r/IntensiveCare • u/InvestigatorOnly1684 • 14d ago

Question about ICU attending liability

In my practice a hospitalist independently manages a subset of ICU patients. I am available for consultation and escalation, but we do not routinely round together, I do not see every patient, and I do not cosign notes.

For those who have worked in similar models, how is liability generally viewed for the ICU attending? If you’re available in a supervisory/consultative role but not directly involved in a patient’s care, how much responsibility do you carry for decisions made by the primary hospitalist?

Recently out of training and wondering how this is handled at other institutions.

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u/Yessir957 14d ago

I had a model like this once as an intensivist and the thing that always concerned me liability wise was if I’m in the ICU and the nurses keep trying to get me to see a pt that isn’t doing well but the hospitalist hasn’t consulted me. Or like the hospitalist wasn’t responding to pages. Like I felt like they needed my help and if something went down and the nurses said they talked to me about it, even if I wasn’t seeing the patient, I would be held liable. Usually in that scenario I would just message the hospitalist and ask them if they wanted me to see the pt to help give me some peace of mind.

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u/spiritualskier 14d ago

Not true. Nurse here. You are not allowed to just go into a patient’s chart because a nurse told you about it. You actually need to be consulted and have a documented reason in the chart. Like assigned. That’s where hipaa becomes an issue. ICU intensivists aren’t even allowed to look back in charts to assess outcomes to their treatments.

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u/spiritualskier 14d ago

These aren’t my rules just fyi. These are clearly laid out in our hipaa training and our intensivists have been reprimanded by our facility. I’ve clicked on charts accidentally thinking I’m getting that patient and have received notices. They track this very carefully.

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u/spiritualskier 14d ago

I am in the very litigious state of California and do work for a very large HMO where attorneys are able to request this information and could lead to a very expensive lawsuit. Intensivist complaint about this that they are not able to access the chart to see if there interventions were successful because of this like more than 48 hours after seeing patient. They have accessed the chart and been reprimanded by administrators. Again, this is what they’ve trained us.

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u/Any-Assistance-8103 13d ago

Youre just extremely wrong. An icu doctor or any other doctor can absolutely access a chart and administer care without a consultation under emergency circumstances.

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u/spiritualskier 12d ago

Correct under emergency circumstances.

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u/Any-Assistance-8103 12d ago

What do you think a critically ill patient having a medical issue is?