Society of Critical Care Anesthesiologists President's Column

SOCCA members are well aware of the opportunities and challenges associated with the practice of critical care medicine – as well as the value of combined anesthesiology and critical care medicine training to critically ill patients. At the same time, some anesthesia colleagues have suggested there are limited roles for critical care anesthesiologists. Critical care physicians, with their specialized training and abilities, will be needed to treat the highestacuity patients whether in a “traditional” intensive care unit or other hospital setting. In the United States and elsewhere, this demand for critical care physicians is predicted to continue to increase with a resultant shortage of critical care physicians. The unique skills of critical care anesthesiologists provide value added within hospital systems and thus further increase the demand for critical care anesthesiologists. The practice of critical care anesthesiology involves immersion in the high-acuity hospital setting and thus entails more than daily “rounds” in an intensive care unit. Critical care anesthesiologists manage critical care units and thus critical care resources. The intensive care units consume a large portion of hospital resources, with critical care anesthesiologists responsible for utilizing these resources appropriately within their hospital settings. As a result, critical care anesthesiologists are by the nature of their roles intimately involved in hospital functions. These include quality-ofcare initiatives and patient safety, processes to improve the delivery of care, approaches to improve efficiency of care, and development of clinical protocols and guidelines, among others. The key contributions of critical care anesthesiologists within their institutions and the experience and exposure gained through these efforts prepare and poise them for health care leadership roles. The background provided by the continuous interactions with other services and hospital functions while caring for