 Compliance with those regulations is usually evaluated with respect to effectiveness and meeting public need by the local cities/communities, assisted by specialised physicians.Typically, community or service area ("Rettungsdienstbereich") employs a medical director, (Ärztlicher Leiter Rettungsdienst), with a role that is similar to EMS medical directors elsewhere.The medical director is responsible for the creation and issue of regulations, protocols, and standards of care on behalf of the community.