At one time, the medical director would schedule herself to ride at least twice a month, with each crew. We now have a new one that comes and visits us routinely.
I am firm believer, that an EMS can only be as strong as their medical leader is involved in the service.
Our Medical Director routinely runs calls with us. He holds, and often does then instructing of, Monthly educational classes. He is available by phone 24hours a day. He also works in on of the ER's, so we get the almost instant QA when we transport there.
Its a huge change from the previous company that held the contract for our county.
Our medical director has taught portions of my medic class, and graded our oral boards for class. He was the physician working the day I did my physician mentoring clinical, and I shadowed him that day. He is almost always at the monthly A&R/training held at one of the local hospital, and also comes out to the different fire departments every couple months or so for training. He is very approachable. Occassionally he will show up in the field on runs, and worked as a paramedic before becoming a doctor. He is one of the docs in the area that pushes for more progressive protocols for us, and I have heard him alude to the fact that it frustrates him that some of the other MDs that are a part of the committee that approves our protocols are so conservative and resistant to change.