When It Comes To The ICU, Less is Better

A recent New England Journal of Medicine article suggests perhaps less is better in the Intensive Care Unit (ICU). This came from the June 6, 2013  publication.Image

The article analyzes the effectiveness of having a night-time ICU specialist in attendance during the night shift.  This study is relevant because there is an increasing trend of adopting the practice of nighttime physicians as part of the hospital team.

This was a one-year randomized trial in an academic center. The primary outcome was length of stay in the hospital and secondary outcomes included in-hospital mortality, discharge disposition, and recent readmission to the intensive care unit.

Despite the nighttime physician patient’s being seen 100% of the night’s versus 0% in the control group which did not have on-site nighttime physicians in attendance there was no statistical difference in the 2 different care models.

Bottom-line: This study suggests no benefit to hiring a nighttime doctor to see patients in the intensive care unit. The cost and resource utilization implications of this information is dramatic. In this case, less care appears to be better

About thedoctorsreport

Dr. Kordonowy is board certified by the American Board of Internal Medicine and has been in private practice since 1993. His group practice is in Fort Myers, Florida. His website is: www.drkordonowy.com. He earned his degree from the University of Kansas School of Medicine in Kansas City, Kansas and completed his residency as Chief Resident at Orlando Regional Hospital System. As Chief Resident, Dr. Kordonowy was recognized as the Outstanding Resident by the American College of Physicians. He is a member of the American Medical Association, American College of Physicians, and the American Society of Internal Medicine. In December 2005, Dr. Kordonowy became Board Certified in the new field of Clinical Lipidology by the American Board of Clinical Lipidology. Lipidology is the specialty of diagnosis and management of cholesterol and triglyceride metabolism disorders. Cardiovascular disease risk assessment is also part of this specialty. He now serves as president of the Independent Physicians Association of Lee County. He is active in the Lee County Medical Society, the Florida Medical Society , the Florida Lipid Foundation, National Lipid Association and the American Medical Association.
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2 Responses to When It Comes To The ICU, Less is Better

  1. Bob Hertz says:

    less doctoring at night does not mean less attenton to patient needs,attention & comfortm I hope
    Also i suggest all doctors and medical people be more atteentive to seniors (and itgers) who complain about their care in senior facilities and medical facilities. If a patient complains about poor care, abusive care, physical or other, be aware of their responsibility to report these complaints for investigation with the proper organizations. I think medical responsibility would also have them, with their concern, check with the facility to correct it, and of course, still report the problem for investigation. I did feel very poorly treated in Indepent living at Calusa Harbour. Fortunate for me,with help and support I was able to leave Independet Living at Calusa Harbour. I found a more suitable place, not a similar residence. Can one be too independent living for independent living in such a facility? any other opinions, re: this or questions, contact me at HertzRobert@aol.com. I am to share and listen, as much as I can. My phone:239-561-0167
    Mayb we can start a support group? Maye Dr. K who I appreciate and think very well of, will help us help seniors.

  2. Bob Hertz says:

    a great idea

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