Primary care?

[Guest Aidan]

Hello,

 

I know this may seem like a stupid question, but I hear this term being used quite frequently, and I'm not exactly sure what it refers to. Could somebody please provide a definition? Also, how does primary care differ from secondary, tertiary care? And how many levels are there?

 

Thanks for your help!

[Guest moo]

Primary care refers to the specialties to which a patient first if he/she has a problem. Thus things like Family Med, General Internal med, pediatrics and ob/gyne constitute primary care. Some even include psychiatry and emergency in there.

 

Many people refer to family docs as the "gatekeeper" of the medical system in Canada, i.e., you need to get a referral from a primary care doc before you can see a specialist. In the US, this is not really the case as depending on your insurance (HMO v. PPO, medicare v. medicaid, etc.) you can go see a specialist (e.g., dermatologist) right away without a referral.

[Guest 0T6]

primary care's basically the "first-contact" between a patient and the medical system - i.e. a family doc or pediatrician

secondary care's basically the next step past that - specialists like urologists or cardiologists and such

tertiary care involves HIGHLY specialized medicine i.e. neurology/neurosurg and usually involves being admitted into a unit with intensive care/treatment/support

 

I think it stops at tertiary..

[Guest aneliz]

While OB/GYN and internal med are considered primary care in the states, they are considered specialties in Canada...meaning that you almost always need a referal from a family doc to be seen by one...

 

In Canada, primary care essentially = family medicine

 

(and some pediatricians that do general community pediatrics or essentially, family medicine for little people)

 

Secondary care = someone you are referred to by your family doctor - specialties like cardiology, psychiatry, surgery, etc

 

Tertiary care essentially means more 'high level - high risk' care - sicker patients, more toys... there is an official definition which goes something like "24/7 availability of in house surgeons, anesthesia and critical care specialists"

 

Some people talk of quaternary care - which essentially means care involving a 'world expert' in whatever you have or a 'one-in-the-country' diagnostic or treatment modality.

[Guest DrSahsi]

I would include Emergency Medicine under the umbrella of "Primary Care."

 

- Rupinder

[Guest mydream88]

Ok, I have another bold question to ask.. I hear about it every evening at midnight during Chicago Hope and every thursday on ER, what does HMO stand for?

 

I am embarrassed to ask this but I dont know .

 

thanks,

mydream88

[Guest UWOMED2005]

I think it stands for "Health Management Organization," or at least something to that effect. It's an America specific term for a specific type of private insurance company.

 

It's a myth that Canada has public insurance coverage whereas Americans pay for their Health Care. We both pay for Health Care - us through taxes, Americans either through cash, employee benefits and/or if they are truly poor coverage is from tax money. And Americans too don't have to worry about how to pay for a triple bypass or neurosurgery for brain mets, well, as long as they have the right employee benefit package or are wealthy. But Americans spend $300 for health care for every $100 Canadians spend.

 

That's just one of the reasons I prefer living la vita frigo. . .

[Guest PerfectMoment]

MRI machines in every hospital prolly has something to do with that :|

[Guest moo]

HMO=Health Maintenance Organization, PPO=Preferred Provider Organization. If you are old or poor, you are covered by the governement under a plan called Medicare or Medicaid, respectively. These work similarly to the Canadian system except that drugs are not paid for under medicare (most drugs are under medicaid). Most working class people have coverage under their employer. The problem lies in people who've just lost their job and are not eligible for medicare/medicaid or people who run small businesses who can't afford private insurance. Basically how an HMO works is like this: they contract with a large number of primary care physicians and if you are under an HMO you are free to see any physician within this network. If you want to see a physician outside of network you have to pay out of pocket. There are different ways of reimbursing the physician by the HMO but the most common is fee-for-service. If the primary care physician thinks you need a referral he has to get approval from the HMO to see if it's covered and then you can go. For a PPO, there's a little bit more leniency, as you are allowed to see physicians outside of plan (and they pay for most of it) AND you are also allowed to see a specialist without a referral. Drug coverage varies with each of HMO/PPO.

 

Again the problem is with people who are out of a job or whose employers decide not to provide coverage because it has gotten too expensive. There are 44 million people who are uninsured in this country and it is getting to be quite a bit of a crisis. I'm sure that within ten years there will be some sort of a universal system but the private system will remain intact.