?

Haven’t you been paying attention?

It doesn’t protect patients – it helps medical directors feel that they are protecting patients.

Then why do they do it?

Most EMS systems do not have much of a budget for a medical director.

That’s not exactly intelligent!

You have heard the phrases “You get what you pay for” and “Your life is our hobby”?

So, OLMC is cheap?

Only until the lawyers start to see how easy it is to convince a jury that it encourages bad patient care.

So, people think OLMC is a cheap way to provide medical oversight?

Well, real medical oversight is considered far too expensive.

What do you mean real medical oversight?

That’s a post for another day.

In the latest posting of The Ambulance Driver’s Perspective, Ambulance Driver writes The Two Most Important Words in an EMS Protocol. This gives a different perspective on OLMC requirements.

If you have not already read this, go read what AD wrote.

My other posts on OLMC requirements and Medic X are:

OLMC (On Line Medical Command) Requirements Delenda Est

OLMC = The Used Car Dealers of EMS?

OLMC For Good Medics

Fun with explosives – NTG.


  1. […] But the medical directors start mumbling about their creation – Medic X (the incompetent medic). […]

  2. […] claim that requiring OLMC (On Line Medical Command) permission to treat patients does not work and actually lowers the quality of medic in a system. You state that Medic X, the example of the […]