We always had to report to Medical Control. Very early in my career there was a problem, as stated in an earlier post, that whoever picked up on the other end may or may not have been qualified to give orders. It might have been an LPN that happened to be helping in the ER. Of course there was no way a Medic was going to take orders from an LPN. In that case it was mostly letting them know what we were bringing in and usually a doc was in listening distance to give any additional questions or orders. Eventually on qualified RN's or in rare circumstances the doc may were able to respond. MICN's came more frequently. But I found that most of the time, if the Medic was proficient enough, the nurse would just take the report and would not have to give additional orders. I always strived to give enough info that they would not have to ask more questions. But this is not always the case. There are those who may not have given sufficient treatment or relayed enough info, so the nurse may have to give additional orders or have questions to know more about the pt. and what they were bringing in.
So it's not always the case of betting orders, but to let the receiving hospital notification of what is being brought to them so that they can prepare if need be. I don't see where eliminating contacting medical control and/ or communication with a receiving hospital.
I never had a problem with being given additional orders or questions. And sometimes you may have to ask what the doctor on duty may prefer you to do.
I think the biggest issue is that whether or not the person, RN or MICN, on the receiving end is qualified to give a Medic orders. And you have to consider other services that may not be ALS and rely on medical control for appropriate treatment, especially those that may not have personnel as experienced as some others.
As far as MICN's in our area, it was not a title given to an RN that worked the ER. But rather they worked in the field and had experience working along side Medics. They are required so many hours of ride time a month. It may be different in other areas but that's how it was here.
Sorry if I rambled, been a rough morning. :?