Pulmonary medicine and (adult) critical care medicine in Europe: Fig. 1.—

There has been growing concern within the European Respiratory Society (ERS) that pulmonary physicians are becoming less involved in the practise of intensive care medicine (ICM). A Working Party (WP) was therefore established to identify issues that might explain this trend. No precise terms of reference were issued to guide this exercise. The WP ensured that its report focussed on improving patient care. With this proviso, the WP aimed to: 1) briefly identify the current working practices of pulmonary physicians practicing ICM in six European Union (EU) countries (France, Germany, Greece, Italy, Spain and UK); 2) discuss possible opportunities to expand the influence of pulmonary physicians in the provision of acute care; and 3) determine the implications of 1) for training programmes. The following methods were employed. 1) Relevant literature was extracted and a draft report concerning the three points discussed previously was prepared and circulated to the members of the WP. 2) A 1-day meeting was held in Paris on March 26th, 2001, and the contents of the draft report discussed and refined. 3) A second draft was prepared and circulated. 4) A final report was forwarded to the executives of the ERS. In Europe, ICM is one of the most recent clinical disciplines to evolve. The polio epidemic in Denmark in 1952 showed that careful airway management with the application of positive pressure ventilation could dramatically reduce mortality in patients who presented with paralysis of the respiratory muscles. This focus on airway care and ventilatory management encouraged anaesthesiologists to lead the way in the introduction of critical care facilities. Technological advances in the 1960s led to the development of sophisticated physiological monitoring equipment. The subsequent recognition that the diagnosis and management of critical illness required additional skills to those incorporated into training in anaesthesiology, attracted clinicians trained in …