An intensive care physician has expertise in diagnosing, managing, and follow up of critically ill or injured patients. There is no doubt that such patients should be evaluated by an intensivist, but which structural model of intensive care unit (ICU)—open or closed? Who should be the decision maker of the critically ill patient? Should definitions of ICU organization be cast in stone? These questions dwindle in the minds of physicians who care for the critically ill in many parts of the world. This article brings forth the advantages and limitations of both types of organizational structures and proposes the way forward.
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