Elsevier

Journal of Critical Care

Volume 29, Issue 6, December 2014, Pages 1121-1122
Journal of Critical Care

Correspondence
The shortage of critical care physicians: Is there a solution?,☆☆,,★★

https://doi.org/10.1016/j.jcrc.2014.08.001Get rights and content

Abstract

Objective

The objective of this study is to provide a solution to the critical care physician shortage.

Data sources

The data sources are Medline search of published articles regarding the critical care physician shortage, the current training model, and the roll of family physicians.

Data extraction

The US population continues to age, increasing the need for critical care services due to the burden of acute and chronic illnesses. At the same time, it has been suggested that a highly staffed intensive care unit (ICU) including physicians, nurses, and pharmacists promotes standardized care that improves survival and length of stays (hospital and ICU). This has led to a rise in critical care physician staffing.

Unfortunately, estimates indicate a shortage of critical care physicians over the next 10 years or even sooner if the Leapfrog initiative is implemented, making apparent the vulnerability of the field. Published estimates indicate that intensivists currently provide care to only 37% of all ICU patients in the United States and that they are located primarily in large hospitals and teaching institutions.

Traditionally, to enter a fellowship in critical care, one would have to be trained through the internal medicine, anesthesia, or surgery pathways. Recently, the American Board of Emergency Medicine, in conjunction with The American Board of Internal Medicine, opened the pathway for emergency physicians to enter a critical care fellowship.

Conclusions

Family Practice is the second largest collective group of physicians in the United States—second only to internal medicine. In most of rural America, where there are limited physicians serving the population, family practitioners fill the gap and provide services otherwise unavailable to those patients. This group that can potentially be trained in critical care and help solve the crisis has been prevented from doing so.

References (14)

  • D.C. Angus et al.

    Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: can we meet the requirements of an aging population?

    JAMA

    (2000)
  • G.S. Martin et al.

    The effect of age on the development and outcome of adult sepsis

    Crit Care Med

    (2006)
  • P.J. Pronovost et al.

    Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review

    JAMA

    (2002)
  • A. Milstein et al.

    Improving the safety of health care: the Leapfrog initiative

    Eff Clin Pract

    (2000)
  • Task Force on Guidelines, Society of Critical Care Medicine Guidelines for categorization of services for the critically ill patient

    Crit Care Med

    (1991)
  • R.A. Cooper et al.

    Economic and demographic trends signal an impending physician shortage

    Health Aff

    (2002)
  • B.D. Weiss

    Family physicians in university hospital intensive care units

    J Fam Pract

    (1983)
There are more references available in the full text version of this article.

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