Who has the authority to manage patient care on scene?

The authority to manage patient care on scene is held by the on-scene physician if they are appropriately licensed. This is based on the principle that medical professionals who are actively present and qualified to provide care have the responsibility to direct patient management in emergency situations.

An on-scene physician, unlike other personnel, has direct access to the patient and can assess their condition, make clinical decisions, and implement treatment in real time. Their role is critical, especially in complex medical emergencies where immediate and informed decisions can significantly affect patient outcomes.

In contrast, personnel such as paramedics, while skilled and trained, traditionally operate under medical protocols and the direction of a medical director or physician who is not necessarily present at the scene. Hospital staff awaiting patients at a facility do not have direct input into the management of the patient prior to handover. Administrative personnel, while they may organize resources and coordinate support, do not hold clinical authority over patient care decisions in the field. Therefore, the presence and licensure of a physician at the scene grant them authority to direct patient care effectively.