The Critical Care Professional Societies Address the Critical Care Crisis in the United States

Abstract

T he four major critical care societies in the United States—the American Association of Critical Care Nurses (AACN), the American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the Society of Critical Care Medicine (SCCM)—have united in their efforts to address the manpower shortage of health-care providers who care for the critically ill. This is one of the most pressing issues affecting the future of our aging population and American medicine. While it has been generally acknowledged and widely appreciated that the shortages in nursing, respiratory care practitioners, and pharmacists have already reached crisis levels, there had been conflicting forecasts of the adequacy of the present and future physician labor market throughout the 1990s.1–4 Because of this, the ACCP, ATS, and SCCM formed the Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS) in 1995 and commissioned a study with the following goals: (1) determine current patterns of care for the critically ill and patients with pulmonary disease, (2) anticipate how demand for care might change in the future, and (3) project supply based on the current workforce and training. The COMPACCS study,5 published in 2000, has convincingly predicted that the aging of the population of the United States will create a demand for care that will outpace the future supply of critical care medicine specialists, and that the effects of this shortfall in manpower will start to reach crisis proportions after 2007. Shortly after the COMPACCS study was published, the ACCP, ATS, and SCCM came to the realization that they needed to join forces with the AACN to reverse the manpower shortages and their worsening trends, and that they needed to become actively engaged in trying to help solve the issues within their power. Therefore, in 2001, these four societies, collectively representing 100,000 healthcare professionals, formed the Critical Care Workforce Partnership that promptly set out to accomplish two goals. The first was to analyze the current models of how critical care medicine was being delivered in the United States and what the four societies could do together to help alleviate the pressures that the manpower shortages were creating for their patients and their members. The results of this analysis and recommendations for action are the subject of the FOCCUS (Framing Options for Critical Care in the United States) Task Force report in this issue (see page 1514). The second goal was to develop strategies to work with public policy makers to make short-term and long-term changes at the federal level that would favorably impact the reduced critical care provider workforce. The results of this effort are the subject of the report by Ewart and colleagues in this issue entitled “The Critical Care Medicine Crisis: A Call For Federal Action” (see page 1518). During the writing of this white paper, the ACCP, on behalf of the Critical Care Workforce Partnership, had the opportunity to consult with members of Congress *From the Pulmonary, Allergy, and Critical Care Medicine Division (Dr. Irwin), University of Massachusetts Medical School, Worcester, MA; and the American College of Chest Physicians (Ms. Marcus and Mr. Lever), Northbrook, IL. Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (e-mail: permissions@chestnet.org). Correspondence to: Richard S. Irwin, MD, FCCP, Pulmonary, Allergy, and Critical Care Medicine Division, U Mass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA; e-mail: irwinr@ummhc.org special reports