When a 119 emergency call comes in at the Fire-fighting Central Command Room, an ambulance is dispatched to the scene, meanwhile the request for Doctor Helicopter dispatch is sent to a base hospital. The Doctor Helicopter carrying a Flight Doctor and a Flight Nurse onboard lands at the Rendezvous Point*, the Flight Doctor and the Flight Nurse get into the ambulance, and they immediately begin treating the patient. The Doctor Helicopter service uses light twin engines class helicopter for a better maneuverability to land in confined spaces such as school yards, parks, or vacant lots. As well as these emergency dispatches, Doctor Helicopter also transport patients from one medical institution to another as interfacility transport. In most cases, this is to transport patients to medical institutions that provide more advanced medical care.

Since Doctor Helicopters are helicopters for emergency medical services, urgency is an important criterion for dispatches. In regional areas, however, medical institutions are being consolidated, which means they are disappearing from local communities. For the residents of these medically under-served areas, there is the need for a means of getting to a distant medical institution, even if the urgency is low. The reality is that Doctor Helicopters are also used for this sort of local medical care. In addition, the operation like a “Doctor Delivery Helicopter” in which doctors are dispatched to remote areas such as mountains and remote islands is also an issue to be considered.

One of the important missions of the Doctor Helicopter service is to operate during major disasters. Major disasters mean large numbers of injured people who need to be transported in a short time to locations spread out over a wide area outside the disaster zone. There are already 53 Doctor Helicopters across Japan and they are required to operate in coordination with Self-Defense Force helicopters, Police helicopters, Fire and Disaster Management helicopters, and Maritime Safety helicopters. Standardized rules are needed to practice this sort of coordination with precision, during dispatches and also during operations in disaster-stricken areas. The Japanese government sets out the requisites in the Basic Disaster Management Plan, while the Ministry of Health, Labour and Welfare has formulated the Guidelines for Establishment of Doctor Helicopter Operational Systems in Large-scale Disasters. In addition, to enable Doctor Helicopters to take off and land freely during a disaster, Article 176 of the Ordinance for Enforcement of the Civil Aeronautics Act provides a special provision that removes the regulations of the Civil Aeronautics Act.