Wirelessly posted (Opera/9.80 (BREW; Opera Mini/6.0.3/27.2338; U; en) Presto/2.8.119 320X240 LG VN530)
From what I understand, paramedic programs have been around long enough that in most cases the medics now follow an SOP that doesn't require them to ask permission from a doctor to perform most procedures. There are probably a few instances where they do have to consult first. Of course, there's always the courtesy notifications to a hospital of what is being brought in by the medics.
In addition to Med 1-10, Arizona also had Med 11-15. These were 453.025, 453.075, 453.125, 453.175, and 460.525. (Med 15 is on the same channel as DPS CID 5 - Pinal County, but used a different CTCSS.) The CTCSS on all the MED channels was 136.5. I had heard Boswell hospital security on 453.075 or 453.175 in the past. I don't know if they're still on there. They may have gone MotoTrbo since I used to hear them.
I don't know about the FCC releasing EMSCOMM to be licensed by businesses. If you look in the nationwide listings, you'll see that the split frequencies, such as 463.0125, etc, have been assigned to medical use.