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Editorials: Point and Counterpoint |

Rebuttal From Dr Davidson

Bruce L. Davidson, MD, MPH, FCCP
Author and Funding Information

CORRESPONDENCE TO: Bruce L. Davidson, MD, MPH, FCCP, 12209 Shorewood Dr SW, Seattle, WA 98146


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(3):628-629. doi:10.1016/j.chest.2015.11.029
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Extract

Dr Rubenfeld writes, “Will we need more intensivists? Almost certainly.” Dr Rubenfeld is more thorough than I when refuting postulated intensivist physician estimates. On these two important topics, we agree.

However, he proposes “simple comparative effectiveness evaluations,” an oxymoron. Dr Rubenfeld floats false either-or phrasing, eg, choosing between intensivists or family doctors, that Dr Koshland described (and I cite) in my article. This fallacy, a selectively imposed zero-sum argument for those two training categories ignores other categories such as ever-larger allocations for information technology, imaging, and drug costs. We can afford to train in critical care and family medicine if budgets are set after managing priorities appropriately.

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