Models of critical care delivery: Physician staffing in the ICU

Although a consensus has emerged over the value of intensive care units (IC Us) in improving both the outcome and efficiency of critical care, the opti mal staffing configuration of physicians who provide this care remains cont roversial. The value of open ICUs, where many clinicians can admit and care for patients, versus closed ICUs, where an on-site intensivist or housesta ff team (or both) provides primary care of the critically ill patient is on e aspect of this controversy. The roles of the intensivist, the ICU housest aff team, and the ICU director have also been debated. This article reviews the available literature on physician staffing in critical care units and its relationship to outcome and cost-effectiveness of care.