What is Acute Medicine?

Acute Medicine or Acute Internal Medicine is a new and developing specialty involved in the immediate and early (<72 hour) management of adult patients afflicted with a wide range of conditions who present to, or from within, hospitals requiring urgent or emergency care.

Traditionally, acute medical conditions were handled by Internal medicine / General medicine physicians together with other super specialties such as Cardiology, Pulmonology, Neurology and Nephrology. Acute medicine was developed to answer the wide gaps in acute care due to the mounting pressure on healthcare capacities across different facilities.

The rise of acute medicine physicians lead to the realization for the need of an Acute Medical Unit (AMU), equipped and staffed to manage emergent conditions. In the UK, where Acute Medicine was recognized as a seperate specialty since 2009, AMUs have become an integral part of NHS facilities.¹

The Why?

The advocacy for acute medicine as a specialty is supported by two improtant demands: the need of patients to receive expert acute care and the need of hospitals to deliver a service on limited resources with greater efficiency and co-ordination.²

Acute medicine is different from Critical Care/Intensive Care medicine, in that the former involves the treatment of severely ill patients who need close observation but do not require intensive care.³

Acute Medical Unit (AMU)

Acute medical units (AMUs), as defined by the Royal College of Physicians in London (RCP), is “a dedicated facility within a hospital that acts as the focus for acute medical care for patients who have presented as medical emergencies to hospital”.⁴

AMUs are an integral part of most modern healthcare systems. An AMU admits the acutely ill, via the emergency department/casualty and hospital wards, for further assessment, care, and treatment for a maximum designated period. Several studies, primarily across the UK, have reported significant benefits (including reductions in in-patient mortality and length of stay).⁵

Acute Medicine in India

In India, acute illnesses are routinely managed by internal medicine/general medicine physicians, who are also responsible for a significant number of patients who require both acute and non-acute care. Acutely ill patients in the wards and from the ER are also usually managed by critical care units (CCUs/ICUs), manned by anesthesiologists or critical care consultants.

While a well staffed, adequately equipped hospital with enough resources can handle the volume of acutely ill patients, the same is not true for institutions with lesser man power and operational capabilities. In such institutions, redirecting emergent conditions, but not critically ill, to ICUs cannot be the answer, as these units and their resources are easily depleted.

AMUs can act as a bridge in these cases, creating a buffer zone for patients needing acute care, minimizing the loss of valuable ICU beds and resources, and by bringing down hospitalization costs for the patients. Equipping and staffing an AMU will involve lesser investment and operational costs as compared to ICUs.





1. Dean, J., Jones, M., Dyer, P., Moulton, C., Price, V., & Lasserson, D. (2022). Possible futures of acute medical care in the NHS: a multispecialty approach. Future healthcare journal, 9(2), 125–132.
2. Armitage, M. (2004) “Acute medicine: Making it work for patients,” Clinical Medicine, 4(3), pp. 203–206.
3. Royal College of Physicians (2007). Acute Medical Care. London: Royal College of Physicians of London. ISBN 978-1-86016-321-0.
4. Reid, L. E. M., Pretsch, U., Jones, M. C., Lone, N. I., Weir, C. J., & Morrison, Z. (2018). The acute medical unit model: A characterization based upon the National Health Service in Scotland. PloS one, 13(10), e0204010.
5. Wachter, R.M. and Bell, D. (2012) “Renaissance of Hospital Generalists,” BMJ, 344(feb13 1).