Acute medicine

Lore & Background

The field developed in the United Kingdom after the Royal College of Physicians of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow published a joint report in 1998 emphasizing the importance of appropriate care for people with acute medical problems. Further reports led to its recognition in 2003 as a subspecialty of General Internal Medicine by the Specialist Training Authority. Around the same time, care for acutely admitted patients was concentrated in 'medical assessment units' (MAUs), later renamed 'acute medical units' (AMUs), where a physician experienced in acute medical problems could assess and treat patients for the first 48 hours, aiming for early discharge or transfer to a specialist ward. Severely ill patients who need close observation but do not require intensive care may be treated in a physician-run high-dependency unit.

Reader's Guide

Acute medicine emerged in the early 2000s in the United Kingdom as a response to reports emphasizing appropriate care for acute medical problems. Its significance lies in creating dedicated acute medical units (AMUs) that concentrate specialist assessment and treatment within the first 48 hours of admission, aiming to reduce hospital stays and improve outcomes. In 2007, some questioned the specialty's long-term future if UK government emergency department targets ceased, but Robert Wachter noted that acute medical units have been associated with lower inpatient mortality, improved patient and staff satisfaction, reduced hospital stays, and increased throughput. A further development has been the increase of ambulatory care, allowing patients to attend clinics or assessment areas for monitoring instead of admission, now common for suspected deep vein thrombosis and other conditions identified by the NHS Institute for Innovation and Improvement. The Society for Acute Medicine was founded in 2000 as the national representative body for staff caring for medical patients in the acute hospital setting. In the Netherlands, the Dutch Acute Medicine society formed in 2012, holding its first Congress that year and aiming to ensure 12 training posts throughout the country.

Did You Know?

• Acute medicine was recognized as a subspecialty of General Internal Medicine in 2003 by the Specialist Training Authority.
• The Society for Acute Medicine was founded in 2000.
• In 2009, the General Medical Council approved acute medicine as a distinct specialty.
• The Dutch Acute Medicine society was formed in 2012 and held its first Congress on 28 September 2012 in Amsterdam.