Internists’ identity roles were those of leader and partner. Conclusionsĭespite a common perception of each other’s practical roles, tensions can arise between internists and intensivists in complex situations of ICU admission decisions. Training in communication skills and interprofessional education interventions aimed at a better understanding of each other roles would improve collaboration.ĭecisions to admit a patient to intensive care (ICU) are often complex. Such decisions are made under time pressure and in a context of fair allocation of resources. Admissions decisions on general internal medicine wards may involve assessment of patients with advanced diseases or elderly patients with multiple comorbidities, for whom the appropriateness of intensive care is uncertain. ICU admission decisions involve the internist on the ward and the ICU doctor.

When a medical in-patient becomes critically ill, the situation is assessed by the internist, who determines whether intensive care is needed and whether the intensivist should be called. The intensivist assesses the patient and discusses the situation with the internist, before the admission decision is made. The two doctors must work together and share their clinical expertise to make the best decision for the patient. Hence, a good collaboration between the two doctors is needed, which supposes availability of clinical information, efficient communication and decision autonomy of collaborators.

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