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INTENSIFIED ICU OR INTENSIVIST?
O P Kapoor
Hon. Visiting Physician, Jaslok Hospital and Bombay Hospital, Mumbai,
Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
Years back ICCU (Intensive Coronary Care Unit) was started in the hospitals. Later on, it was superceded by or unit of ICU was added (Intensive Care Unit) and then it was realised that not only heart patients need ICU but any serious patient needs ICU.
All these specialised care units have been recognised for the "hardware part of the units" which means machines. It is only lately that it has been and the mortality of the patients admitted in these units depends on the Intensivist which is the "software" of the ICCU. These Intensivists are doctors who are specialised in managing the serious patients and they stay in the unit all day and night long. They are unlike the specialists who visit patients when they have time and often do not reach in time.
Now that it has been increasingly recognised that most of the patients in the ICUs develop a "multi organ failure", the speciality of the Intensivist is being promoted all over the world. Even in a city like Bombay with a population of 50 million, there are not more than 8-10 Intensivists realised that all this was wrong and the morbidity (qualified as intensivist).GPs should keep in mind, that next time they send a patient to an ICU in a hospital, they should know the name and qualifications and experience of the Intensivist who is looking after the unit and is on duty. Then only the reduction in mortality and morbidity and lakhs of rupees spent by the patients will be laudable.
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