The shortage of critical care physicians: is there a solution?

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.