Primary, secondary, tertiary and quaternary care


In medicine, service levels refer to the complexity of medical cases handled by physicians and the skills and specialties of providers. The levels are divided into the following categories:

  • First aid
  • Secondary care
  • Tertiary care
  • Quaternary care

As a patient, you may hear these terms at times. Therefore, knowing their definitions can help you better understand what your doctor is talking about and help you recognize the level of care you are receiving.

This article explains the service levels, what type of service provider is involved at each level, and in what situations you may need help at the different levels.

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Primary care: essential

Most people are familiar with primary health care. This office is your first stop for most of your symptoms and medical problems. You can request primary health care in the following cases:

  • Illness – You can contact your healthcare provider when you notice a new symptom or when you have a cold, flu, or other infection.
  • Trauma : You can also seek primary care for a bone fracture, muscle pain, skin rash, or any other acute medical problem .
  • Referral : In addition, primary health care is generally responsible for coordinating your care between specialists and other levels of care.

Also, you will likely see your Primary Care Provider (PCP) for regular checkups, general checkups, and wellness visits.

Primary health care providers can be:

There are also some primary health care specialties. For example, OB-GYNs, Geriatricians, and Pediatricians are primary care physicians. But they also specialize in serving a specific group of people.

Research has shown that primary health care providers benefit the health system by:

  • Expand access to health services
  • Provide better health outcomes
  • Reduction of hospital admissions and visits to the emergency department.

Most health insurance policies require you to designate a primary health care provider. In most cases, you can choose a family doctor, general practitioner, obstetrician-gynecologist, geriatrician, or pediatrician for this role.

Secondary help: specialists

Secondary care is when your PCP refers you to a specialist. Secondary care means that your doctor has referred your treatment to someone with a more specialized knowledge of whatever health problem you are facing.

Specialists focus on a specific body system or a specific disease or condition. Examples of professionals include:

  • Cardiologists focus on the heart and blood vessels.
  • Endocrinologists focus on hormonal systems, including diseases like diabetes and thyroid disease.
  • Oncologists specialize in treating cancer, and many of them specialize in a specific type of cancer.

Your insurance company may ask you to get a referral from your PCP instead of seeing a specialist directly.

Sometimes problems arise on the secondary link. They may include:

  • The wrong specialist : Sometimes doctors refer people to the wrong specialist . This can happen because symptoms often overlap in different health conditions. So your symptoms may indicate a problem, when in reality it is another condition that requires a different specialist.
  • Lack of coordination of care : You can also have problems if you visit more than one specialist, each treating a different condition. Sometimes in such cases, doctors may not fully coordinate your treatment. Ideally, professionals should work with their primary care team so that everyone knows what others are recommending.

Tertiary care and hospitalization

If you are hospitalized and require a higher level of specialized care, your doctor may refer you to tertiary care. Tertiary care requires highly specialized equipment and expertise.

At this level, you will find procedures such as:

A small local hospital may not be able to provide these services. Therefore, if you need more complex medical care, you may need to be transferred to a medical facility that provides highly specialized tertiary services.

Research has shown that when you receive tertiary care for certain chronic conditions, such as diabetes and chronic kidney disease, your PCP must continue treatment. This is because your PCP can help you create and maintain a long-term treatment plan.

Quaternary care

Quaternary care is considered an extension of tertiary care. However, it is even more specialized and quite unusual.

By their nature, not all hospitals or medical centers offer quaternary treatment. Some may only provide quaternary care for certain diseases or body systems.

Quaternary toilet types include:

  • Experimental Medicine and Procedures
  • Unusual and specialized operations


Treatment levels refer to the complexity of medical cases, the types of conditions the doctor is treating, and his or her specialization.

Primary care includes your PCP. You go to them for things like acute illnesses, injuries, exams, or to coordinate care among specialists.

Secondary help is the help of a specialist. These specialists can include oncologists, cardiologists, and endocrinologists.

Tertiary care is a higher level of specialized care in a hospital. Similarly, quaternary care is an extension of tertiary care, but it is more specialized and unusual.

Get the word of drug information

In most cases, you will only receive primary or secondary care. However, if you have a serious medical injury, condition, or condition, your doctor will take it to the next level.

Understanding service levels will help you navigate the medical system and get the care you need.

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