Home Critical Care A look at hospitalist work in the ICU

A look at hospitalist work in the ICU

February 2012

Published in the February 2012 issue of Today’s Hospitalist

WHILE THERE’S A SHORTAGE of hospitalists across the nation, there’s an even greater shortage of intensivists. As a result, hospitalists often end up doing double duty by working the wards and the ICU. According to the 2011 Today’s Hospitalist Compensation & Career Survey, 71% of hospitalists say they work in the ICU. Here’s a look at how many hospitalists are working in the ICU and the roles they play.

Who’s providing critical care?
When it comes to the type of patients treated, 76% of adult hospitalists say they work in the ICU, compared to only 38% of pediatric hospitalists.

Among different employment models, hospitalists at national hospitalist management companies are most likely to work in an ICU; 89% say they work alongside intensivists. Only 28% of hospitalists at universities and medical schools, by contrast, say they work in the ICU.

And not surprisingly, hospitalists who work at teaching hospitals are less likely to work in the ICU (56% answered yes) than their colleagues at nonteaching hospitalists (84%).

Level of supervision
But not all hospitalists working in the ICU have an equal role. While just over half of all hospitalists say they serve as an attending in the ICU, 14% say they don’t.

There are also differences by specialty. Pediatric hospitalists working in the ICU are much less likely to serve as an attending (28%) than adult hospitalists (61%).

Hospitalists work as ICU attendings most frequently in the South (69%) and the Mountain region (72%), and least frequently in the Northeast (40%).

Are consults mandatory?
While more than half of hospitalists report functioning as full-fledged attendings in the ICU, most say they’re not required to call for critical care consults.

Just over one-third of hospitalists, however, say they must get a critical care consult when working in the ICU. The other two-thirds say that consults are optional.

While these numbers are fairly similar across different hospitalist employment models, differences emerge if you sort the data by geography. In the Northeast, for example, 41% of hospitalists say critical care consults are mandatory. In the Midwest, by comparison, only 26% of hospitalists say that consults are mandatory.