The relationship between the surgeon and the intensivist in the surgical intensive care unit

When a patient enters the intensive care unit, the admitting surgeon also enters a new environment. In some hospitals, the surgical intensive care unit (SICU) is "closed"--critical care providers manage care; in others the unit is "open," and the admitting surgeon is in charge. A third system is the "mixed" model of ICU administration; a collaborative approach. This article addresses concerns and conflicts that frequently arise between admitting surgeons and intensivists. It is written from the perspective of two surgeon-intensivists who have been in both roles. Recent behavioral and social research on ICU conflicts and their resolution is reviewed, and and new strategies for conflict resolution are also presented.