At the SCCM

I'm at the SCCM meeting for a few days.  Yesterday I gave a talk called "Strategies for 24-hour Coverage of Rural ICUs".  I used Kansas as a paradigm for rural states.  Did you know that approximately 51% of our population lies outside the counties of Sedgwick, Shawnee, Wyandotte, and Johnson.  That's of interest, because according to the census bureau only one in four Americans lives in a rural area.  I did a quick poll at the beginning of the talk to see how many people in the room had grown up in a town of 25,000 or smaller.  In keeping with national census data, about 25 % of the room raised their hands.  I then asked how many people (critical care specialists) live or work in towns of that size today.  Far fewer hands.  Statistics show that 10% of physicians live or work in rural areas, vs. 25% of the population liiving there.  Of the critical care physicians in our state, my count shows about 10% outside of the major metropolitan counties, though the number fluctuates over time.  One can easily see that the possibilities for 24-hour intensivist coverage are limited.  I'm planning to do this talk for our meeting on January 14, so that we can discuss our options and what we're already doing to ensure that midwesterners all receive the highest quality critical care services.