Formed in 2000, SAM was established at a time when the concepts of acute medicine and the Acute Medical Unit (AMU) were in their infancy. Since that time things have moved forward considerably – most hospitals now have an AMU and acute medicine has been approved as a specialty in its own right. Large numbers of specialist acute physicians have been appointed to drive forward changes in the management of patients on the AMU, and several hundred specialist registrars are now training in Acute Internal Medicine. SAM has played a pivotal role in many of these developments and is represented on many national committees enabling a strong voice for acute physicians within the Royal Colleges and other key organisations.
Hospital at home is useful only when it offers ward-level diagnostics and treatment, not remote monitoring alone. In frail acute illness, early point-of-care ultrasound can distinguish congestion from dehydration, shape escalation decisions, and sometimes prevent the delirium and deconditioning of an avoidable admission.