The Value of Physicians as Part of a Helicopter Emergency Medical Services Crew: A Review

Objective: The benefit and utility of a physician on a US-based air ambulance is an often-debated topic in the prehospital setting. There remains the question of what, if any, effect a physician crewmember has on patient outcome. Our goal was to assess the literature to date and determine if there exists a benefit to staffing air ambulances with physicians. Methods: PubMed and Cochrane databases were searched for English language studies from 1980 to 2020 using the terms “flight physician” and “physician-staffed helicopter.” Studies were chosen for inclusion based on the presence of a comparison of physician-staffed crews with non–physician-staffed crews. The included studies had their references reviewed for additional studies meeting the inclusion criteria. Results: A total of 19 articles were included, and their overall opinion of the benefit of a physician was assessed. Ten studies demonstrated a benefit, 8 showed no benefit or favored a nonphysician crew, and 1 was equivocal. Conclusions: Although some studies showed a benefit to having physicians staff an air ambulance, some showed no benefit, leaving our findings inconclusive. More data are needed to determine if the inclusion of these crewmembers has a positive effect on patient outcomes.