Levels of care: from self-care to the emergency department
- Self-care: rest, fluids, a balanced diet, a first-aid kit, and over-the-counter (OTC) medicines bought without a prescription.
- Primary care: the family doctor (general practitioner, GP), nurse or local health centre. This is the first door for most problems, for check-ups and vaccines. At night and on holidays, a night and holiday care service or on-call clinic takes over.
- Secondary care: specialists (skin, heart, eyes, orthopaedics) and tests, usually after a referral from the primary doctor.
- Hospital (tertiary) care: operations, intensive care, long stays.
- Emergency department: only for sudden, serious danger: chest pain, stroke signs, heavy bleeding, severe injury, difficulty breathing.
Using the right level saves time for you and keeps emergency teams free for those in real danger.
Emergencies: talking to a dispatcher
Call 112 (or your local emergency number; in India also 108 for an ambulance). The dispatcher decides what help to send, so answer calmly:
- Where are you? (address, landmark, or GPS from the phone)
- What happened?
- How many people, and are they conscious and breathing?
- Your name and phone number.
Do not hang up first. The dispatcher may guide you through first aid, such as chest compressions, until the ambulance arrives.
Medicines, supplements and the pharmacist
A medicine treats or prevents disease and must prove that it works and is safe. A dietary supplement (vitamins, minerals, herbal pills) is a food product; it does not have to prove it cures anything.
Always read the leaflet: what it is for, the dose, how often, maximum per day, who must not take it, interactions, side effects and expiry date.
Common OTC side effects: paracetamol overdose harms the liver; ibuprofen and aspirin can irritate the stomach; some allergy tablets cause sleepiness. Never take two products with the same active ingredient.
Pharmaceutical care means the pharmacist checks your medicines, explains how to use them and spots dangerous combinations. Reimbursement means the public system or insurer pays part or all of the price of medicines on its list when a doctor prescribes them.
Patient rights and evidence-based care
Every patient has rights, written in law in most countries:
- Information: to be told clearly about illness and treatment options.
- Consent: to agree or refuse before treatment (for children, parents also decide).
- Privacy and confidential medical records.
- Dignity, respect and pain relief.
- Complaint: to a hospital, a patient rights ombudsman (an independent official) or a court.
Good care is evidence-based: treatments are tested in clinical trials, where one group gets the new treatment and another gets the usual treatment or a placebo, chosen at random, so we can see what really works.
Perinatal care (around birth) has its own standards: regular check-ups in pregnancy, a safe birth, the mother's right to information and support, and early checks for the newborn.
E-health and who pays
E-health uses digital tools: an online patient account with your records, test results and vaccinations; e-prescriptions sent as a code; e-referrals; and telemedicine, a consultation by phone or video. Keep your login safe, like a bank password.
Preparing for a visit: write symptoms (when they started, what helps), a list of medicines and allergies, questions to ask; for blood tests ask whether you must fast.
Funding: money comes from (1) taxes, (2) compulsory health insurance contributions paid to a national health fund, (3) private insurance and (4) out-of-pocket payments. Pooling means healthy people's money helps sick people, so no one faces the whole cost alone.
Try it: make a family health card: emergency numbers, nearest clinic, pharmacy and hospital, each person's allergies and regular medicines.
Key formulas and definitions
- Levels of care: self-care → primary → secondary (specialist) → tertiary (hospital); emergency via 112
- Referral: primary doctor sends you to a specialist or test
- Patient rights: Information, Consent, Privacy, Dignity, Complaint
- 112 call: Where? What? How many? Stay on the line
- Funding sources: taxes, social insurance, private insurance, out-of-pocket
- Medicine ≠ supplement: only medicines must prove they treat disease
Worked examples
1. Riya has a runny nose and a mild sore throat for one day. Where should she go first?
Self-care: rest, warm fluids, and if needed an OTC medicine after asking the pharmacist and reading the leaflet. If it lasts or gets worse, see the primary care doctor.
2. A grandfather suddenly cannot lift one arm and his speech is slurred. What should the family do?
These are stroke signs. Call 112 at once, say where, what happened and that he is conscious, and follow the dispatcher's advice. Do not drive to the family doctor.
3. A student has had knee pain for two months. What is the usual path?
Primary care doctor → examination → referral to an orthopaedic specialist and an X-ray if needed → treatment or physiotherapy.
4. A cold remedy and a painkiller both contain paracetamol. Why is taking both risky?
You double the dose of the same active ingredient and may pass the safe daily limit, which can damage the liver.
Common mistakes
- Going to the emergency department for a mild cold. It delays care for people in danger.
- Thinking supplements are medicines. They do not have to prove they cure disease.
- Not reading the leaflet, or mixing products with the same active ingredient.
- Hanging up on the 112 dispatcher before they finish asking questions.