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January 13, 1989

Comparison of Critical Care by Family Physicians and General Internists

JAMA. 1989;261(2):243. doi:10.1001/jama.1989.03420020095020

To the Editor. —  The study by Drs Hainer and Lawler1 is an interesting attempt to compare the outcome of patients treated in special care units by two groups of attending physicians: family physicians and general internists. There were essentially no differences in length of stay, readmission rate, mortality, hospital charges, or other variables for patients treated by the two groups. These results were cited by the authors to suggest that both groups should have equal access to special care units, even in large teaching hospitals.Although we agree that all physicians should have access to intensive care units, we question the design and conclusions of this study. No mention is made of admission or discharge criteria for the patients admitted to the units. In addition, it would appear that all patients were actually managed by an intern and a third-year medical resident and that neither family physicians nor