Before the trend to specialisation, although many consultant physicians developed an expertise in their chosen areas, most physicians practiced general internal medicine and dealt with a wide range of medical problems. These included patients admitted as emergencies, patients with multiple disorders or diagnostic dilemmas, patients referred to outpatient clinics for investigation and diagnosis, and patients referred by specialist services - as outpatients or urgent inpatient referrals. For complex situations with multiple disorders, an overview from a generalist can be very helpful to prioritise the different problems ands lead to a more holistic approach to investigation and management.

The demands of admitting and managing acutely ill medical patients have spawned a new specialty within General Medicine. Acute Medicine has been established to improve the quality and safety of care for people who are acutely ill. It is defined in the RCP's report Acute Medicine - Making it Work for Patients as: 'That part of general (internal) medicine concerned with the immediate and early specialist management of adult patients with a wide range of medical conditions who present in hospital as emergencies.'