THE PRACTICE OF CRITICAL CARE MEDICINE - A NATIONAL SURVEY REPORT

Aggressive reimbursement reform has been an imposing directive for car e providers of ICU medicine. Timely knowledge of actual care routines obtained from a large sample of actively practicing physicians should be mandatory when developing any guidelines or practice standards. A q uestionnaire was therefore designed by the steering committee of the A CCP Council on Critical Care and sent to its members. The 1,294 respon ses were analyzed for demographics of the individual practitioner, loc al aspects of ICU staffing and policies, reimbursement, and a specific practice issue, nutrition. The typical respondent was aged 41 to 50 ( 41 percent), was a pulmonary subspecialist (68 percent), was not criti cal care certified (55 percent), worked 25 to 50 percent of his or her total time in the ICU (40 percent), and would continue ICU practice d espite poor reimbursement (82 percent). Physicians practiced within a group (53 percent), in a 100- to 500-bed hospital (69 percent), with h ouse staff available (60 percent), and predominantly cared for Medicar e patients (55 percent). The following data may allow better judgments to be made pertaining to the implementation of care policies in the c urrent ICU environment.