Taylor Ledden McMaster (Host): Hello, listeners. Thanks for tuning into the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Taylor Ledden McMaster. Joining me today is Liberty Erfe, Director of Population Health at Riverside Healthcare. She's here to talk about when to go to the emergency room versus immediate care versus primary care.

 Before we get into today's episode, we're going to take a quick break for a message about MyChart.

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Host: And we're back. So, Liberty first, can you briefly introduce yourself and your role in population health?

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Yes, Taylor. Thank you for inviting me to do this. I am Liberty Erfe. I started at Riverside in the year of 2000 in telemetry unit. I started as a certified nurse assistant, staff nurse, and then a team leader. So that is my home base is telemetry unit. I also work on various leadership roles within the organization. So I became the manager of population health department in 2022, and now as a director of population health. So in my role, I design and implement key population health priorities, and I also work on programs and interventions targeted to the right patients to improve quality and cost of care. I also help drive initiatives that identify high risk populations and implement evidence-based care management interventions.

Host: Fantastic. So you've been through a lot of different places, so you know quite a bit about our healthcare organization here, which is why I think you're the perfect person to have this conversation with.

Can you explain the general differences between the emergency room, immediate care, also known as urgent care and primary care?

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Sure. So emergency room is the part of the hospital, the most accessible part of the hospital where life-threatening conditions are triaged and evaluated firsthand. So an immediate care facility is a medical center providing prompt walk-in services for non-life threatening illnesses and minor injuries without the need for an appointment. So these centers bridge the gap between a primary care doctor's office and an emergency room. So offering convenient care for conditions like colds, flu, sprains or small cuts, often with extended hours and lower costs than emergency room.

Did you know that you can also go to immediate care for school and sports physical? And to reiterate also, they see patient 18-months and up.

And for primary care, this is a facility within a healthcare setting that serves as a patient's first point of contact for general health needs. This includes preventative services, common illnesses, and chronic condition management.

Host: Fantastic. Thank you for giving that description. So with that in mind, why would you say it's important for patients to know where to go before a medical issue arises?

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: I'm glad you asked that because it's part of our very big, huge initiative to know the differences of these three different services that we provide at Riverside.

So it is important for patients to know where to go before a medical issue arises, to enable rapid and informed decision making, and this is also to ensure continuity of care and improved health outcomes. So having a plan in place minimizes the stress and confusion during a medical crisis, and especially when emotions run high and every second counts.

Host: Yeah, no doubt. So what are some clear warning signs? This is kind of a broad question, but clear warning signs that someone should head straight to the emergency room.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Yes, so definitely chest pain. When you're experiencing chest pain, go to emergency room. Sudden confusion, a facial droop, sudden weakness at the left or right side of your body. Head trauma, severe uncontrolled bleeding, difficulty breathing, and of course severe abdominal pain. Head to emergency room right away.

Host: Okay. Yeah, that's really helpful to know. So conversely, what are some kinds of situations that are better suited for immediate care over the ER?

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Yes, so when you need to see a medical provider today, but your regular doctor is not available, go to immediate care.

When you have a minor illness or injury that requires prompt medical attention, go to immediate care and when your symptoms are not severe enough to be considered an emergency, but cannot wait for a routine appointment with your primary care physician head to immediate care, definitely. And also note again, the immediate care only sees patient 18-months and older.

And to just be specific with some symptoms that you might have to be suited for immediate care would be minor cuts and burns, sprains and strains, urinary tract infection, cold and flu symptoms, minor upset stomach, headaches, back pain, pink eye and ear ache.

Host: So same question, but for primary care, what kinds of things can wait for those appointments?

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Yes. So in primary care, we all know that this is a continuous coordinated care from a team of providers like our doctors, nurse practitioners, and physician assistants. This basically access a patient's home base for wellness and provides referrals to specialists when needed.

Host: Fantastic. So on that note, before we continue our conversation, we're going to talk quickly about the importance of primary care. 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 Riversidehealthcare.org/primarycare. From annual screenings to well checks and everything in between, having a primary care provider that you can trust makes all the difference.

And we're back talking about the differences between the ER, immediate care and primary care. How might going to the wrong type of facility impact a patient's treatment, what they're paying and the time in between getting access to care?

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Yes. I'm glad you asked that Taylor because delaying accurate diagnosis and necessary treatment, incur higher and often unnecessary expenses and increase the risk of adverse health outcomes.

Host: Fantastic. Then how does seeking care in the right setting help reduce strain on the healthcare system as well as the patient?

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Yes. So seeking care in the appropriate setting helps reduce its strain in the healthcare system and the patient, by lowering costs, improving health outcomes, and maximizing the efficient use of the resources. For the healthcare system, it prevents the overuse of expensive high level services like emergency rooms for non-emergencies. So for patients, it actually leads to better care, higher satisfaction, and reduced out-of-pocket costs.

Host: Great. And now we're in 2025. It's a digital era. What role does Telehealth play in making this decision?

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Okay, so when home is where you want to be, get care from virtually anywhere with Riverside's telehealth, video visits. We know that telemedicine visits are available only in Illinois for adults and children, ages two years and older.

So our healthcare professionals will ensure you receive the same great care whether through telehealth or in-person.

Host: Awesome. Great. Now to end our conversation, we're going to play a little rapid fire game. I'm going to give you a symptom or situation and you're going to tell me whether that is something for the emergency room or ER, immediate care, or primary care. So chest pain that came on suddenly.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Emercency room.

Host: Yes, and everyone should know that if you were listening earlier. High fever and a stiffneck. Sore throat for three days. Deep cut that won't stop Bleeding.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Emergency room.

Host: Sprained ankle with mild swelling.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Immediate care.

Host: Rash that's spreading quickly. Sudden weakness on one side of the body.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Emergency room.

Host: Persistent cough for two weeks.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Primary care.

Host: Ear ache that started overnight.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Immediate care.

Host: Severe allergic reaction with difficulty breathing.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Emergency room.

Host: Pink eye symptoms.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Immediate care.

Host: Broken bone with bone, visibly poking through skin.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Oh my gosh. Emergency room.

Host: Yes. Migraine, that's not responding to over the counter medicine. Ongoing management of high blood pressure.

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Primary care,

Host: Minor burn from cooking,

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Immediate care.

Host: Thank you. That was, that was fun. And again, yeah, if you were paying attention at the beginning of this conversation, you should have been playing along too and getting those answers correct.

Is there anything else on this subject that you would like listeners to know about?

Liberty Erfe, DNP, RN, EBP (CH), CDP, CN IV: Yes, Taylor. I encourage everyone to get the health screenings they need to detect and prevent common diseases such as breast cancer, stomach or lung cancer, osteoporosis and diabetes, by talking to your primary care provider.

Any non life threatening conditions go to immediate care. And lastly, any severe life-threatening illnesses go to emergency room.

Host: Great. Well, thank you so much for your expertise and your time. We really appreciate it. And thank you listeners for tuning into the Well Within Reach podcast. Be sure to like and subscribe to Well Within Reach on Apple, Spotify, or wherever you get your podcasts.

To learn more about the services at Riverside Healthcare, go to riversidehealthcare.org.