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Slifkin RT et al. – Existing recommendations for DMD qualifications may be difficult to attain in rural communities. To develop programs that will support medical direction for rural EMS agencies, it is important to learn what physicians identify as the barriers to serving as DMDs, and whether there are alternative and innovative ways to provide an optimal level of medical oversight. Solutions will likely be multi–faceted, as EMS activities and organizational structures are diverse and the responsibilities of the DMD are broad.

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