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Discussion in 'Internal Medicine and IM Subspecialties' started by soxman, Apr 15, 2007.
Do Hospitalists work in the ICU setting or are they usually bound to working in the floors?
The short answer is yes, absolutely, they work in ICU's, but the extent that they actually practice "critical care medicine" varies widely. The issue basically comes down to whether the ICU staffs intensivists...if so, the hospitalist will usually have a much more limited role. On the other end of the spectrum, at some places the hospitalist will do everything from placing lines to managing the pressors and so on. Where I am now, we have no intensivists (we have pulmonary/critical care specialists who consult on patients, but their role rarely goes beyond the lungs) so as hospitalists we have to handle the other critical care issues, obviously in consultation with other services. We usually don't do procedures outside of emergent lines (surgeons do the routine ones), but again, that's certainly not true at all places.
Yup. Some private hospitals use hospitalists as in-house intensivists with pulmonary consulting for bronchs, etc. Much moolah for the hospitalists that way since they get to bill all the procedures and critical care time.
Yes, private hospitals routinely hire hospitalists to staff their ICUs. In the past there was concern about whether critical care specialist/intensivists would lose their jobs due to the rise of hospitalists. But considering the recent studies showing that ICUs staffed by board certified intensivists had lower mortality rates, the demand for pulm/cc is on the rise and generally only hospitals that can't hire pulm/cc for whatever reason would choose to use hospitalists for their ICUs.