中国病理生理学会危重病医学专业委员会成立20年，取得了很大进步，成为我国医学界的一支有生力量。现在，面临着新的挑战。循证医学的局限性和弊端影响着危重病医学在发展中左右摇摆。不忘当初为什么要创建重症加强护理病房（intensive care unit，ICU），为什么要发展危重病医学。出路何在，需要认真思考。精准医学很可能是发展的重要趋势。这是一项复杂而庞大的工程。不论是临床医学或者基础医学，单独依靠哪一个方面都不可能完成。临床医师要找到自己的位置，担负起新的历史使命。

Chinese Society of Critical Care Medicine has been a remarkable driving force for the development and progress of intensive and critical care medicine in mainland China since its establishment 20 years ago. Nowadays critical care medicine is facing with multiple new challenges, with the pendulum swinging back and forth due to the limitations and drawbacks of evidence-based medicine. One possible solution is to bear in mind the original objective, that is, why we need intensive care unit and/or critical care medicine and how they will succeed. Precision medicine, might be another solution, yet a long way before success. Integration of clinical medicine and basic research might help the intensivists to make progress in the future.