8．医師の役割 Pros & Cons—Con：術後管理は主治医が行うべき

Perspective from clinical practice Pros and Cons of physician-physician coordination：Surgeons should see the post-operative patient

ICUに入室している術後患者の管理を集中治療医が主体的に行う，いわゆるclosed ICUと，執刀した主治医が主体的に管理を行うICUのどちらがよいかについては議論の余地がある。集中治療医が充足しているとは言えない本邦では，すべての施設でclosed ICU管理を追求していくことは非現実的である。また，ICU退室後の病棟で管理を行うのは主治医であり，その主治医を多職種でサポートする体制を構築し，院内全体の医療の質と安全性の向上に寄与することこそが，今の集中治療医に求められていることなのではないだろうか。

It is debatable whether the closed ICU, in which the intensivist takes initiative for the management of post-operative patients in the ICU, or the non-closed ICU, in which the attending physician who performed the operation, takes initiative for the management of post-operative patients in the ICU, is better. As there is a shortage of intensivists in Japan, it is unrealistic to pursue closed ICU management in all facilities. The attending physician manages patients who have been discharged from the ICU on general wards, therefore, building a system to support the attending physician with multidisciplinary support and contributing to improving the quality and safety of healthcare in the hospital as a whole is required of intensivists today.