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Pulmonary and Critical Care Medicine in ChinaPulmonary and Critical Care Medicine in China FREE TO VIEW

Wei Huang, MD; Zhi-dan Zhang, MD; Zheng-lin Li, MSc
Author and Funding Information

From the Department of Critical Care Medicine (Dr Huang), 1st Hospital of Dalian Medical University; the Department of Critical Care Medicine (Dr Zhang), 1st Hospital of Chinese Medical University; and the Department of Emergency Medicine (Mr Li), Dalian Municipal Central Hospital.

Correspondence to: Wei Huang, MD, Department of Critical Care Medicine, 1st Hospital of Dalian Medical University, Dalian, China 116011; e-mail: huangwei9898@gmail.com


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(6):1433-1434. doi:10.1378/chest.14-0206
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To the Editor:

We read with great interest the recent article by Qiao et al1 in CHEST (January 2014) concerning a joint statement regarding the proposed establishment of a new subspecialty, pulmonary and critical care medicine (PCCM), in China. We appreciate, to some extent, the authors’ analysis with respect to the valuable roles pulmonologists play in critical care medicine (CCM). However, we would like to point out that, in the statement, many important facts linked to the contemporary development of CCM in China were neglected.

First, as far as we know, CCM is a multidisciplinary field of medical specialty of which respiratory medicine (RM) is an integral part, but not the only driving force. This concept of an interdisciplinary medical approach being the mainstay of CCM is widely acknowledged. In China, it is well known that the first real ICU, established in Beijing in 1982,2,3 originated from general surgery. Meanwhile, a multiple organ failure unit was also established in Tianjing.4 These departments developed over time and became autonomous. Therefore, it is unreasonable to regard RM as the origin of CCM in China.

Second, we could not agree with their assertion that “there are now no formal or consistent pathways to train and develop experience in CCM (in China).” Since 1997, at least three nationalized CCM societies in China have been established,3 and CCM was officially recognized as an independent clinical discipline in 2009.2 These CCM societies have successfully provided many years of specialist training programs2,3 to enrich the expertise of doctors and nurses who desire to work in ICUs.

Third, the scope of medical practice of each specialty or specialist is clearly defined in Chinese health regulation law. The unjustifiable move to merge CCM and RM as a new subspecialty, PCCM, will definitely lead to unnecessary conflicts among specialists.

The saying goes, “Never run faster than your guardian angel can fly.” It is worth noting that, in China, the potential consequences of the rapid expansion of RM into all kinds of related professions, including CCM, will ultimately dilute its core value. Therefore, we suggest that providing solutions to the difficulties facing CCM in China should be prioritized, rather than resorting to the formation of a new PCCM specialty.

References

Qiao R, Rosen MJ, Chen R, Wu S, Marciniuk D, Wang C; on behalf of the CTS-ACCP Pulmonary and Critical Care Medicine Workgroup. Establishing pulmonary and critical care medicine as a subspecialty in China: joint statement of the Chinese Thoracic Society and the American College of Chest Physicians. Chest. 2014;145(1):27-29.
 
Liu L, Liu DW, Qiu HB. Critical care medicine in China: history and perspective. Chin Med J (Engl). 2013;126(10):1806-1808.
 
Du B, Xi X, Chen D, Peng J; China Critical Care Clinical Trial Group (CCCCTG). Clinical review: critical care medicine in mainland China. Crit Care. 2010;14(1):206.
 
Fox RC, Swazey JP. Critical care at Tianjin’s First Central Hospital and the fourth modernization. Science. 1982;217(4561):700-705.
 

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References

Qiao R, Rosen MJ, Chen R, Wu S, Marciniuk D, Wang C; on behalf of the CTS-ACCP Pulmonary and Critical Care Medicine Workgroup. Establishing pulmonary and critical care medicine as a subspecialty in China: joint statement of the Chinese Thoracic Society and the American College of Chest Physicians. Chest. 2014;145(1):27-29.
 
Liu L, Liu DW, Qiu HB. Critical care medicine in China: history and perspective. Chin Med J (Engl). 2013;126(10):1806-1808.
 
Du B, Xi X, Chen D, Peng J; China Critical Care Clinical Trial Group (CCCCTG). Clinical review: critical care medicine in mainland China. Crit Care. 2010;14(1):206.
 
Fox RC, Swazey JP. Critical care at Tianjin’s First Central Hospital and the fourth modernization. Science. 1982;217(4561):700-705.
 
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