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Intro: Riverside Healthcare puts the health and wellness information you need well within reach.

Terry Streetman (Host): Welcome back to Well Within Reach, brought to you by Riverside Healthcare. I'm Terry Streetman, Marketing Communications Representative. And we're here today with Liz Deck, an advanced practice provider with Riverside Medical Group, Internal Medicine Bourbonnais. We're going to talk today about primary care and learn about the different types of primary care providers. Thanks for joining us, Liz.

Liz Deck: Thank you for having me.

Host: Absolutely. Before we get into our questions, we'll take a quick break for a message about myChart.

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Host: Okay, we're back. Welcome to the podcast again, Liz. Can you tell us and our listeners a little bit about your background and your role here at Riverside?

Liz Deck: Certainly. I'm happy to do that. I have been an advanced practice provider since 2004, and have practiced Internal Medicine since that time. I work in Bourbonnais Internal Medicine. I see patients aged 18 through 104. It's a very busy practice, a very enjoyable practice. As a primary care provider, I am able to help the patients with their annual exams, answer their questions about immunizations, order their lab work, any x-rays that they may have, and get back to the patient regarding the results of their information.

Host: Okay.

Liz Deck: So, it's a great profession. It is a great opportunity to interact with people. I also precept student nurse practitioners, so they get the opportunity to have that full patient experience in their clinical rotations.

Host: That's great. Okay. So, I guess we'll start with the basics here. Just in general, what is a primary care provider and why is it so important to have one for overall health?

Liz Deck: It is so important to have a primary care provider for your overall health. This is the person who can conduct your annual exam, the person who orders your lab work, answers your questions, gets you to a specialty provider in the event that there's a need such as orthopedics or heart or neurosurgery or anything of that nature that primary care just does not handle. This person works on keeping immunizations up-to-date; again, works on referral sources and is there through myChart to answer questions of a non-emergent nature; answer phone calls of perhaps maybe a more emergent nature that we need to get the patient in that day or very soon to be seen for their questions and their physical needs. We also work on mental health issues that the patient may have if we're able to prescribe medications they need or get them referred to counseling or psychiatry if need be.

Host: Okay. Well, it sounds like I've heard it described in some ways as like the quarterback for your healthcare, really helping to lead you in the right directions for all the things you need, and that feels really important

Liz Deck: And that's what we want to do. We want to help guide the patient. We know the patient often is on the internet looking up their own information. We sometimes want to make sure what the patient has Googled about their healthcare and what their interpretation is or their understanding. And if we need to correct that, we're able to get that done.

Host: Well, that's great. That's really important for folks who want to maintain their health. And so, we've kind of talked about some of these things, but what would you say are the long-term benefits of building that relationship over time with a primary care provider, rather than using urgent care or telehealth or, I guess, Google.

Liz Deck: Correct. We want to be able to talk to the patient, develop that relationship. That is really, really important to develop that relationship of trust and confidence and overall knowledge base to have the patient understand and be assured that they're going to get the correct information from their primary care provider. Immediate care is a wonderful thing. They do a great job of taking care of our patients and generally they're singularly focused. There's one singular problem that they can address for the patient. Maybe they have questions about an upper respiratory infection or a cough, or something that just requires immediate care. And the primary care provider then does a different task of overall reassurance, confidence, knowledge base, and helps the patient understand that they're there for them through the lifecycle.

I've had many patients for 15 years. So, it's great to establish that relationship to be able to be there to answer the questions, to see them on a routine basis. Many patients have longer term needs related to chronic conditions, such as diabetes, high blood pressure, cholesterol issues, depression, anxiety, low back pain, whatever the situation is. So, we need to be there for our patients on a regular basis and see them for chronic conditions so that chronic condition does not get out of hand. And we find a lot of satisfaction and we think the patient does also with their ability to contact their primary care provider and then get the answers they need to go forward.

Host: That's great. Yeah, I think that that understanding of those long-term issues and how they interact with each other, like you're not going to get that from immediate care. So, when it comes to that kind of care, then with a primary care provider, there are a lot of different terms that maybe people don't understand. Can you explain to us the differences between Family Medicine, Internal Medicine, and Pediatrics, and how someone knows which one is right for them and their family?

Liz Deck: Sure. Family provider, whether that be a physician or a nurse practitioner is able to cover the lifecycle. So from newborn through advanced age is a primary care provider in a family practice. Internal Medicine covers patients who are 18 years old or older throughout the adult lifecycle. Pediatrics covers newborn through age 18. And sometimes the pediatrician will see the patient a little bit older than that, and then refer them to either family practice or Internal Medicine.

Host: Okay. That is really helpful. Because I'm sometimes not sure on that myself. Okay. So, you talked about this, you touched on a little bit. How does a primary care provider then help manage those chronic conditions, the diabetes, the high blood pressure, the asthma, and that coordinating role you talked about with specialty providers?

