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February 26, 2003

Intensivist Consultation and Outcomes in Critically Ill PatientsIntensivist Consultation and Outcomes in Critically Ill Patients

JAMA. 2003;289(8):985-987. doi:10.1001/jama.289.8.985a

To the Editor: I am surprised that Dr Pronovost and colleagues1 did not mention 2 trends that are exerting a powerful influence on ICU care in the United States.

The first of these trends is the rapidly growing hospitalist movement. Approximately 7000 hospitalists practice in the United States, a number projected to grow to 19 000 in the next few years.2 Several studies have demonstrated significant improvements in efficiency and outcomes when hospitalists care for general hospitalized patients.3 A second trend is the projected massive shortage (35% by 2030) of intensivists in the United States.4 This magnitude is so large that even substantial increases in ICU training programs cannot stanch it for the foreseeable future.

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