Patient-Focused Critical Care Enhancement Act
February 28, 2007
Mr. DURBIN. Why hold off for tomorrow, what we can do today? The current healthcare crisis in our nation did not happen overnight. It has been accumulating as a result of a lack of serious attention to the most pressing healthcare issues, including healthcare workforce shortages. As a husband and a parent, I pray every day that my wife and children will have access to the quality healthcare they deserve when they need it. As a public official, I believe that it is my responsibility to help make that care available for not only my own family, but also for the families in the state of Illinois and across the nation.
The growing shortage of critical care physicians undermines the quality and availability of health care services in the United States. This shortage can be expected to disproportionately impact rural and other areas of the United States that already often suffer from a sub-optimal level of critical care services. When a loved one needs a critical are doctor, would we not want one to be available? If research tells us that their recovery may be better and their recovery time faster, would we not want our loved one to have access to a critical care doctor?
The Leap Frog Group has clearly documented that significant improvement in outcomes –in both quality and cost – result when a critically ill or injured patient is seen by an intensivist. With a greater use of intensivists, an estimated 54,000 deaths that currently occur in ICUs could be avoided. Unfortunately, only one-third of our critically ill citizens are treated by physicians and nurses specifically trained to manage their complex health issues.
In June 2003, Congress asked the Health Resources and Services Administration (HRSA) to examine the healthcare needs of a growing population and the availability of pulmonary and critical care physicians. In its May 2006 report to Congress entitled "The Critical Care Workforce: A Study of the Supply and Demand for Critical Care Physicians," HRSA found that the country does not have enough physicians trained in critical care medicine to treat all those in need of the care. The report projected future demand for these services and found that, as a result of having to staff ICUs with critical care doctors, a total of 4300 intensivist physicians will be needed when only 2,800 are available. The HRSA report recognized that the demand in the United States for critical care medical services is rising sharply and will continue to do so.
To proactively address the healthcare needs of our nation, I am pleased to join with my colleague, Senator Crapo, today to introduce legislation to address the looming shortage of critical care providers. Our bill, "The Patient-Focused Critical Care Enhancement Act" authorizes a series of modest and sensible measures that – if enacted now instead of waiting for this shortage to worsen – can help to obviate the problem.
First, the Patient-Focused Critical Care Enhancement Act would direct the Agency for Health Research and Quality to assess the current state of and recommend "best practices" for critical care medicine. The authorization of demonstration projects on innovations in ICU services and on family-centered, multi-disciplinary approaches to critical care services are important for determining how to improve the quality of the care delivered and how to best make use of our existing resources of critical care doctors.
Our bill would also expand telemedicine opportunities for critical care physicians to promote efforts relating to critical care and ensure that all communities have greater access to this important, life-saving care. For our rural communities and medically underserved areas, the need for critical care doctors is exacerbated. This bill will hopefully expand the effectiveness of existing critical care providers in environments where intensivists are in short supply.
Finally, to address the supply problem, the bill would allow for the National Health Service Corps to support and encourage critical care providers to practice in medically underserved areas.
The Patient-Focused Critical Care Enhancement Act is strongly endorsed by the key medical specialty societies and patient groups involved in critical care medicine, including the American College of Chest Physicians, the American Thoracic Society, the Society for Critical Care Medicine, the Association of Critical Care Nurses and the Acute Respiratory Distress Syndrome Foundation.
This multi-pronged approach is to look at both short term and long term solutions to a growing concern. But, in today’s complex healthcare situation, multiple solutions are a necessity. We do not want to face this shortage in the future in a direr situation as the nursing shortage currently is.
The answer to the opening question is simple. We must not hold off for tomorrow what we can do today and we must not wait for our healthcare crisis to worsen. Our country will face a critical care workforce shortage. I want my family to have access to the best quality care when they need it, and this includes having access to a critical care doctor. Passage of the Patient-Focused Critical Care Enhancement Act is a step in that direction.
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