Hospitalists & the Intensivist Shortage

The growing intensivist shortage is challenging hospitals’ ability to care for critically ill patients. Despite numerous recommendations that intensivists manage critically ill adults, the majority of American hospitals cannot meet this standard. As a consequence, hospitalists have become de facto intensivists in many hospitals, with 75% reporting that they practice in the ICU. While legitimate concerns have been raised whether hospitalists are uniformly qualified to practice in the ICU, the issue has become moot at many hospitals where intensivists are either in short supply or entirely absent. Efforts are needed to ensure that hospitalists manage critically ill patients safely, effectively, and seamlessly. In the Journal of Hospital Medicine and Critical Care Medicine, the Society of Hospital Medicine and the Society of Critical Care Medicine co-published a position paper on training the hospitalist workforce to address the intensivist shortage. In this paper, we discussed the potential value of hospitalists in the ICU and the importance of enhancing hospitalists’ skills to provide critical care services. Adding Value & Enhancing Skills of Hospitalists Hospital medicine and critical care medicine share similar structures, competencies, and values, positioning hospitalists as a logical solution to the intensivist shortage. Many of the competencies needed for practicing critical care medicine are encompassed in internal medicine training as well as in core competencies in hospital medicine. The ideology and mechanics of high-performing hospitalist and intensivist programs are similar, yet despite these commonalities, hospitalists remain largely untapped as a potential source of new intensivists. Exploring Alternative Critical Care Models With no solution to the intensivist shortage in sight, alternative critical care delivery models are needed. We proposed a 1-year...