I think it's true that the skills (and they definitely are real skills) of a good many of those highly trained medical people is dependent upon the technology available in hospitals or treatment centers. The further into the woods you are, the more reduced anyone's treatment capabilities become.

I am currently reading, with great pleasure, the latest edition of [/u]Medicine for Mountaineering[u], which goes significantly beyond typical first responder/first aid measures. Still, in a good many discussions, the ending is the familiar "evacuation to definitive care is required." In a good many disaster situations, that option may not be realistic.