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Editorials |

ICU Physician Staffing24/7 Intensivist Staffing: What Else Do We Need to Know?

Craig M. Lilly, MD, FCCP
Author and Funding Information

From the Department of Medicine, University of Massachusetts Medical School.

CORRESPONDENCE TO: Craig M. Lilly, MD, FCCP, Department of Medicine, University of Massachusetts Medical School, UMass Memorial Medical Center, 281 Lincoln St, Worcester, MA 01605; e-mail: Craig.Lilly@umassmed.edu


FINANCIAL/NONFINANCIAL DISCLOSURES: The author has 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. 2015;147(4):867-868. doi:10.1378/chest.14-2661
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In this issue of CHEST (see page 951), Kerlin and colleagues1 provide another layer of evidence that 24/7 intensivist staffing is not associated with significant mortality or length-of-stay benefits. The observation that high-intensity critical care specialist involvement is associated with lower mortality and costs for adults with severe illness and injuries2 led to the hypothesis that 24/7 on-site intensivist staffing would result in better outcomes than daytime-only on-site staffing.3,4 The role of 24/7 intensivist staffing models for improving outcomes is an important issue in an era when the supply of critical care specialists is insufficient to meet the demands of an aging population.5 Concentrating specialists in ICUs that provide 24/7 staffing is expensive for institutions that can retain enough intensivists and reduces access to specialist care for other ICUs who must compete for a smaller pool of qualified specialists.

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