Correct me if I'm wrong (no doubt someone will), but doesn't the fact that on most Air Ambulances there is a lack of space to work on the casualty enter the equation? What's the point of having a clever doctor if he can't do his stuff in the air? Said clever doctor has to do it all on the ground, draining the aircraft of fuel (assuming it's not shut down) and negating the efforts to achieve the golden hour. With the exception of his/her ability to provide rapid sequence intubation (which helps but isn't essential - there are other ways to manage airways), having a doctor on board an Air Ambulance is over-egging the pudding somewhat, don't you think?