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The Difference Between Primary, Secondary and Tertiary Health Care


At some point or other, you may have heard health professionals talk about primary, secondary or tertiary health care. These terms, which are used throughout the world, refer levels of care, for cases ranging from mild to serious.

Primary Care

The primary care level is the “gatekeeper”, the first point of medical consultation. As a patient you are usually seen by a primary care physician, also called a general practitioner or family physician. Primary care is provided at a doctor’s office, health center or Urgent Care center. The Emergency Room is also often a source of primary care for the un- or under-insured.

According to the New England Healthcare Institute, demand for primary care continues to grow as patients become older and sicker. At the same time, there’s an increasing shortage of general practitioners. To meet the demand, physicians are starting to utilize nurse practitioners and physician assistants.

Secondary Care

Medical specialists and other health professionals, who typically don’t have initial contact with patients, provide secondary care. For example, a primary care physician might refer a patient to a cardiologist, rheumatologist, or a urologist or other specialty physician. Some secondary care physicians do not require a patient to have a referral from a primary care practitioner.

Another category of secondary care is hospital care, or acute care. The term covers care as an admitted patient in a hospital, a visit to a hospital ER, attendance in childbirth, medical imaging (radiology) services and care within an intensive care unit.

Physical therapists, respiratory therapists, speech therapists, occupational therapists and other allied health professionals often work in secondary care.

Tertiary Care

Patients being treated requiring a higher level of care in a hospital may be considered to be in tertiary care. Physicians and equipment at this level are highly specialized. Tertiary care services include such areas as cardiac surgery, cancer treatment and management, burn treatment, plastic surgery, neurosurgery and other complicated treatments or procedures.

A fourth level of care, quarternary care, is a more complex level of tertiary care. Uncommon, highly specialized and experimental treatments and procedures are considered to be at the quarternary care level.

For more information about health care, find additional articles in the Einsurance online journal.

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