Given that my field, bioethics, is considered new, and has been around a good 30-40 years, I think it’s still pretty safe to call intensivists new, too. Obviously not 5-years new, but 20 years isn’t long for a specialty to exist.

Critical care medicine (i.e. the specialization in intensive care) isn’t *all* that new or uncommon in the U.S. It’s been recognized by the American Board of Medical Specialties since 1986, and the American Board of Internal Medicine has awarded more critical care certificates than it has in endocrinology, nephrology, infectious disease, and other specialties that aren’t particularly unheard of (http://www.abim.org/resources/dnum.shtm). And that likely doesn’t count people certified in critical care by other primary boards.

Divisions of diagnostic medicine are pretty rare, but they do exist. E.g., St. Louis Children’s Hospital has a Diagnostic Center (http://www.stlouischildrens.org/tabid/89/itemid/187/Diagnostic-Center.aspx)

US ICUs are generally run by the parent unit admits and tends to their patients using specialized resources the ICU makes available. (These are called open ICUs.) Australia has closed ICUs, with their own attendings, chiefs, and structure that any other unit would have. Patients are transferred to their care, and they manage the unit.

This is actually a stunningly good idea for multiple reasons, including the very basic fact that the problems you encounter in the ICU are vastly different than the sorts of things the average patient in an average unit is going to encounter. On a practical side, it’s also easier on hospital finances if one group is managing a unit.