What Is Specialized Healthcare?

One look on the internet for types of healthcare facilities and you can feel a bit overwhelmed. There are physicians’ offices, urgent care centers, outpatient clinics, ambulatory surgical centers, independent emergency centers, hospitals and several other settings to receive medical care. So when you are sick, how do you know which doctor to see and where?

Primary Care Doctor Versus Specialist

The doctor who will treat you fits into two categories: primary care provider (PCP) and specialist^[i]. A primary care provider is also known as a family practice doctor, internist, general practitioner or geriatrician (for older adults) who is trained in a diverse range of medicine and medical procedures. A PCP is your initial-level contact to see with your basic health needs and concerns. A specialist is a medical doctor who has completed additional training in a specific medical field such rheumatology, gastroenterology or dermatology.

Traditionally, your PCP is the gatekeeper of your overall health and is the one who will refer you to a specialist; however, a study published in the Journal of the American Geriatrics Society found that more than 30 percent of seniors with multiple chronic conditions consider their specialist as their main physician. Some health plans require you to see a PCP first before seeking specialized care.

Specialized Healthcare Centers

In recent years, the U.S. healthcare system has shifted to offer more niche medical programs that provide specialized healthcare. These medical programs are often referred to as centers of excellence^[ii] that focus on the same diseases, disorders or medical conditions with a team of the best and brightest medical specialists in their respective fields. For example, elite cardiologists collaborate on the latest research, treatments and surgery techniques for cardiovascular disease, or oncologists pool resources to offer patients premier treatment and disease management.

Healthcare centers of excellence are located typically within hospitals, medical campuses and medical schools, and concentrate on specific medical conditions including diabetes, pulmonology and orthopedics. Most urban areas have at least one in-demand center of excellence that treats patients from the region and surrounding states. For example, the Rothman Institute in Philadelphia is known as the center of excellence in hip, knee and joint diseases. In Phoenix, the Barrow Neurological Institute is internationally recognized in neurosciences. Patients who have contracted rare or deadly infectious diseases are often sent to the University of Nebraska Medical Center in Omaha.

For patients who need an even higher level of specialty care, a number of nationally known medical institutions such as the Mayo Clinic, Johns Hopkins Medicine, Cleveland Clinic and UCLA Medical Center treat multiple diseases and disorders. To review the best hospital and medical specialties nationwide and regionally, visit the 2018-2019 rankings by U.S. News & World Report.

Questions to Ask About Specialized Healthcare

When your health issues are beyond your primary care provider’s expertise, your primary care provider will usually refer you to a specialist. Here are suggested questions to ask of your primary care doctor about specialized care:

• Why do I need specialty care?
• May I choose the specialist or do I need to go with your recommendation(s)?
• What is the specialist’s background and expertise in treating my condition?
• What kind of services will a specialty center provide me?
• How much does care through a specialty center cost?
• Will my insurance/Medicare cover specialty care costs?
• What are other options for treating my health condition?
• How will you coordinate or be involved in my care with the specialist?
• What diagnostic testing is needed before seeing the specialist?
• Will your office assist me with getting an appointment with the specialist?

When it comes to choosing specialized healthcare, you may want to research a few specialists or centers of excellence in your area, and be sure to ask family and friends about doctors and facilities they have used and recommend.

19 Common Medical Specialty Doctors

The older we get, the harder it is to understand and remember all the various types of medical specialists and how they work with the body. Here is a list of the most common specialist doctors:

Allergy/Immunology – branch of medicine dealing with the immune system

• Specialist: allergist/immunologist (allergy doctor)
• Significant Health Conditions: immune system disorders, asthma, food allergies, eczema
• Possible Diagnostic Tests: allergy skin tests, allergy blood tests, food allergy tests

Anesthesiology – branch of medicine that administers surgery sedation or treats chronic pain

• Specialist: anesthesiologist, pain management specialist (put-you-out or pain relief doctor)
• Significant Health Conditions: surgery, chronic pain, hospice and palliative care
• Possible Diagnostic Tests and Procedures: medical history and pre-op evaluations, pain medicine injections

Cardiology – branch of medicine dealing with the heart and cardiovascular system

• Specialist: cardiologist (heart doctor)
• Significant Health Conditions: heart failure, heart attack, stroke, irregular heartbeat, coronary heart disease, high blood pressure
• Possible Diagnostic Tests and Procedures: echocardiogram, electrocardiogram (EKG), stress test, cardiac catheterization

Dermatology – branch of medicine treating the skin, mucous membranes, hair and nails

• Specialist: dermatologist (skin doctor)
• Significant Health Conditions: autoimmune diseases, chronic hives, dermatitis, genetic skin disorders, moles, skin cancers, skin infections, varicose veins, vasculitis
• Possible Diagnostic Tests and Procedures: allergy skin tests, mole removal, skin biopsies, Mohs surgery, laser surgery, scar revision, tattoo removal

Endocrinology – branch of medicine dealing with the endocrine system and hormone secretions

• Specialist: endocrinologist (hormone doctor)
• Significant Health Conditions: diabetes, thyroid disease, pituitary and adrenal disorders
• Possible Diagnostic Tests: thyroid function tests, blood sugar levels, 24-hour urine collection test, ACTH stimulation test, bone density test

Gastroenterology – branch of medicine dealing the digestive system

• Specialist: gastroenterologist (stomach doctor)
• Significant Health Conditions: acid reflux; ulcers; irritable/inflammatory bowel disease; hepatitis C; hemorrhoids; colon cancer; diseases of the pancreas, liver and gallbladder
• Possible Diagnostic Tests: endoscopic ultrasound, colonoscopy, sigmoidoscopy, liver biopsy

Gynecology– branch of medicine dealing the female reproductive system and genital tract

