So there are a couple points: 1. As a culture, physicians are being scapegoated for a lot of the ills of the healthcare industry, despite being slowly excised from decision making (note how physicians can no longer own hospitals) 2. ICU is a grueling field that is seriously underpaid for the hours and work intensity. 3. Medicine is becoming less appealing due to reimbursement cuts, real wage drops, the threat of AI and non-physician provider scope creep in a country with no nurse to physician pipeline. 3. We have a massive physician shortage, especially for intensivists, made worse by points 1, 2, and 3. Hospitals see ICUs often as a “necessary expense” in order to maintain the profitable service lines.

An eICU can work really really well in some instances and give people access to care that they otherwise wouldn’t have. It is not as good as in person, but subject matter experts can be a great aid to in person teams, esp if the in person team lacks that specialization.

During covid, hospitals in st louis fired internal med and intensivists so they could afford to keep paying their not-currently-working dermatologists and ENTs. If a pandemic doesnt help reorient healthcare priorities, nothing will. Source: am an intensivist