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In medicine, levels of care signify the complexity of the medical cases doctors treat and the skills and specialties of the providers. The levels are distributed in the following categories :

  • Primary care
  • Secondary care
  • Tertiary care
  • Quaternary care

As a patient, you may at times hear these terms. So, knowing their definitions could 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 levels of care, what type of provider is involved in each level, and what situations might need different levels of care.

What are Levels of Care?


Most people have a great deal of knowledge about primary care. This office is your first stop for most of your symptoms and medical worries. You may seek primary care for the following :

  • Illness – You might see your primary care doctor when you notice a new symptom or when you come down with a cold, the flu, or some other infection.
  • Injury – You might also seek primary care for a broken bone, a sore muscle, a skin rash, or any other acute medical problem.
  • Referral – Also, primary care is generally responsible for coordinating your care among specialists and other levels of care.

In addition to this, you will probably see a primary care provider (PCP) for regular screenings, general check-ups, and wellness visits.

Primary care providers might be :

  • Doctors
  • Nurse practitioners
  • Physician assistants

There are a few primary care specialties as well. For example, OB-GYNs, geriatricians, along with pediatricians are all primary care doctors. But they also happen to specialize in caring for a specific group of people.

Studies have shown that primary care providers benefit the healthcare system through :

  • Enhancing access to healthcare services
  • Providing better health outcomes
  • Reducing hospitalization and use of emergency department visits

Most health insurance policies need you to designate a primary care provider. In most cases, you could choose a family practice physician, internist, OB-GYN, geriatrician, or pediatrician for this role.

Primary, Secondary, Tertiary and Quaternary Care


Secondary care is when your primary care provider directs you to a specialist. Secondary care means your doctor has transferred your care to someone who has more specific expertise in whatever health problem you are experiencing.

Specialists focus either on a particular system of the body or a specific disease or condition. Examples of specialists include :

  • Cardiologists are all about the heart and blood vessels.
  • Endocrinologists focus on hormone systems, including diseases such as diabetes and thyroid disease.
  • Oncologists specialize in treating cancers, and many focus on a particular type of cancer.

Your insurance company might require that you receive a referral from your PCP rather than going directly to a specialist.

Sometimes problems arise in secondary care. These might include :

  • Wrong specialist – Sometimes, doctors direct people to the wrong kind of specialist. That could happen because symptoms often overlap between a variety of health conditions. So, your symptoms might suggest one problem when, in reality, it is another condition that requires a different specialist.
  • Lack of coordination of care – You might also experience problems if you are seeing more than one specialist and each is treating a different condition. Sometimes in these cases, doctors may not fully coordinate your care. Ideally, specialists should work with your primary care health team to make sure everyone knows what the others are recommending.


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

At this level, you will find procedures like :

  • Coronary artery bypass surgery
  • Dialysis
  • Plastic surgeries
  • Neurosurgeries
  • Severe burn treatments
  • Complex treatments or procedures

A small, local hospital might not be able to provide these services. So, if you require more advanced care, they might need to transfer you to a medical center that provides highly specialized tertiary level services.

Studies have shown that when you are in tertiary care for specific chronic conditions such as diabetes and chronic kidney disease, your PCP must remain involved. That is because your PCP could help you establish and maintain a management plan for the long term.

Levels of Care


Quaternary care is regarded as an extension of tertiary care. However, it is even more specialized and highly uncommon.

Because it is so particular, not every hospital or medical center offers quaternary care. Some might only provide quaternary care for particular medical conditions or systems of the body.

The types of quaternary care include :

  • Experimental medicine and procedures
  • Uncommon and specialized surgeries


Levels of care refer to the complexity of medical cases, the types of health conditions a physician treats, and their specialties.

Primary care includes your primary healthcare provider. You see them for things such as acute illnesses, injuries, screenings, or to coordinate care among specialists.

Secondary care is the care provided by a specialist. These specialists might 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 uncommon.

Primary Care Physician


The majority of the time, you will only receive primary or secondary care. However, when you have a serious injury, condition, or disease, your doctor will move you to higher levels.

Understanding the levels of care will help you navigate the medical system and receive the care you require.

If you or anyone you know is suffering from diseases and conditions, our expert providers at Specialty Care Clinics will take care of your health and help you recover.

Call 469-545-9983 to book a telehealth appointment for an at-home check-up.

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