At the start of the 2006 fiscal year for the City of Dallas, Dallas City Manager, Mary Suhm, along with City of Dallas Director of Medical Emergency Services, Dr. Paul Pepe, and newly-appointed Dallas Fire Chief, Eddie Burns, Sr., made a major surprise announcement disclosing the appointment of Dr. S. Marshal Isaacs as Medical Director for the 2,000 member Dallas Fire-Rescue Department. A nationally recognized EMS medical authority, Dr. Isaacs had been the longstanding Medical Director for the San Francisco Fire Department (SFFD). 

Dr. Isaacs' newly-created position was established to provide a major advancement for the unified, maturing Dallas Metropolitan Area EMS systems, known as the BioTel System, the large federation of 15 larger and medium-sized municipalities that receive centralized medical oversight from the Emergency Medicine (EM) faculty at the University of Texas Southwestern Medical Center (UTSW) - Parkland Memorial Hospital Section of EMS, Homeland Security and Disaster Medicine.

In remarks to fellow city officials, Dr. Paul Pepe, the first President-Elect of National Association of EMS Physicians (NAEMSP) and also Chair of Emergency Medicine at UTSW-Parkland, noted that, "Dr. Isaacs is the quintessential physician-public servant who possesses a longstanding track record of dedicated services to EMS personnel and firefighter first responders. He also brings along proven expertise in conducting controlled clinical trails, community AED programs and creative solutions to difficult problems in the delivery of prehospital medical care".

Dr. Isaacs helps to further round out the evolving team of EMS leaders in Dallas which, in addition to Dr. Pepe, a two-time NAEMSP Ronald Steward Award winner, and Dr. James Atkins, the acclaimed, award-winning (three-dacade) Director of EMS Education at UTSW, includes the likes of former NAEMSP President and recent Neely Award winner, Dr. Ray Fowler and Dr. Kathy Rinnert, who has served as Chair of the NAEMSP EMS Fellowship Committee and as the Physician Board Member for the Council for Accreditation of Ambulance Services (CAAS). Dr. Isaacs will partner at a senior level with Dr. Fowler, who also serves as the deputy medical director for system-wide BioTel operations, and Dr. Rinnert, EMS Fellowship Director at UTSW-Parkland to further advance the 9-1-1 system for the entire Dallas area.

Dr. Isaacs, is being specifically assigned to oversee DFR to directly and personally provide round-the-clock medical oversight and quality improvement services for the City of Dallas' EMS program, one of the busiest in the nation with nearly 500 EMS incidents a day and more than 400 certified paramedics. He will work closely with Fire Chief Burns and his command staff, particularly EMS Assistant Chief, Joseph Vasquez, and EMS Deputy Chief, Joseph Kay. 

Dr. Isaacs will also be joined in these endeavors by four EMS fellows in the Dallas system and veteran Dallas Assistant EMS Medical Director for On-Scene Response, Dr. Fernando Benitez, who recently authored the "On-Scene Supervision" chapter in the most current edition of the core NAEMSP text, Prehospital Systems & Medical Oversight. 

As part of their initial efforts, Dr. Isaacs and his DFR EMS partners have launched an "EMS Vision Process", a comprehensive assessment and consensus process that will provide a roadmap for future improvements in the Dallas EMS System. In addition, the new DFR team has already begun a revised incident inquiry system and a multitude of new processes to enhance job satisfaction and system improvements for EMS crews and the citizens they serve.

In addition to his DFR duties, Dr. Isaacs will serve as a senior Attending Physician and Faculty Member in Emergency Medicine (EM) at the Parkland Hospital Emergency-Trauma Center and as a full Professor at the University of Texas Southwestern Medical School. He has already received the highest level evaluations from the resident staff and he has become a Co-Investigator for the Dallas site in the National Institutes of Health (NIH) Resuscitations Outcomes Consortium (the ROC).

Dr. Isaacs is a veteran large-city EMS-Fire Department Medical Director who brings with him an award-winning, nationwide reputation for expertise in out-hospital care, including delivery of on-scene patient care, ground-breaking through the efforts of Dr. Pepe, City of Dallas Director of Medical Emergency Services for Public Safety, Public Health and Homeland Security, the actual recriutment process was a joint venture involving many members of DFR and UT Southwestern alike, including Chief Burns and numerous DFR personnel. In fact, as an ever-popular presenter at the annual Gathering of Eagles Conference hosted each year in Dallas, he was already well known to many DFR members and the UT Southwestern staff. His selection was essentially unanimous.

In terms of background, Dr. Isaacs, a native of New York City, began his education at Union College in New York, during which time he completed studies of comparative health care systems at the University College of London and University College at Uppsala, Sweden. He later served as a congressional intern for then U.S. Representative, Albert Gore, Jr., and following graduation from The State University of New York at Stony Brook Medical School in 1988, Dr. Isaacs entered formal residency training in Emergency Medicine (EM) at the renowned Allegheny General Hospital program in Pittsburg, Pennsylvania, where he later served as the program's Chief Resident during the 1990-1991 academic year.

