Innovative Interdisciplinary Strategies to Address the Intensivist Shortage

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The 1990s were a time of great uncertainty around physician supply and demand in the United States. Enrollment in medical school was static, physicians retired randomly, and uncertainty about clinical workload and efficiencies led to opposing views of the future. One projection held that care would be progressively tightly managed as a cost-control measure, hospitals would close for the lack of need, and primary care physicians would refer only rarely to specialists as preventative health measures led to longer healthier lives (1). Another projection foretold a steady increase in the demand for services, especially life-prolonging services as the population aged (2). As a surgical resident, I (T.G.B.) saw only general agreement that bad judgment, accident, and the human predilection for violence would ensure a steady supply of trauma patients who would require immediate operative services (3). Accordingly, I chose to focus on trauma care.
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