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Analyzing the Healthcare Pyramid Essay (Critical Writing)

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Updated: Jun 22nd, 2022


The U.S has a unique healthcare system; its health system is not unified, and it does not have universal healthcare coverage. Its healthcare system can be best elucidated as a hybrid system (Niles, 2018). It comprises three care levels: primary, secondary, and tertiary care levels (Niles, 2018). This paper provides a comprehensive analysis of these healthcare pyramid levels and delineates the two types of professionals providing care at every level.

Primary Care

Primary healthcare designates the initial care level patients to receive; it emphasizes patient wellness and severe health conditions’ prevention. This form of care is delivered by healthcare professionals skilled and trained in providing comprehensive initial contact and continuing care to persons with undiagnosed health concerns not constrained by the problem’s source, diagnosis, or organ system. They are accountable for addressing significant aspects of people’s healthcare needs, practicing in community and family contexts, and establishing sustained relationships with patients (Niles, 2021). Services provided include patient education, counseling, health maintenance, disease prevention, and health promotion. Primary care professionals collaborate with other healthcare experts and use referrals and consultations.

Secondary Care

Secondary healthcare represents the second tier within the health system pyramid. It relates to medical care delivered by specialists or facilities upon referral by primary healthcare providers; it demands more specialized proficiency, equipment, or knowledge compared to primary care. Secondary care focuses on helping individuals struggling with more complex or severe health conditions requiring specialists’ support (Niles, 2018). This care level is provided in inpatient facilities and can best be elucidated as care for individuals with stable vital signs that require intensive specialist care. Secondary care services include scheduled operations, and specialist clinics, including rehabilitation services, obstetric services, renal clinics, and cardiology services. Primary care professionals deal with the whole-body system, whereas secondary care specialists are skilled in managing a particular organ system such as the heart or kidney.

Tertiary Care

Tertiary care relates to specialized consultative care typically delivered to referred patients and inpatients in settings comprising highly skilled personnel and advanced medical equipment. Tertiary care is ranked one level higher than secondary care. Tertiary care providers offer support to patients with unstable vitals who encounter life-threatening conditions. The primary features or elements of tertiary healthcare include specialized medical personnel, advanced diagnostic support services, and specialized intensive care units (ICU) (Niles, 2021). Tertiary care is provided in critical care, organ transplant, trauma, emergency room, and intensive care units. Tertiary care services include palliative, advanced neonatology, plastic surgery, neurosurgery, and cancer management services (Niles, 2021). Other complex surgical and medical interventions, such as therapy for severe burns, also constitute tertiary care.

Nurse Practitioners (NPs) are advanced practice registered nurses (APRNs) with specialized education and clinical training. Completing an advanced degree program provides NPs with the authority to practice independently and assume roles similar to those executed by physicians; however, this authority varies by state. A master of science in nursing degree is the minimum academic qualification for becoming an NP. Furthermore, NPs are certified by the American Academy of Nurse Practitioners Certification Board (AANPCB) and require relevant state licensure to practice in primary care facilities (Niles, 2021). The regulations governing NPs’ roles differ from one state to another. Their general responsibilities include managing patient treatment, analyzing and ordering diagnostic procedures and tests, diagnosing illnesses, and conducting physical assessments. NPs may also prescribe medications within the established limitations. Controlled substances’ prescriptions by NPS may be strictly proscribed or regulated in certain states. NPS is required to practice under a physician’s supervision; however, this depends on a specific state’s jurisdiction.

Adult-gerontology acute care NPs (AG-ACNP) deliver care to inpatient and referred patients in secondary care facilities. One must acquire a graduate education in nursing, particularly a master’s degree, to work as an AG-ACNP. They must also be certified by the American Association of Critical-Care Nurses (AACN) or the American Nurses Credentialing Center (ANCC) and obtain state-specific licensures (AG-ACNP, n.d.). Their role is to deliver advanced nursing care to the elderly, older adults, and adult patients with critical, chronic, and acute conditions. Some other duties include gathering and evaluating data based on a client’s history, physical findings, symptoms, and diagnostic data to select the most appropriate action course (AG-ACNP, n.d.). AG-ACNPs must practice collaboratively with various healthcare experts to stabilize and better patients’ health.

