Improving care to critically ill patients may require a stepwise process.  The overall goal is to implement an organized system of ICU care.  The first step in this process should include directly impacting the care of ICU patients by involving those practitioners who are best trained in their care.

Perhaps the easiest solution in this regard is to require that all patients admitted to the ICU receive consultation from a critical care physician with ongoing daily involvement.  Until an intensivist-led service can be developed, which should be the goal, consultative medicine stands to improve the chances that patients admitted by a generalist or physician from another specialty receive specific interventions related to their critical illness.

In order to achieve maximum effectiveness, the consultation should continue daily until the patient is discharged from the ICU.  While the admitting physician retains ultimate responsibility for the care of the patient in this system, his or her admitting physician can benefit from the assistance of the intensivist.