When to See a Doctor

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.

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.

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

• Difficulty breathing

• 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)

• A severe allergic reaction

• 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.