Acute care NPs (ACNPs) work in various tertiary healthcare facilities, including procedural or interventional care, trauma care, and critical and emergency care. They must acquire a graduate nursing education, particularly a master’s degree (AG-ACNP, n.d.). ACNPs who desire to work with adults could acquire the ACNPC-AG (acute care nurse practitioner certification for adult-gerontology) provided by the AACCN (AG-ACNP, n.d.). The ANCC offers the AGACNP-BC (Adult-gerontology acute care nurse practitioner certification) credential. The Pediatric Nursing Certification Board (PNCB) offers the CPNP-AC (certified pediatric nurse practitioner-acute care) credential (AG-ACNP, n.d.). ACNPs should also obtain state-specific licensure to practice in a particular state. They perform different roles depending on their work surroundings.

Peterson Health Center is an example of a primary health care institution situated in the U.S. The center attends to patients with terminal diseases or illnesses. Emory Healthcare is another example of a primary care setting. Services offered by the institution include annual health examinations, and routine immunizations, such as Pneumovax, tetanus, and influenza (Welcome to Emory Clinic, n.d.). The facility also provides laboratory services, minor injury treatment services, and care for typical diseases to advanced, complex, or long-term health issues.

Cancer Treatment Centers of America (CTCA) is a for-profit healthcare organization situated in the U.S, with its headquarters located in Boca Raton, Florida. It consists of three outpatient care centers serving cancer patients across the U.S and a network of five cancer research and care centers (Cancer won’t wait, n.d.). New York-Presbyterian Hospital is an internationally recognized academic healthcare facility dedicated to excellence in community service, education, research, and inpatient care. It is among the most extensive and comprehensive healthcare settings and an outstanding provider of preventive, ambulatory, and inpatient care (New York-Presbyterian, n.d.). The institution offers up-to-date interventional treatment and cardiac surgery practices, including heart transplants.

Mayo Clinic is a tertiary-level facility ranked among the best healthcare organizations in the U.S. The hospital focuses on providing care to patients with complex and severe conditions (About Mayo Clinic, n.d.). Cleveland Clinic is also an example of a tertiary-level healthcare facility known for advanced patient care expertise. These services include urology, rheumatology, pulmonology, orthopedics, neurosurgery, nephrology, gynecology, geriatrics, endocrinology, gastroenterology, and cardiology (Our commitment to safe care, n.d.). The institution has pioneered several breakthroughs in the medical sector.


I have acquired vast knowledge of the healthcare levels and their roles in ensuring quality care delivery. Currently, I am familiar with the different types of healthcare organizations and the services they offer. My understanding of the roles executed by various medical professionals in different care settings has also improved significantly. Moreover, my cognizance of the academic qualifications, state licensure, and certification requirements for various professions has also been significantly enhanced. I am, therefore, inspired to work hard in my studies and gain the required experience and accreditation to scale up the ladder and serve the nation at the highest specialty level, the tertiary level.


Adult-gerontology acute care nurse practitioner (AG-ACNP). (n.d). Web.

About Mayo Clinic. (n.d.). Web.

Cancer won’t wait: Don’t put off the care you need. (n.d). Web.

New York-Presbyterian: About us. (n.d.). Web.

Niles, N. J. (2021). Basics of the U.S. health care system. Burlington, Massachusetts: Jones & Bartlett Learning.

Niles, N. J. (2018). Navigating the U.S. health care system. Burlington, Massachusetts: Jones & Bartlett Learning.

Our commitment to safe care. (n.d.). Web.

Welcome to Emory Clinic primary care services (n.d.). Web.

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