When to see a Family Physician?
There is a common confusion: the Family Physician is seen as a "gateway" — someone who refers you to the real specialist. That is not the case. They are the specialist of the whole: the professional able to resolve most of a person's health needs throughout life, and to coordinate when another specialist is, in fact, necessary.
But in practice, when should you see a Family Physician?
Situations in which the Family Physician is the right choice
- New symptoms with no defined cause: pain that persists, fatigue, changes in sleep, changes in weight. Before knowing which specialist to turn to, it is the Family Physician who investigates and guides.
- Chronic diseases: hypertension, diabetes, dyslipidemia, hypothyroidism, asthma, anxiety, mild to moderate depression. Most can be well managed in a family practice, with longitudinal follow-up.
- Prevention and evidence-based check-up (vaccines, screenings, lifestyle).
- Family health: caring for the couple, the children and the elderly parents with a single reference physician simplifies and improves care.
- Care coordination: if you already see several specialists, it is the Family Physician who gathers the reports, avoids duplicate tests, identifies drug interactions and keeps the overall picture in view.
- Mental health at the primary level: anxiety, sleep, grief, everyday emotional distress — it does not always require a psychiatrist.
When the focal specialist is more appropriate
- Specific and complex single-organ diseases (oncology, elective surgeries, advanced management of autoimmune diseases, etc.).
- Specialized invasive procedures.
- Conditions refractory to management in primary care.
Even in these cases, having a Family Physician alongside shortens paths, avoids repeated tests and helps make more informed decisions.
When to go to the emergency room
The ER is for urgency and emergency: intense chest pain, sudden shortness of breath, signs of stroke (facial droop, weakness in an arm or leg, slurred speech, sudden loss of vision — in Brazil, call SAMU 192), active bleeding, significant trauma, very high fever in a small child, severe loss of control of a chronic disease. It is not for resolving a symptom of weeks. Many conditions that lead to the ER could have been cared for earlier, in a clinic.
New or persistent symptom for days/weeks, without warning signs
- Where to go
- Family physician (scheduled appointment)
Hypertension, diabetes, asthma, anxiety, mild to moderate depression
- Where to go
- Family physician, with continuous follow-up
Prevention: vaccines, screenings, lifestyle
- Where to go
- Family physician
Facial drooping, weakness on one side, slurred speech, sudden vision loss
- Where to go
- Emergency services (192) or ER, immediately
Severe chest pain, sudden shortness of breath, active bleeding, major trauma
- Where to go
- Emergency services (192) or ER
Complex single-organ disease, surgery or specialized procedure
- Where to go
- Focal specialist, with referral and coordination by the family physician
The biggest difference
The difference between having a Family Physician and not having one lies less in a specific appointment, and more in what happens in the months between one appointment and the next. Having someone who knows your history changes the way you are cared for.
If you do not yet have this physician — perhaps it is time.
Frequently asked questions
What does a family physician do?
The family physician cares for the whole person, at every age and over time: investigates new symptoms, follows chronic diseases, guides prevention and vaccines, and coordinates referrals when another specialist is needed. A classic study of US data (NEJM, 2001) estimated that, for every thousand adults in a month, about 113 visit primary care, while 13 go to an emergency department.
What is the difference between a family physician and a general practitioner?
In Brazil, Family and Community Medicine is a medical specialty, with its own residency and board certification. The family physician sees people of all ages, considers the family and community context and is dedicated to continuous care in the office and at home. The term “general practitioner” is often used for physicians without specialization or for Internal Medicine, which focuses mainly on adults.
When should I go to the emergency room instead of booking an appointment?
Go to the emergency room or call emergency services (192 in Brazil) if there are warning signs: severe chest pain, sudden shortness of breath, active bleeding, significant trauma or signs of stroke — facial drooping, weakness in an arm or leg, difficulty speaking or a sudden change in vision. Symptoms that have lasted days or weeks, without these signs, are usually better assessed in an appointment.
Does seeing the same doctor every time make a difference?
The evidence suggests it does. A systematic review published in BMJ Open (2018) found that, in 18 of 22 studies, greater continuity of care with the same doctor was associated with lower mortality. The studies are observational, but the finding was repeated across different countries and health systems. Knowing your history helps interpret symptoms and avoid repeated tests.
References
- Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457-502. doi.org/10.1111/j.1468-0009.2005.00409.x
- Green LA, Fryer GE, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med. 2001;344(26):2021-5. doi.org/10.1056/NEJM200106283442611
- Pereira Gray DJ, Sidaway-Lee K, White E, Thorne A, Evans PH. Continuity of care with doctors—a matter of life and death? A systematic review of continuity of care and mortality. BMJ Open. 2018;8(6):e021161. doi.org/10.1136/bmjopen-2017-021161
- Brasil. Ministério da Saúde. AVC — Acidente Vascular Cerebral [Internet]. Brasília: Ministério da Saúde [citado 2026 out 17]. www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/a/avc