Surgical Critical Care and Private Practice Surgeons: A Different World Out There!

Stephen M. Cohn, Michelle A. Price, Ronald M. Stewart, Michael G. Corneille, John G. Myers, Janet McCarthy, Rachelle B. Jonas, Stephanie M. Hargis, Daniel L. Dent

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Few graduating residents seek surgical critical care (SCC) fellowships; fewer than half of positions fill. We hypothesized substantial differences exist in practice patterns and attitudes between SCC surgeons in academic practice (ACs) and in private practice (PVTs). Study Design: A survey instrument was sent to 1,544 board-certified SCC intensivists in North America. Results: Of those invited, 489 responded (32% response rate). Respondents were mostly men (88%) and Caucasian (86%), with a mean age of 48 years; 60% were ACs, 28% were PVTs, and 12% reported "other;" 94% currently practiced SCC. PVTs (50%) were more likely than ACs (18%) to provide SCC for only their own patients, less likely (24% versus 74%) to function as an "ICU attending," and less likely to work with residents (36% versus 91%) and fellows (4% versus 60%; all p < 0.001). PVTs (48%) spent more time performing elective operations than ACs (27%; p < 0.001). They were more likely than ACs to relinquish management of SCC patients to medical consultants: infectious disease (34% versus 12%), cardiology (31% versus 12%), and pulmonary (23% versus 3%; all p < 0.001). Conflicts with medical specialists were a bigger problem for PVTs (43%) than for ACs (17%; p < 0.001). Conclusions: Private practice surgical intensivists are more likely than academic intensivists to provide critical care for only their own patients and to use consultants to avoid conflicts.

Original languageEnglish (US)
Pages (from-to)419-425.e7
JournalJournal of the American College of Surgeons
Volume206
Issue number3
DOIs
StatePublished - Mar 2008

ASJC Scopus subject areas

  • Surgery

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