Houston has 5 physicians employeed to oversee medical operations. The 'Medical Director' has the authority to approve the level of prehospital care which may be rendered by each of the departments members, establish and monitor compliance with field performance guidelines and establish and monitor training standards. A staff of four physicians provides on-line and/or on-scene medical direction for all critical patients 24 hours per day.
The docs and the EMS Supervisors (Paramedics) have a pager which monitored 154.160 and alerted for major medical events ("710 Page") such as cardiac arrest, entrapments, multiple patients, and other specific medical events.