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Secondary, Tertiary, and Quaternary Care

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Medical professionals frequently talk about levels of care. They're divided into the categories of primary care, secondary care, tertiary care, and quaternary care. Each level is related to the complexity of the medical cases being treated as well as the skills and specialties of the providers. 

Since you sometimes hear these words as a patient, their definitions can help you better understand exactly what doctors, nurses, and other medical staff are referring to. It can help you navigate the medical system and recognize the level of care you're receiving
 

Secondary Care Specialists
When your primary care provider refers you to a specialist, you are then in secondary care. Secondary care simply means you will be taken care of by someone who has more specific expertise in what is ailing you.

Specialists focus either on a specific system of the body or a specific disease or condition. For example, cardiologists focus on the heart and its pumping system. Endocrinologists focus on hormone systems and some specialize in diseases like diabetes or thyroid disease. Oncologists have a specialty in treating cancers and many focus on a specific type of cancer.

Secondary care is where most people end up when they have a medical condition to deal with that can't be handled at the primary care level. Your insurance company may require that you receive a referral from your PCP (Primary care providers)  rather than going directly to a specialist.


There are times when problems with specialty care develop. One reason may be that you have been referred to the wrong kind of specialist. For example, your initial symptoms may indicate one thing when in reality it is another condition that requires a different specialist.

You may also experience problems while seeing more than one specialist if each is treating a different condition. In these cases, your care may not be fully coordinated. The specialists should work with your primary care health team to ensure everyone knows what the other is recommending.


Tertiary Care and Hospitalization
Once a patient is hospitalized and needs a higher level of specialty care within the hospital, he may be referred to tertiary care. Tertiary care requires highly specialized equipment and expertise.

At this level, you will find procedures such as coronary artery bypass surgery, renal or hemodialysis, and some plastic surgeries or neurosurgeries. It also includes severe burn treatments and any other very complex treatments or procedures.

A small, local hospital may not be able to provide these services, so you may need to be transferred to a medical center that provides highly specialized tertiary level services. 

Quaternary Care
Quaternary care is considered to be an extension of tertiary care. It is even more specialized and highly unusual. Because it is so specific, not every hospital or medical center offers quaternary care. Some may only offer quaternary care for particular medical conditions or systems of the body.

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