A Society of Critical Care Medicine task force recently reviewed the 1992 intensivist definition guidelines in order to craft a new definition of an intensivist relevant to the current realm of team-based healthcare that could be applied globally. This Concise Critical Appraisal reviews that new definition.
Nomenclature regarding intensivists is variable and inconsistent. While most definitions include a background and training in an intensive care unit (ICU), the scope of practice, training, and certification requirements creates ambiguity, misunderstanding, and imprecision. In 1992, the Society of Critical Care Medicine (SCCM) published guidelines defining the role of an intensivist, but it was limited to the United States and was mostly physician based.
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In 2025, Wu et al and a multidisciplinary SCCM task force reexamined the 1992 intensivist definition in order to craft a new definition for modern roles that could be applied globally.
2 Ninety-four percent of the task force members agreed that an intensivist is a physician who has successfully completed an accredited program or equivalent critical care/intensive care medicine training and maintains advanced certification and dedication to the area of critical care medicine in the way of professional work. This should not minimize the contribution and dedication of the nonphysician multidisciplinary members of the ICU team. The consensus statement emphasized how critical care procedures can be performed by other team members. Accredited training specialty programs typically include dedicated postgraduate board certification.
During the past decades, the intensivist’s roles have evolved. While some roles may be performed by other members of the multiprofessional critical care team (e.g., advanced practice providers), the intensivist coordinates and guides the team’s specialized care of the critically ill or injured patient. The intensivist oversees the resuscitation of patients with, or at risk for, critical illness or injury and organ failure to prevent imminent deterioration.
One of the newer roles of an intensivist is to triage patients in non-ICU locations and promote optimal critical care outcomes. In the past, intensivist care was limited to patients in closely monitored, designated units. Now it includes triage and management of critically ill or injured patients outside the boundaries of the ICU, including the emergency department, medical wards, telehealth platforms, and post-intensive care recovery clinics.
The intensivist’s role has also recently expanded to include rapid response team leader.
3,4 The intensivist is expected to recognize acute deterioration and either initiate aggressive treatment with the primary intention of cure or render conservative treatment with the primary intention of comfort.
The intensivist’s role is to provide ethical, efficient, and high-quality direct patient critical care utilizing best practices with interventions that minimize complications. Direct clinical care assists in the resuscitation and stabilization of patients with organ failure. While the intensivist’s role is not essential to critical care in every setting, intensivists are meant to elevate the practice of critical care. They allow for palliative support and end-of-life care to patients and families.
As the intensivist’s role within the multiprofessional team evolves, their activities and services essential to critical care will also continue to adapt to the local culture and regulations. This may prove especially crucial in resource-limited areas with a scarcity of life-support technology, facilities, equipment, and personnel.
References:
- [no authors listed]. Guidelines for the definition of an intensivist and the practice of critical care medicine. Guidelines Committee; Society of Critical Care Medicine. Crit Care Med. 1992 Apr;20(4):540-542.
- Wu D, Dzierba AL, Ablordeppey EA, et al. The definition of the intensivist in the era of global healthcare: 2024 consensus statement from the Society of Critical Care Medicine Defining Intensivist Task Force. Crit Care Med. 2025 Mar 1;53(3):e548-e554.
- Hilton AK, Jones D, Bellomo R. Clinical review: the role of the intensivist and the rapid response team in nosocomial end-of-life care. Crit Care. 2013 Apr 26;17(2):224.
- Jones DA, DeVita M, Bellomo R. Fapid-response teams. N Engl J Med. 2011 Jul 14;365(12):139-146.
