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LETTER TO EDITOR
Year : 2020  |  Volume : 9  |  Issue : 9  |  Page : 5072-5073  

“Review” a core pillar of urgent care provision in primary care


Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, UAE; Primary Care, NHS North West London, London TW3 3EB, UK

Date of Submission17-May-2020
Date of Decision16-Jun-2020
Date of Acceptance01-Jul-2020
Date of Web Publication30-Sep-2020

Correspondence Address:
Dr. Moien A B Khan
Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Tawam Hospital Campus, Al Ain, 17666

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_894_20

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How to cite this article:
Khan MA. “Review” a core pillar of urgent care provision in primary care. J Family Med Prim Care 2020;9:5072-3

How to cite this URL:
Khan MA. “Review” a core pillar of urgent care provision in primary care. J Family Med Prim Care [serial online] 2020 [cited 2020 Oct 21];9:5072-3. Available from: https://www.jfmpc.com/text.asp?2020/9/9/5072/296365



Dear Editor,

I read with interest the joint position paper for the development of urgent care services in India.[1] It is a timely development and thoughtful foresight in an effort to improve primary health care provision in India.[2]

Though urgent care deals with immediate care, it can vary widely from within and outside countries.[3] Urgent care services are often fragmented and hence often need to be integrated within primary care.[4] Moreover, with the newer urgent care models, such unscheduled care are not time-restricted for the patients till routine care is available.[5],[6] Especially with a multi-diverse country like India such an innovative model of care calls for a newer integrated urgent care approach, which should address the population needs. With the four “R” model, I would like to propose an additional R to the model as “review”, because continuity of care is an integral part of the primary care and a fundamental principle of safe and effective practice.

Urgent care centers treat people with minor ailments and injuries who wish to avoid hospital emergency departments. Experience from the United Kingdom and from other countries suggests that the common reason for the urgent care attendance are sprains, minor injuries, which would require follow-up care of minor fractures, burns, redressings casts, and sutures.[6],[7] In addition, patients who had an acute presentation of chronic diseases are frequent visitors to such urgent care.[3],[4]

Evidence suggests trainee experience influences their decision to work in similar care in the future.[8] Hence not teaching the trainees to “review” as being a core pillar of urgent care practice may be a missed opportunity for the trainees to increase their skills related to continuity of care and following up in a primary care setting. Furthermore, such broader training increases the trainees' confidence and stimulates independence for future practice. Therefore, having an integrated fellowship curriculum, which includes comprehensive care will teach the trainees the very essence of the core values of primary care.[9]



 
  References Top

1.
Roy P, Kumar R, Aggarwal P, Vhora R, Gupta M, Aggarwal V, et al. Framework for development of urgent care services towards strengthening primary healthcare in India–Joint position paper by the Academy of Family Physician of India and the Academic College of Emergency Experts. J Fam Med Prim Care 2020;9:1801.  Back to cited text no. 1
    
2.
Mohan P, Sethi H, Reddy KR, Bhan MK. Designing primary healthcare systems for future in India. J Fam Med Prim Care 2019;8:1817-20.  Back to cited text no. 2
    
3.
Cowling TE, Ramzan F, Ladbrooke T, Millington H, Majeed A, Gnani S. Referral outcomes of attendances at general practitioner led urgent care centres in London, England: Retrospective analysis of hospital administrative data. Emerg Med J 2016;33:200-7.  Back to cited text no. 3
    
4.
Baier N, Geissler A, Bech M, Bernstein D, Cowling TE, Jackson T, et al. Emergency and urgent care systems in Australia, Denmark, England, France, Germany and the Netherlands–Analyzing organization, payment and reforms. Health Policy 2019;123:1-10.  Back to cited text no. 4
    
5.
O'Malley AS, Samuel D, Bond AM, Carrier E. After-hours care and its coordination with primary care in the U.S. Journal of general internal medicine 2012;27(11):1406–15. doi.org/10.1007/s11606-012-2087-4 6.  Back to cited text no. 5
    
6.
Steeman L, Uijen M, Plat E, Huibers L, Smits M, Giesen P. Out-of-hours primary care in 26 European countries: an overview of organizational models [published online ahead of print, 2020 Jun 29]. Fam Pract. 2020;cmaa064.   Back to cited text no. 6
    
7.
Weinick RM, Bristol SJ, DesRoches CM. Urgent care centers in the US: Findings from a national survey. BMC Health Serv Res 2009;9:79.  Back to cited text no. 7
    
8.
Hayward G, Drinkwater J, El-Gohary M, Burgess H, Heneghan C. GP training in out-of-hours care: Implications for the future workforce. Educ Prim Care 2015;26:95-101.  Back to cited text no. 8
    
9.
Hashim MJ. Principles of family medicine and general practice–defining the five core values of the specialty. J Prim Health Care 2016;8:283-7.  Back to cited text no. 9
    




 

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