[The position of the emergency physician in the emergency medical service].

The participation of emergency physicians guarantees the quality of a modern emergency medical service (EMS). Within the scope of cost savings in health-care system, it is questioned whether emergency medical services in the future can be managed without emergency physicians. Deficits of structure and qualitaty of the emergency physician service are raised objections. Recent studies have shown that preclinical care carried out by an emergency physician assure better results. An ongoing improvement in the quality of care should be achieved by the introduction of the new professional training for physicians "emergency medicine". In a direct comparison of two emergency medical services, one with emergency physicians, one only with paramedics it could be demonstrated that the integration of emergency physicians will increase the rate of patients, whose vital status could be improved by more than 20 %. The rate of patients discharged from hospital after cardiopulmonal resuscitation is 3 fold higher than in a rescue service without emergency physicians. However this improvement of quality of care by physicians is linked to higher financial charges. Another aspect supporting the obligatory employment of emergency physicians in Germany is the jurisdiction guaranteeing the right of the patient to receive advanced medical treatment only by (emergency) physicians.