In medicine, the term primary care has a number of related definitions. Most people think of it in context of primary care physician, a doctor who delivers healthcare for the majority of simple illnesses and who typically has a group of established patients. This is the way the term is used by many health insurance companies, especially health maintenance organizations that expect people to have this type of physician. It could simply mean average and consistent care over a period of time from the same doctor, usually a general practitioner. Alternately, the term can also apply to a certain level of care, usually the first care people might receive unless it’s determined they need greater intervention.
The first two definitions of primary care are related. A number of doctors, nurse practitioners and physicians assistants, especially in clinics and doctor’s offices, care for adults and/or children. They treat average or common illnesses and they often do routine physicals and checks. These become the family doctors, whether or not a health insurance company demands people have one. Over time a specialist in this type of care forms relationships with patients and might care for them for most of their lives. They represent continuity of care and are the first point of contact a person has with the medical world if he or she gets ill.
There can be different types of people who deliver primary care. Doctors may be pediatricians, obstetricians, internists, and general practitioners, and any nurse practitioners or physicians who work in these offices are part of the primary healthcare team. One thing these medical practitioners must do is determine if the level of illness in a patient exceeds their expertise. For those people who have HMOs, doctors must make referrals to specialists, but this has always been a function of these physicians, even when a referral isn’t needed for health insurance purposes. When a patient has a complicated symptom or illness that would be better treated by a specialist, the primary healthcare worker often suggests seeing a specialist.
This is related to the second definition of primary care. Hospitals are said to deliver secondary and tertiary care. Secondary care would be offered at most community hospitals, and tertiary care is usually offered at very large hospitals that may be connected to a medical school or university. Doctors may sometimes determine that primary care is not enough and a patient needs secondary or possibly tertiary care (for rarer illnesses). Occasionally the emergency room is as a potential primary facility, though it can offer more extensive care too. Often, primary or specialist doctors are the ones who determine the necessity of hospitalization.
