The decision regarding when to see a doctor or other health care professional may vary, depending on whether the visit is for preventive care (routine visits), for medical problems, or for an emergency. (See also Introduction to Making the Most of Health Care and Using Telemedicine.)
Routine visits
Generally, everyone should routinely see their doctor, dentist, and eye doctor for preventive care. Women should routinely see their primary care doctor or gynecologist for gynecologic examinations. People can obtain a schedule of what type of care is required and how often visits are needed from their primary care doctor. Usually, infants and older people need more frequent preventive visits, but frequency also depends on a person’s health conditions. For example, a person with diabetes or a heart disorder (or risk factors for them) may need to have checkups and often testing relatively frequently.
Visits for a problem
When symptoms or other medical problems develop between preventive visits, people may be unsure whether they need to see a doctor. Many symptoms and problems can be handled at home. For example, most routine colds do not require a doctor’s attention or antibiotic treatment. Many small cuts and abrasions can be handled by first cleaning them with mild soap and water, then applying an antibiotic ointment and a protective covering (see Wounds: First-Aid Treatment).
People with certain disorders should see a doctor sooner rather than later when new symptoms develop. For example, if people with a chronic lung disorder (such as asthma or chronic obstructive pulmonary disease) begin to have difficulty breathing or if people with a weakened immune system get a fever, they should see a doctor promptly. The immune system may be weakened by diabetes, human immunodeficiency virus (HIV) infection, use of chemotherapy drugs, or other conditions. People with chronic disorders should discuss with the doctor in advance what new or changed symptoms should prompt a nonroutine visit.
When unsure about the need to see a doctor or other practitioner, people should call their primary care doctor for guidance. Some doctors can be contacted through an online portal or by e-mail for nonemergency questions. Others prefer to be contacted by telephone. Doctors cannot give all-inclusive guidelines for when a visit is necessary because symptoms with the same cause vary too much and symptoms with different causes overlap too much. However, some problems clearly require a call to a health care practitioner.
Some Reasons to Call a Doctor*
Problem | Reasons to Call |
|---|---|
Vomiting or inability to keep fluids down Painful swallowing Coughing that lasts more than 2 or 3 weeks or coughing up blood Earache Difficulty breathing Symptoms that last more than 7 days | |
Black or bloody stools More than 6 to 8 watery stools per day in children Symptoms that last more than 7 days Symptoms of dehydration (such as very dry mouth and armpits, confusion, and decreased urination), particularly in children and older people Abdominal pain or fever > 100.4° (38° C) | |
A feeling that food is stuck in the throat Development of or change in heartburn, particularly during exercise Frequent heartburn, belching, or regurgitation Persistent nausea or vomiting Persistent or severe abdominal pain Change in bowel habits Blood in the stools or black stool | |
General problems | Symptoms that prevent participation in usual activities, particularly new or worsened shortness of breath with exertion Unexplained weight loss Dizziness or an about-to-faint feeling Persistent fatigue, particularly if new Sweating not related to exercise, especially heavy or cold sweats |
Severe headache that peaks in intensity within seconds Memory loss or confusion Blurred or double vision Slurred speech Loss of balance or dizziness Seizures Numbness or weakness in an arm or leg or the face Nausea or vomiting with a new headache | |
Heart problems | Rapid or irregular heartbeats (palpitations) |
Leg problems | Pain in the calves that worsens when walking Swelling in the ankles or legs, particularly new swelling of one foot or leg |
No periods by age 16 Sudden stopping of periods A period that lasts much longer than usual or is excessively heavy A sudden feeling of illness while using tampons Severe or disabling cramps | |
Rash | Fever of 100.4° F (38° C) or above A rash that is painful, involves swelling, or oozes |
Swelling or redness in or around an eye Problems with vision | |
Moderate or severe abdominal pain Symptoms of dehydration, particularly in children and older people Green, black, or bloody vomit | |
* The list of problems and the reasons to call a doctor are only a small sample. | |
Visits to the emergency department
In general, true emergencies should be handled by calling 911 or the local emergency service to provide ambulance service to the nearest hospital. However, deciding what qualifies as an emergency is sometimes difficult because symptoms vary greatly. Learning as much as possible about symptoms of life-threatening disorders (such as heart attack and stroke) in advance is useful, and good judgment is often required. If the problem seems possibly life threatening, the emergency department is the place to go. The following examples clearly require a visit to the emergency department:
Signs of a heart attack, such as chest pain, shortness of breath, and dizziness
Signs of a stroke, such as sudden muscle weakness, paralysis, abnormal or lost sensation on one side of the body, difficulty speaking, confusion, problems with vision, sudden dizziness, loss of balance and coordination
Heavy bleeding
Burns that are open, char, or blister the skin; that result from inhalation; that cover a large area; or that are on the hands, face, feet, or genitals
Severe injury (as in a motor vehicle accident)
Poisoning that causes symptoms (if symptoms are minor or do not develop, the poison control center can be called first at 800-222-1222 for advice)
Signs of shock, such as dizziness, confusion, and cold, clammy skin
Sudden, severe pain anywhere
Vomiting blood or coughing up a relatively large amount of blood (more than a few streaks in sputum)
Sudden, severe worsening of a serious chronic disorder, such as asthma or diabetes
Going to the emergency department for less serious problems may be appropriate when the person's primary care doctor is unavailable, such as during weekends or during the night. However, emergency department personnel may be unfamiliar with the person's medical history, and periodic crowding may mean long waits to see a doctor. In some health insurance plans, calling the primary care doctor first may be required in order to be reimbursed for a visit to the emergency department, unless symptoms suggest a life-threatening disorder. People should know the requirements of their insurance plan before an emergency develops.
