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
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