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.