We will need more intensivists !!
Currently in USA, only 37% of critically ill patients are cared for by intensivists and an estimated 360,000 deaths occur each year in ICUs not managed by intensivists. In 2003, the US Senate asked Health Resources and Services Administration (HRSA) to work with the American College of Chest Physicians (ACCP) to update critical care workforce models in order to more accurately assess the adequacy of supply for critical care physicians. In the newly released US Department of Health and Human Services Report to Congress: The Critical Care Workforce: A Study of the Supply and Demand for Critical Care Physicians, it has been predicted that the demand for critical care services will increase rapidly, while the intensivist supply would not be able to care for a greater proportion of critically ill patients. The shortage is will be exacerbated by the year 2020 due to the aging population and the increased utilization of intensivists.
By 2020, the demand for intensivists would likely increase by 129 percent above the current supply.
Some Suggestions include:
- Increase role of eICU
- Possible rationing of critical care services or regionalization of ICU services like trauma system
- Restructuring current Medicare reimbursement system
- Expanding National Health Services Corps and J-1 waiver program
- Only deserving patients getting admission to ICU
- Decreasing care for know futile outcomes by more public/physician education
Read full report:HRSA Report to Congress. The Critical Care Workforce: A Study of the Supply and Demand for Critical Care Physicians