Amanda Wilde (Host): A look at navigating primary care, urgent care, and the ER on this episode of Curating Care, a podcast brought to you by St. Clair Health, expert care from people who care. I'm Amanda Wilde, and joining me is Dr. Amanda Hercules-Smith, Medical Director of St. Clair Health Urgent Care. Dr. Hercules-Smith, it's great to have you.

Amanda Hercules-Smith, MD: Thank you. Thank you for having me as well. Thank you.

Host: Thank you for being here. To know a little more about you, can you describe your role at St. Clair Health as Medical Director of Urgent Care?

Amanda Hercules-Smith, MD: Absolutely. So, I have been with St. Clair Health for about eight years. I took over medical directorship of the urgent care facility. I'm also a primary care provider within the St. Clair Medical Group. And with the urgent care, I am responsible for some day-to-day operations, but mostly for maintaining the quality of care and the standard of care that is synonymous with St. Clair Health System provides. Most recently, we've also introduced our express care.

Host: You've had several roles in the field. Just one more personal question. What drew you to this field of medicine and internal medicine?

Amanda Hercules-Smith, MD: So internal medicine in particular, interesting story, I thought when I graduated from medical school I was going to be—actually, when entering medical school, I thought I was going to be a pediatrician. But I was drawn to internal medicine as I felt that I would be able to see a range of ages. I was able to take care of patients from 18 to 100 plus and manage chronic medical conditions. That was exciting for me. And the flexibility with internal medicine, being able to do both inpatient and outpatient care and follow patients through a continuum, I think that's probably why I chose the specialty I'm in.

Host: And you're a primary care provider as well as medical director of urgent care. Why is having an established primary care provider so important for a patient's long-term health? And what types of concerns are best managed through primary care versus same-day care settings?

Amanda Hercules-Smith, MD: So, your primary care provider should be the navigator for your healthcare. It should be the quarterback. And so, your primary care provider should be your first portal of entry into the health system, the person who is managing your chronic conditions, diagnosing new conditions, providing appropriate referrals. I might be biased, but your primary care provider is really the most important contact that you should have for your healthcare, the person who you would build that long-term relationship with.

Host: Right. And you described your end of that following people through chronic illnesses or, you know, through adulthood and through end of life. That goes both ways. Along with a vast primary care network, St. Clair Health offers express care and urgent care services. Can you explain the difference between the two?

Amanda Hercules-Smith, MD: Yeah, absolutely. So at the express care, it is quick access for common medical conditions such as common illnesses, urinary tract infections, flu-like illnesses, upper respiratory infections, common skin conditions that can be treated fairly quickly.

Urgent care, slightly more complex, where we can treat injuries, fractures, do certain procedures. And so, at the urgent Care, we also treat upper respiratory infections, UTIs, screen for certain conditions. But I think the acuity of care is slightly higher at the urgent care. And at the urgent care, we're also able to offer imaging, X-ray imaging, and point-of-care testing.

Host: You've just described some of the most common conditions you see in express care and urgent care. Are there other capabilities or services available that patients may not realize?

Amanda Hercules-Smith, MD: So at our urgent care, we also offer treatment of migraines, and we also offer IV fluids. We offer nebulizer treatments, which would not be traditionally found at every urgent care or express care. Absolutely.

Host: And when should someone seek care at the emergency room instead of express care or urgent care? Are there certain warning signs patients should never ignore?

Amanda Hercules-Smith, MD: Absolutely. So, things like chest pain, shortness of breath, head injuries, trauma, severe bleeding should be seen at the emergency room. Something that's life-threatening should definitely go to the emergency room rather than express care or urgent care.

Host: Patients today value convenience and flexibility. How do online reservations, walk-in availability, and telemedicine options help improve the patient experience?

Amanda Hercules-Smith, MD: Absolutely. So, healthcare should fit into our lives. And so at both express care and urgent care, we have walk-in capability and we have online reservations, making it convenient for patients, which, in our system, we try to accommodate as much as possible. We want you to have access to care when you need it at the time that you need it.

Host: How are express care and urgent care connected to the broader St. Clair Health System if a patient needs follow-up or specialty care?

Amanda Hercules-Smith, MD: Absolutely. At express care and urgent care, we're able to appropriately refer patients and connect patients to the primary care network and to specialty clinics. Conveniently, we see a lot of injuries. And so, our orthopedic clinic has walk-in hours, which is available to our patients. And so, being established in the express care or urgent care enters you into the system, making access to specialty care easier.

Host: So, you are then part of the network.

Amanda Hercules-Smith, MD: Absolutely.

Host: What advice would you give someone who may be delaying care because they're busy or just unsure of where to go? It seems a little nebulous, so we sort of just try to move on.

Amanda Hercules-Smith, MD: Yeah. Do not wait. Do not delay care Do not wait until a problem becomes a bigger one. Most of these conditions can be treated very easily at express care or urgent care or even in the primary care network before they become a serious problem. And the reason for the express care and the urgent care is that you have access all the time. We also have our emergency room, but the express care and urgent care, easy walk-in, low wait times, and very competent medical providers.

Host: Where can people go to learn more about their care options or to find a primary care provider?

Amanda Hercules-Smith, MD: Yeah. So, on the St. Clair website, We certainly have the list of primary care providers. Even just calling the express care or urgent care, we do have capability to help refer patients to the appropriate providers One of the advantages of working within the St. Clair Health network is that I feel like we have a provider for everyone.

Host: Lastly, Doctor, if listeners take away one thing from today's conversation, what would you want them to remember?

Amanda Hercules-Smith, MD: St. Clair Health is here for you. Whether you have an established primary care provider, whether you see a specialist within the system, we have care options. We're here to take care of you. Hence, the reason we have express care and urgent care facilities that are available to you to receive care when you need it. And so, that's our biggest takeaway, is that we're here for you, and you do not have to be established within our system to receive appropriate care

Host: Dr. Hercules-Smith, that is very reassuring. I really appreciate today's conversation about navigating primary care, urgent care in the ER so we can be better prepared and know where to turn when we need these services. Thank you for all you do for our community health.

Amanda Hercules-Smith, MD: Thank you. Thank you for having me.



Host: That was Dr. Amanda Hercules-Smith. For more information, go to stclair.org. If you enjoyed this podcast, please share it on your social channels and check out the entire Curating Care library for topics of interest to you. Thanks for listening to Curating Care, brought to you by St. Clair Health.