The role of the emergency medical service (EMS) medical director in EMS medical oversight is multifaceted, complex, and often misunderstood. The roles and requirements of the EMS medical director should be laid out clearly in the form of a contract. This should delineate the authority of the position and allow improvement of the system, the providers within the system, and the public in general. EMS medical oversight requires an understanding of state, federal, and local legislation and regulations involving prehospital medical care and transport. Due to the complexity of state, local, and federal regulations, the focus typically shifts to more of prehospital medical care and protocol management. ACT can help navigate not just one portion but all.