Which level of care is considered the second level, with a team that has not had first contact with the patient, examples include cardiologist or dermatologist, and often requires inpatient hospitalization or ambulatory same-day surgery?

• A. Basic or first level care, outpatient, PCP gatekeeper
• B. Inpatient hospital-based, highly specialized services
• C. Second level, team has not had first contact with patient, e.g., cardiologist, dermatologist, often requires inpatient hospitalization or ambulatory same-day surgery
• D. Out-patient, preventative, diagnostic treatment services

Answer: (C)

Secondary care involves specialist services provided after a referral from primary care, by teams that have not yet had prior contact with the patient. When a patient needs a cardiologist or a dermatologist, for example, they typically are seen at this level, often in hospital settings or for ambulatory same-day procedures, and care can require inpatient hospitalization. This distinguishes it from primary care, which is the first contact and gatekeeper for referrals, and from higher-level tertiary or purely outpatient preventive and diagnostic services, which are either more specialized or less intensive. So the scenario described fits secondary care—the patient is seen by specialists who did not have initial contact, with services that may involve hospitalization or day surgery.