• Specialist: gynecologist (female doctor)
• Significant Health Conditions: urinary tract infections, overactive bladder, cervical/ovarian/uterine cancer, chronic pelvic pain, urinary/fecal incontinence
• Possible Diagnostic Tests: urine test, pelvic exam, breast exam, Pap smear, colposcopy, diagnostic laparoscopy, genetic testing

Nephrology – branch of medicine dealing with the kidneys

• Specialist: nephrologist (kidney doctor)
• Significant Health Conditions: kidney stones, polycystic kidney disease, diabetic nephropathy, kidney failure, renal disease, hypertension
• Possible Diagnostic Tests: blood pressure check, urine protein test, GFR (glomerular filtration rate) blood test, kidney ultrasound, kidney biopsy

Neurology – branch of medicine dealing with the nervous system (brain, spinal cord and nerves)

• Specialist: neurologist (nerve doctor)
• Significant Health Conditions: neurological diseases (dementia, Parkinson’s etc.), stroke, injuries to the brain and spinal cord, disc and nerve pain, seizure disorders
• Possible Diagnostic Tests: neurological exam, brain scan, genetic testing, CT scan, MRI, electroencephalography (EEG), electromyography (EMG), lumbar puncture (spinal tap)

Oncology – branch of medicine dealing with cancer

• Specialist: oncologist (cancer doctor)
• Significant Health Conditions: more than 100 types of cancer
• Possible Diagnostic Tests: cancer screening tests, CT scan, PET scan, biopsy, genetic testing

Ophthalmology – branch of medicine dealing with eye and vision care

• Specialist: ophthalmologist (eye doctor)
• Significant Health Conditions: vision changes, cataracts, eyelid abnormalities, bulging eyes, eye injury, excess tearing, eye pain, floaters or flashes of light, diabetes
• Possible Diagnostic Tests: complete medical eye exam, eye pressure testing, pupil dilation, ocular motility photography, corneal topography

Orthopedics – branch of medicine dealing with the musculoskeletal system (bones, joints, ligaments, tendons and muscles)

• Specialist: orthopedic surgeon/orthopedist (bone doctor)
• Significant Health Conditions: fractures, arthritis, bursitis, dislocations, spinal pain, joint pain, herniated discs, ligament tears, bone deformities, bone infections, bone tumors
• Possible Diagnostic Tests: x-ray, arthrogram (joint x-ray), bone scan, CT scan, MRI, discography

Otolaryngology – branch of medicine dealing with the ears, nose and throat

• Specialist: otolaryngologist (ears, nose and throat doctor (ENT))
• Significant Health Conditions: hearing loss, ear infection, balance disorders, ear noise, facial and cranial nerve pain, nasal allergies, sinusitis, nasal polyps, larynx (voice box) diseases, voice and swallowing disorders, snoring/sleep disorders, tumors, facial trauma, facial deformities
• Possible Diagnostic Tests: full ENT exam, ear otoscope exam, nasal endoscope exam, throat culture, x-ray, CT scan

Podiatry – branch of medicine dealing with ankles and feet

• Specialist: podiatrist (foot doctor)
• Significant Health Conditions: arthritis, injuries from accidents or sports, foot and ankle deformities, bunions, heel pain, diabetes complications, arch problems, ingrown toenails, swollen ankles/feet
• Possible Diagnostic Tests: x-ray, CT scan, bone scan, ultrasound, nerve conduction test

Psychiatry – branch of medicine dealing with mental and emotional disorders

• Specialist: psychiatrist (shrink, head doctor)
• Significant Health Conditions: depression, anxiety, bipolar and related disorders, personality disorders, eating disorders, addictive behaviors, suicidal thinking
• Possible Diagnostic Tests: psychological clinical assessment, neurological testing, blood tests

Pulmonology – branch of medicine dealing with the respiratory tract

• Specialist: respiratory physician, pulmonologist (lung doctor)
• Significant Health Conditions: asthma, lung cancer, tuberculosis, occupational lung disease
• Possible Diagnostic Tests: bronchoscopy, sputum study, arterial blood gas

Radiology – branch of medicine that reviews and interprets imaging tests, and treats conditions such as cancer

• Specialist: radiologist (imaging doctor)
• Significant Health Conditions: broken bones, tumors, cancer
• Possible Diagnostic Tests: x-ray, ultrasound, CT scan, MRI, PET scan

Rheumatology – branch of medicine dealing with rheumatic diseases

• Specialist: rheumatologist (arthritis doctor)
• Significant Health Conditions: osteoarthritis, rheumatoid arthritis, gout, lupus, autoimmune disorders, tendinitis, chronic back pain
• Possible Diagnostic Tests: laboratory tests to assess inflammation and/or extra antibody production within the blood, x-ray, ultrasound, CT scan, MRI

Urology – branch of medicine dealing with the male reproductive system and the male and female urinary tract

• Specialist: urologist (urinary doctor)
• Significant Health Conditions: urinary tract infection, kidney stones, urinary incontinence, overactive bladder, erectile dysfunction, prostate cancer, testicular cancer, bladder cancer, kidney cancer
• Possible Diagnostic Tests: urine culture, ultrasound, ureteroscopy, cystography, CT scan, biopsy

^[i] Should Your Primary Care Physician Be a Generalist or a Specialist? New Study Sheds Light on Benefits vs Costs. (n.d.). Retrieved from http://www.healthinaging.org/blog/should-your-primary-care-physician-be-a-generalist-or-a-specialist-new-study-sheds-light-on-benefits-vs-costs/

^[ii] Centers of Excellence in Healthcare Institutions: What They Are and How to Assemble Them. Elrod, J.K., Fontenberry, J.L., (2017). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5516836/