Liz Deck: We have continuing education requirements, and that continuing education office gets us more interested in certain specialties. I know my specialty is that of diabetes, where I have two certifications in diabetes management and education and training for the patient with diabetes. So, to get that patient where they need to be requires a lot of education and continuing education so that we know the latest advancements. We obtain periodicals that we read on our off-time from not being in the office, where there's a lot of information online. As far as continuing education, many times our continuing education hours are done online, so we have the latest advancements in the management. I know, I don't practice diabetes like I did six months ago, so it's all about keeping up. It's all about looking at the latest guidelines. It's all about understanding the role of how medications interact with the patient and how the patient's going to react to the medications that we give them. We have to look a lot at affordability of the medications, no matter what the chronic condition is, whether it is chronic obstructive pulmonary disease, asthma, diabetes, high blood pressure, and so forth. The patient might see something on television, but it might not be quite the right drug for them.

So, we want to make sure we have picked the right medication that is affordable for the patient and that it agrees with the patient. And if not, certainly see the patient within three to four weeks again in the office just to make sure that they're getting along well.

Host: Yeah, that role of sort of a funnel for all the information and sometimes misinformation out there, I can imagine is a pretty big part of that role.

Liz Deck: A lot of commercials have to do with being on a cruise or being at a party and looking to see that everything is wonderful with all their friends, and life is not that way. So, we want tomake sure there's a clearer understanding of how this medication's going to work and help control of, we'll say, diabetes and have them with an understanding that they're going to get along well with the medication. Or if not, or not affordable, we switch them to something else.

Host: Well, that's a great role to play. We're going to talk a little bit more about this. But before our next question, we will take a break to discuss-- of all things-- the importance of primary care.

 Consistency is being able to count on someone to be there when you need them. At Riverside Healthcare, your primary care provider is dedicated to being in your corner, helping you and your family stay healthy and thrive. Find the right primary care provider for you at myrhc.net/acceptingnew. From annual screenings to well checks and everything in between, having a primary care provider that you can trust makes all the difference.

Okay, so we're back. Our next question here, could you explain what MD, DO, NP or PA mean? A lot of letters in there, and break down those roles of physicians versus advanced practice providers in primary care?

Liz Deck: We'll do our best, okay, for that question. An MD is a medical doctor. Someone who has a bachelor's degree, has gone four years to medical school. The last two years of that are into some clinical rotations. So, they can see all about healthcare and what goes on. Their residency program might be from three to eight years in to become a doctor and then to look at a specialty in their chosen field. And then, some others pursue a fellowship such as Neurosurgery or Cardiology or whatever the specialty is, so that they are more ingrained in that specialty and have the knowledge and training in that subspecialty.

DO is a doctor of osteopathic medicine. They have a holistic, patient-centered approach, including osteopathic manipulation treatment of approximately 200 hours within their training. So, that is the difference. They're both considered physicians, both are on staff at Riverside. And we treat them equally.

Host: Absolutely.

Liz Deck: Physician assistant, this is a bachelor's prepared for four years, and then a master's prepared person. So, they both have a bachelor's and a master's degree. Their education is probably totaling six to eight years. And they work under the supervision of a physician. They're able to work independently in the office. And then, the physician is able to approve their work independently. So, it's a great role. They are considered laterals to nurse practitioners.

 Nurse practitioner and NP, I'm a family nurse practitioner, so I could see patients throughout the lifecycle. I've chosen Internal Medicine, so I see patients 18 years through the adulthood. And I have a four-year bachelor's prepared education as well as a master's degree. And I do have a doctorate also, doctorate of nursing practice called a DNP. So, I've got a whole bunch of initials after my name, particularly with the diabetes certifications also. So, again, our role as a nurse practitioner can be certainly that of a primary care provider. You'll find nurse practitioners also in other specialties too throughout Riverside. So, that's a great thing.

Host: Yeah. And that helps, I think, break down sometimes. There's all those letters after the name and not sure what that means, but I think we've covered a lot of those that can help people. So, we've talked about there the difference between physicians and advanced practice providers. Are there things physicians can do or provide that, say, NPs can't? And what limitations should patients be aware of?

Liz Deck: Physicians can do surgery. So, nurse practitioners, physician assistants certainly could assist in a surgical procedure but cannot do the surgery. So, physicians can do surgeries. There are some laws too as to what physicians can sign versus what nurse practitioners cannot. But those are generally being overridden as time goes by. So, nurse practitioners and physician assistants have more privileges as time goes by, such as signing for home care orders. We could never sign for home care orders. And then, came the pandemic and our Illinois governor said, "Yes, nurse practitioners and physician assistants can sign for home care." And that was never rescinded. So, we're just delighted for the changes in the laws. As we are the primary care providers for our patients, we're able to provide those home care orders without delay.

Host: Oh, that's great.

Liz Deck: So that's a very, very valuable. accomplishment. So, we're still looking for things that positive that came out of the pandemic, and that was one of them.

Host: Okay. Again, something we've touched on a little bit, we'll see if you have more that you want toexpand on as far as the training and education that physicians undergo compared to NPS or PAs before they begin practicing primary care.

