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World J Crit Care Med. Feb 4, 2012; 1(1): 10-14
Published online Feb 4, 2012. doi: 10.5492/wjccm.v1.i1.10
Physician staffing pattern in intensive care units: Have we cracked the code?
Deven Juneja, Prashant Nasa, Omender Singh
Deven Juneja, Prashant Nasa, Omender Singh, Max Institute of Critical Care Medicine, Max Super Speciality Hospital, New Delhi 110092, India
Author contributions: Juneja D, Nasa P and Singh O wrote this manuscript.
Correspondence to: Deven Juneja, DNB, FNB (Critical Care), Consultant, Max Institute of Critical Care Medicine, Max Super Speciality Hospital, 1, Press Enclave Road, Saket, New Delhi 110092, India. devenjuneja@gmail.com
Telephone: +91-9818290380 Fax: +91-40-66462315
Received: June 3, 2011
Revised: October 20, 2011
Accepted: December 21, 2011
Published online: February 4, 2012

Intensive care is slowly being recognized as a separate medical specialization. Physicians, called intensivists, are being specially trained to manage intensive care units (ICUs) and provide focused, high quality care to critically ill patients. However, these ICUs were traditionally managed by primary physicians who used to admit patients in ICUs under their own care. The presence of specially trained intensivists in these ICUs has started a “turf” war. In spite of the availability of overwhelming evidence that intensivists-based ICUs can provide better patient care leading to improved outcome, there is hesitancy among hospital administrators and other policy makers towards adopting such a model. Major critical care societies and workgroups have recommended intensivists-based ICU models to care for critically ill patients, but even in developed countries, on-site intensivist coverage is lacking in a great majority of hospitals. Lack of funds and unavailability of skilled intensivists are commonly cited as the main reasons for not implementing intensivist-led ICU care in most of the ICUs. To provide optimal, comprehensive and skilled care to this severely ill patient population, it is imperative that a multi-disciplinary team approach must be adopted with intensivists as in-charge. Even though ICU organization and staffing may be determined by hospital policies and other local factors, all efforts must be made to attain the goal of having round-the-clock onsite intensivist coverage to ensure continuity of specialized care for all critically ill patients.

Keywords: Intensive care units outcome, Intensive care, Physician staffing