How do you know when to call the doctor?

It has always been challenging for healthcare consumers to navigate the shoals of legitimate concern and needless worry as they figure out when to rush to the doctor. “It’s tough stuff,” acknowledges Tom Delbanco, an internist at Beth Israel Deaconess Medical Center in Boston, US.

That’s never been truer than today. There’s more medical information available from more sources of varying credibility than ever before, and that information can both enlighten and frighten. At the same time, out-of-pocket medical expenses are rising and the ranks of primary care physicians are shrinking, meaning that false alarms can have very real consequences for cash-strapped consumers and overworked doctors.

One of the best ways is strikingly simple: Listen to the basics of your body: temperature, weight, sexual interest, menstrual cycles. “All these things are pretty good barometers of good health, and when they go awry, it might be a soft alert that you should look into the reasons,” says Delbanco. Still, he assures, usually the changes are not “associated with a terrible disease”.

While there’s no one-size-fits-all answer, there are some other broadly relevant guidelines. It often comes down to the severity of symptoms, their duration, and whether they progress. And history (both the distant past and more recent developments) can definitely be prologue when it comes to health. An episode of influenza A(H1N1) in a healthy person is something entirely different from the same viral illness in someone with a disease-fighting system hobbled by long-standing medical problems.

Sometimes the best tools for understanding and reassurance are the simplest: the bathroom scale (Delbanco calls it “one of the best lab tests we have”) to detect sudden weight loss or gain; the eye, to observe changes in colour or shape of a skin lesion; the phone, to call a doctor or nurse who, in a brief chat, may be capable of turning down the drone of fear.

“I can offer a lot of reassurance over the phone,” says Elizabeth Roth, an internist at Massachusetts General Hospital. “It’s hard for people to come in, it’s time- consuming, it’s expensive. We never want to bring people in unnecessarily. But there are some times when it’s just not possible to say over the phone that a symptom doesn’t warrant further evaluation.”

We’re all subject to that ‘What if...’

Even health reporters aren’t immune. Days after I’d written about a young man with the condition commonly known as Lou Gehrig’s disease, I became utterly convinced that twitching leg muscles meant I had the disease too. Of course, I didn’t.

“It’s important for everybody to realize that’s a natural phenomenon,” says David Elvin, medical director of Cambridge Family Health, a satellite of Cambridge Health Alliance, US. “Sometimes patients will come in and say, ‘Well, a friend of mine at work was just diagnosed with cancer and he didn’t have symptoms, so I thought I should come in and be checked’.”