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 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. 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 First Aid: 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.

When unsure about the need to see a doctor or other practitioner, people can sometimes call their primary care doctor for guidance. Some doctors can be contacted by e-mail for nonemergency questions. Others prefer to be contacted by telephone. Doctors cannot give set guidelines for when to see a doctor and when it is unnecessary 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.

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Some Reasons to Call a Doctor* Problem Reasons to Call Cold or influenza Vomiting or inability to keep fluids down Painful swallowing Coughing that lasts more than 2 or 3 weeks Earache Symptoms that last more than 7 days Diarrhea Black or bloody stools More than 6 to 8 watery stools in children Symptoms of dehydration (such as very dry mouth and armpits, confusion, and decreased urination), particularly in children and older people Digestive problems A feeling that food is stuck in the throat Development of or change in heartburn, particularly during exercise Frequent heartburn, belching, or regurgitation Persistent or severe abdominal pain Persistent nausea General problems Symptoms that prevent participation in usual activities Unexplained weight loss Dizziness or an about-to-faint feeling Persistent fatigue Sweating, especially heavy or cold sweats Headaches 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 in the arms, legs, or face Nausea Heart problems Rapid or galloping heartbeats (palpitations) Chest pain Leg problems Pain in the calves that worsens when walking Swelling in the ankles or legs Menstrual problems 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 Sinusitis Swelling or redness in or around an eye Problems with vision Vomiting 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. Some Reasons to Call a Doctor* Problem Reasons to Call Cold or influenza Vomiting or inability to keep fluids down Painful swallowing Coughing that lasts more than 2 or 3 weeks Earache Symptoms that last more than 7 days Diarrhea Black or bloody stools More than 6 to 8 watery stools in children Symptoms of dehydration (such as very dry mouth and armpits, confusion, and decreased urination), particularly in children and older people Digestive problems A feeling that food is stuck in the throat Development of or change in heartburn, particularly during exercise Frequent heartburn, belching, or regurgitation Persistent or severe abdominal pain Persistent nausea General problems Symptoms that prevent participation in usual activities Unexplained weight loss Dizziness or an about-to-faint feeling Persistent fatigue Sweating, especially heavy or cold sweats Headaches 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 in the arms, legs, or face Nausea Heart problems Rapid or galloping heartbeats (palpitations) Chest pain Leg problems Pain in the calves that worsens when walking Swelling in the ankles or legs Menstrual problems 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 Sinusitis Swelling or redness in or around an eye Problems with vision Vomiting 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 (see Coronary Artery Disease: Symptoms)
• Signs of a stroke (see Stroke (CVA): Hemorrhagic Stroke)
• 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 (see Allergic Reactions and Other Hypersensitivity Disorders: Anaphylactic Reactions)
• Shock (see Shock)
• 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 primary care doctor is unavailable, as on weekends or during the night. In some health insurance plans, calling the primary care doctor first is 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.

Last full review/revision May 2007 by Marjorie A. Bowman, MD, MPA