 Welcome back to MedSmarter, where we're taking a smarter approach to preparing future physicians. And we have four different types of disease preventions that we're going to learn about today. And that is our primary, secondary, tertiary, and quaternary disease prevention. So let's start off with our primary disease prevention. Primary disease prevention is what we do when we try and prevent diseases from occurring. This is ultimately the top goal in healthcare is to keep people from getting sick rather than responding to their illness and trying to treat it. So what are some examples of preventing diseases before it occurs? Vaccines. For example, HPV vaccine is going to be a good example of primary disease prevention. We can prevent HPV infection from occurring. We can then potentially prevent the occurrence of cervical cancer and other cancers down the road. With secondary disease prevention, this is where we are screening early for diseases and managing them usually before they're symptomatic. So we do pap smears in females on a regular basis to help screen for that cervical cancer. And if we are able to find cervical cancer in that pap smear, then we can hopefully treat that well before it gets to advanced stages and causes major issues elsewhere. Tertiary disease prevention is treatment to reduce complications from disease that's going on or having long-term effects. So a good example of tertiary disease prevention is chemotherapy. We use chemotherapy to try and reduce the complications of cancer. So if a patient has acquired cervical cancer, we can do certain types of treatments like chemotherapy to help reduce the risk of it spreading and growing. Then finally, our quaternary disease prevention. What is quaternary disease? This is where we avoid or quit unnecessary medical interventions to minimize causing harm to a patient. So imaging studies, reducing polypharmacy. So a lot of times if we have patients on multiple medications, that can actually cause some negative effects because some of those medications have side effects that can give other problems and then they need a medication for that. So we don't want to give patients too many medications due to that polypharmacy issue. So something to point out here with these to help you remember these. Primary has a P and we are trying to prevent. Secondaries S, we are screening. Tertiary starts with a T and that's to work on treating a disease and then quaternary is where we're quitting or avoiding unnecessary treatments. Let's continue on and discuss some insurance. These are some sometimes, insurance is sometimes a difficult topic to understand. You may have one question like this on your exam, but let's go ahead and get a good understanding of it right now. So we're going to discuss five different types of insurance plans and things that go along with it. So first we're going to talk about an exclusive provider organization, sometimes abbreviated as EPO. And what these are, they are organizations or health insurance plans that allows you to get healthcare services from specific doctors, hospitals, or other care providers that are in that particular network. It's only for authorized. So if you ever seek treatment with unauthorized providers, unless it's an emergency situation, they will not cover it at all period. That is one of the negative things about an EPO plan. Positive about it though, there do not require referrals to go see specialists. Health maintenance organizations, you've probably heard this called an HMO. That's a health maintenance organization. HMOs are similar to EPOs in a few areas and different in a couple others. They are basically a health insurance plan that's going to limit coverage to a particular network. That network will include doctors, hospitals, and other healthcare providers. Insurance will not cover the cost if you do go to an outside provider. So you want to always choose an HMO plan that is usable in your area or with your preferred physicians. One of the benefits of an HMO is that they do tend to save you money over a long period of time, especially if you're not using the healthcare system very much. They pay the physicians only based upon strict evidence-based guidelines. So if you get treatment that is not supported by the evidence-based medicine, then they will not pay for that medical treatment. One of the cons for an HMO is that it does require a referral. So that means you do have to go to your primary care physician to get a referral to go see a specialist. Alright, the next one we're going to talk about is point of service. Also abbreviated POS for point of service. Patients can see providers outside of the network here. These are good cost-saving plans for some people. They do have higher co-pays and deductibles for out-of-network services, but that does allow patients to see out-of-network providers. So if you're in an area where your preferred provider is in network with an HMO, but your specialty provider is out-of-network, you could go with a POS plan and be able to see your preferred specialty provider. If you do go out-of-network with a POS, then you do have higher co-pays and deductibles with those treatments there. It does, similar to HMO, it does require a referral from your primary care provider to see a specialist. A preferred provider organization, also known as a PPO, this is where you get a list of providers that are preferred by that particular insurance plan for you to visit. You can, however, see providers that are outside of the network. Once again, like the POS, that means you will have higher co-pays and higher deductibles for services with providers that are outside of your network. But a benefit that we do have here is you don't have to have a referral. So if you want to go see a dermatologist for a skin condition, you don't have to first go see a primary care provider to get a referral to the dermatologist. And then finally, we have our accountable care organization. These are groups of doctors that have voluntarily enrolled in these particular programs. These particular programs are specifically associated with Medicare. So doctors, hospitals, and other healthcare providers have voluntary come together so that they can give coordinated care with patients on Medicare. As far as specialists go, the specialists will also volunteer and enroll into this program. So you do not have to have a referral to that. You just have to go to one of the approved specialists.