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Intensive Care Medicine; a Multidisciplinary Approach!
Professor Hugo Van Aken, Director
of the Department of Anesthesiology
and Intensive Care Medicine, UKM
To increase the attractiveness of intensive care for young doctors and to improve the skills of intensive care systematically, there are considerations in the European Union to develop intensive care to a primary independent medical specialty. These plans, however, require closer examination.
Currently only intensive medicine in Spain, Great Britain and Switzerland is recognized as a primary specialist designation. In ten EU countries, including Germany, however intensive care is only additional training for specialists in various fields such as anesthesiologists, cardiac surgeons, cardiologists, internists, neurologists, neurosurgeons, pediatricians, pulmonologists and thoracic surgeons. In many other European countries, the intensive medicine is part of the anesthesiologist training.
2008 both the representatives of the nine disciplines involved in the intensive medicine, as well as the European Union of Medical Specialists UEMS, voted overwhelmingly against the idea that intensive medicine to an independent primary medical specialty to expand. "The reasons for this," said Professor Van Aken, "are obvious. The intensive medicine is simply too complex to be covered only by a medical specialty”. Rather, we need intensive cooperation between specialists, who can treat respective underlying disease competently, specialists in the treatment of organ failure and other experts for specific clinical problems. "A branch of intensive medicine as a distinct field of study, says Van Aken would, to the important multi-disciplinary approach rather hinder than help.
Like the majority of his colleagues, he is convinced that a qualified intensive care of critically ill patients only can be unsured through multidisciplinary collaboration. Nevertheless, intensive care units need a clearly defined hierarchy with a leader who ensured the smooth progress of patient care. This leader may be recruited from different specialist areas. It appears important, however, that all of the participating specialists of intensive medicine complete a special intensive medical training and thus acquire the additional training intensive medicine after an audit.