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I guess it's a pretty straightforward question... is it just anesthesiologists, or can surgeons or primary care people get in on the action, too?
militarymd said:And in private practice.....ANYONE can do critical care...no fellowship or certification required.
proman said:To be considered an intensivist for Leapfrog purposes you can be:
BC + subspecialty certified in CCM (anesthesiology, IM, OB, peds, surgery)
BC in EM + completion of CCM fellowship
BC in IM, anesthesiology, peds, surgery prior to subspecialty certification being available (1986) AND have done a minimum of 6 weeks CCM a year since 1987.
Like MMD said, anyone in private practice open model can take care of patients in the ICU, but they are not intensivists. I've seen FP do it, and I've known internists who were the medical directors of their ICU (town of 15,000). Note that this does not meet Leapfrog requirements.
waterski232002 said:That's like saying a medical student could just do a couple 4th year electives on the general medical wards/ambulatory clinics and they would be qualified to practice as an internist.
If you want to practice and be competent in critical care, do a fellowship. As an internist you get little-to-no experience in any of the life saving procedures crucial to the ICU (central line placement, acute airway management, RSI, cricothyroidotomy, pericardiocentesis, tube thoracostomy).
Firebird said:No I would agree that the fellowship would offer much more of an opportunity to learn Critical Care. However, here are a couple questions.
1. Don't the Pulmonary/Critical care fellowships only require like 6 mo. of critical care management training?
2. If you were doing an IM residency, couldn't you choose to do your electives in critical care settings? That would provide quite a bit more time in the ICU.
proman said:The evidence is clear: residency trained physicians who take care of ICU patients are less cost efficient and have worse outcomes. In addition, the 24 hour direct supervision by fellowship trained intensivists is even better. Why do you fight this?