Does Intensivist Care Harm Patients in the ICU?

Critical care units in the U.S. involve intensivists to varying degrees, ranging from mandatory handoff (closed intensive care unit [ICU] model) to no handoff (open-ICU model); outside the U.S., transfer of care to intensivists generally is mandatory. With a predicted shortage of intensivist physicians in the U.S., we are likely to see more open-ICU models, with elective or mandated consultation by intensivists. Prior evidence suggested that ICU outcomes are better when patients are managed by intensivists, but some experts (including the authors of this study) believe that these studies had methodologic limitations.

To examine this issue further, researchers extracted data on more than 100,000 patients in 123 ICUs in the U.S. from Project I…