From 1991 to 1992, Dr. Isaacs completed a one-year fellowship in prehospital Emergency Medical Services (EMS) at Stanford University under the direction of the previous administrator of the National Highway Transportation Administration (NHTSA), Dr. Ricardo Martinez.  In addition to his EMS Fellowship training, Dr. Isaacs served as the Lead Flight Physician for the Stanford Life Flight air medical transport program, thus gaining significant experience in both ground and air-based EMS.

Following his formal training, Dr. Isaacs then joined the faculty of the University of California, San Francisco (UCSF) School of Medicine, one of the premier meducal schools in the country, eventually becoming a full Professor at the infliential institution in the Department of Surgery. Based as a faculty member and attending EM physician at the country's sole level I trauma center, San Francisco General Hospital (SFGH), Dr. Isaacs first served as the Medical Director of the Paramedic Base Station of the City and County of San Francisco. Soon thereafter (1994), Dr. Isaacs was asked to assume the role of Medical Director for the City's Paramedic Division (a health department service at that time). In turn, he was also appointed Medical Director for the San Francisco Fire Department (SFFD), medically-directing its city-wide Early Defibrillation and Basic EMT/First Responder programs.

In July, 1997, the San Francisco Department of Public Health Paramedic Division and the SFFD were merged into a single agency and Dr. Isaacs had the honor and privilege of serving as the Medical Director for San Francisco's re-organized EMS operational agency. Until his recruitment this year to Dallas, he served as the SFFD Medical Director for those dozen years with outstanding reviews from city officials, paramedics, firefighters and colleagues alike. During his 12-year tenure with the City of San Francisco, he received multiple kudos for advances in patient care, prehospital care research, and proliferation of AEDs throughout the community. This pass year, he received one of the highest peer awards in the field of EMS, the Michael K. Copass Award for Konstanding Excellence in Emergency Medical Services from the U.S. metropolitan EMS medical director consortium, the informal coalition of the jurisdictional medical directors for the nation's 25-30 most populous cities as well as the medical directors/officers for the FBI, U.S. Secret Service, White House Medical Unit, and other relevant federal agencies.


Medical School
SUNY Stony Brook University (1988)
Allegheny General Hospital (1990), Surgery
Allegheny General Hospital (1991), Surgery
Stanford University (1992), Emergency Medicine

Research Interest

  • Cardiac Arrest Resuscitation
  • Mobile Community Healthcare
  • Prehsopital Emergency Medical Services


Featured Publications LegendFeatured Publications

EMS Transport Decision-Making, Alternative Transport Modalities and Alternatives to Hospital Emergency Department Transport: State-of-the-Art and Science and Recommendations for EMS Systems.
S. Marshal Isaacs, MD, Marc Eckstein, MD, Crawford Mecham, MD, Don Locasto, MD, Fionna Moore, MD, Karen Wanger, MD, Neal Richmond, MD, , Jack Ayres, JD, Paul E. Pepe, MD, MPH(Writing Group), et. al., on behalf of the U.S. Metropolitan Municipalities? EMS Medical Directors Consortium* 2014
The Impact of a Novel Urban Fire-Department Based Community Paramedic Program on High Frequency Patients' 9-1-1 Utilization and in Preventing 30-Day Hospital Readmission in Targeted High-Risk Patient Populations.
S. Marshal Isaacs, MD, Scott Goldberg MD, Norman Seals, Kristy Anderson, Gil Salazar, MD, Ray Fowler, MD, Paul Pepe. 2014
Resuscitation center designation: recommendations for emergency medical services practices.
Mechem CC, Goodloe JM, Richmond NJ, Kaufman BJ, Pepe PE Prehosp Emerg Care 2010 Jan-Mar 14 1 51-61
Baseline Carboxyhemoglobin Levels in Firefighters Using the Masimo Rainbow SET Rad-57 Pulse CO-Oximeter.
Black A, Muniz J, Benitez FL, Burkhalter L, Isaacs SM, Luber SD, Pepe PE, Velez LI. Annals Emerg Med 2009 3 54 S77-S78
Evidence-Based Performance Measures for Emergency Medical Services Systems: A Model for Expanded EMS Benchmarking A Statement Developed by the U.S. Metropolitan Municipalities' EMS Medical Directors Consortium.
J. Brent Myers a; Corey M. Slovis a; Marc Eckstein a; Jeffrey M. Goodloe a; S. Marshal Isaacs, James R. Loflin a; C. Crawford Mechem a; Neal J. Richmond a; Paul E. Pepe Prehospital Emergency Care 2008 2 12 141-151
Facilitating EMS turnaround intervals at hospitals in the face of receiving facility overcrowding.
Eckstein M, Isaacs SM, Slovis CM, et al. Prehospital Emergency Care 2005 3 9 267-275

Honors & Awards

  • Special Recognition Award
    Dallas Fire-Rescue, 2014
  • The Michael Keys Copass Award
    Gathering of Eagles The EMS State of the Sciences, 2006

Professional Associations/Affiliations

  • American College of Emergency Physicians (ACEP) (1992)
  • American Medical Association (AMA) (1992)
  • National Association of EMS Physicians (NAEMSP) (1991)
  • Society for Academic Emergency Medicine (SAEM) (1992)
  • U.S. Metropolitan Municipalities' EMS Medical Directors Consortium (1998)