Liz Deck: We have an extensive orientation for our nurse practitioners and physician assistants at Riverside, so we're delighted. We have 12 weeks of an orientation period where they're enculturated in Riverside so they can go to different areas other than where they're going to practice and see what goes on, which is very, very valuable because they're going to be able to refer their patients if they know the services that are available.

And then, our nurse practitioners and physician assistants are prepared with a preceptor or a mentor throughout further time. And there's always times. There's certainly providers within the office of where they're working to ask questions. Again, you can go to your mentor, your preceptor to ask questions. There's others you can certainly call or refer to, ask your questions, get your question answered, and take good care of your patient. So, we want to keep that going for our nurse practitioners and physician assistants within Riverside, that they've always got somebody that they can ask, including their collaborating physician. So, that is a great resource for nurse practitioners and physicians to have here at Riverside and to be able to ask other people.

I've seen physicians also themselves when they have questions to be able to reach out, and I've done this too to our laboratory physicians or to our physicians in interventional or diagnostic x-ray. If we have questions, we're able to call them up or send them a secure message through our phone and ask them questions. So, we're always looking for answers. We're always looking for the right sources to get our answers from, and we have very reliable sources at Riverside to be able to ask those questions. Whether a physician or nurse practitioner or physician assistant, we can get that question answered. But we do have to reach out and there's nothing wrong with that. We got to get the right answer.

Host: Yeah. Well, and it's great to make use of this whole system that we have with all of the different services that we provide here at Riverside, that collaboration, which kind of leads into our next question of how specifically physicians and advanced practice providers collaborate in that primary care setting, and the level of care that patients can expect from both.

Liz Deck: Absolutely. As a primary care provider, I get to look at what does the patient need as are there situations related to their heart that they need to see a cardiologist? So then, I will refer the patient to the cardiologist for that next visit, and then have the patient come back to me on a timely basis and we get those questions answered again and make sure we've covered the lab work, make sure we've covered any cardiac questions. I go back to the note of, we'll say the cardiologist, and make sure those questions are answered with my patient. So, we work in a collaborative setting where as a primary care provider, I may not be able to meet all the needs of my patient, but I know where to refer them and to make sure those questions get answered and that the very best care is given to the patient for that need.

Host: Okay. Well, that's a great collaboration there. And I think further drives home that team element, that there's this whole team of people providing care and backing the care that you're receiving as a patient.

Liz Deck: And it's not just Cardiology. It might be Orthopedics, it might be Neurosurgery, it might be Neurology. It might be Nephrology, Urology. It depends upon what does the patient need. And where do they need to go? And maybe the patient's got an idea of, "I need to see this person." It's like, "No, that's not the right person. Let's get you to the right person." And this is the reason why.

Host: Okay.

Liz Deck: So, we always give the why. Why does this have to happen? Why is this occurring? These are the results. This is where we're going to get you next, and you've taken care of that. And there are times too where we say we have to get the patient to a blood doctor or a cancer doctor. So, those are Oncology, Hematology physicians, and of which we have a great team at Riverside. And many times with our questions, we'll get the patient there, and the physician's able to answer the questions. Look at the lab work that was done and then say you don't have to come back anymore. So, that's always real nice, just to get that assurance, "Yes, this is what it is. We can follow it." Or if we see you every six months, or if we see you every year, we'll follow your lab work and you can continue to see your primary care provider. So, every once in a while that does happen too.

Host: Nice. Yeah. Well, that's great. Okay, so we're getting toward the end here. And so, we've talked about all these different areas of care and the different providers. If somebody is looking for their first primary care provider, what kind of question should they be asking? What qualities should they look for? What advice do you have for them?

Liz Deck: Good question. A lot of people will turn to the internet and look at the ranking or the quality that patients have given before. And we're very appreciative of Riverside's information that goes out from each one of us regarding our patient care. So, I think location is huge. If you're in the area, certainly look for somebody local, or where you can drive to the facilities if we have to refer you to physical therapy or some other type of testing, to be able to make sure you're local to your primary care provider, that they are a phone call away, an email away, how can you best find that person to get along with, make sure you have a good understanding of what they're looking for, that they have come up with a plan for your care, that they've covered all the bases of your medical needs, that they've answered all your questions, and particularly that they took time to listen to you to have an understanding of your needs and to come up with a timeframe to address particularly your chronic issues.

Host: Well, that drives home kind of the name of the podcast, Well Within Reach. Riverside has all these folks close to where you are. And I think also a great reminder if you have a provider that you like or that you would recommend provide those reviews online that helps other people find these great providers.

Liz Deck: Absolutely. That's great.

Host: Okay. Well, we are at the end here. Thank you so much again for joining us today, Liz. We really appreciate your info.

Liz Deck: Thank you so much for having me.

Host: Absolutely. To learn more about primary care at Riverside, folks can visit myrhc.net/primarycare. If you're looking to find a primary care provider right now, visit myrhc.net/acceptingnew or call 855-404-DOCS. That's 855-404-3627. Thanks for tuning into Well Within Reach, presented by Riverside Healthcare. Please take a moment to rate and leave a review for the podcast on Apple, Spotify, or wherever you get your podcasts. And to learn more about Riverside, visit riversidehealthcare.org.