When Should You See an Internist?

Telemedicine is not a substitute for emergency care. If you or someone else is in immediate danger or having thoughts of self‑harm, call your local emergency number (e.g., 112 or 911) or go to the nearest emergency room. For emotional distress or suicidal thoughts, the 988 Suicide & Crisis Lifeline offers free, confidential help 24/7

TL;DR

• Persistent abdominal or digestive pain – See a doctor if belly pain is unexplained, persistent or severe, or if it comes with fever, vomiting, blood or shortness of breath[1].
• High or lasting fever – Contact your doctor if your temperature is ≥ 39.4 °C (103 °F) or any fever lasts more than three days[2]; go to the ER for seizures, confusion, stiff neck or trouble breathing[2].
• Unexplained weight loss – Losing > 10 pounds (5 % of body weight) in 6–12 months without trying can signal an underlying illness; see a healthcare professional[3].
• Chronic fatigue – If tiredness persists for days, interferes with daily life or has no clear cause, consult a clinician[4]; seek urgent care for fatigue with chest pain, shortness of breath, irregular heartbeat or suicidal thoughts[4].
• Severe shortness of breath – Contact a provider if breathlessness is intense or limits activities; sudden or severe dyspnea with chest pain, blue lips or swelling requires immediate emergency care[5].

What Does an Internist Do?

An internist is a physician who specialises in adult health. Internists complete four years of medical school plus at least three years of residency training focused on diagnosing and managing diseases that affect adults. Unlike family physicians who care for patients across all ages, internists concentrate on adults with complex medical needs, chronic diseases, and preventive care. They provide comprehensive care, coordinate with specialists, interpret diagnostic tests, prescribe medications and counsel patients on lifestyle modifications. Many internists also serve as primary care providers, developing long‑term relationships and guiding patients through routine screenings, vaccinations and health maintenance.

With the growth of telemedicine, internists now offer virtual visits via video or phone. Telehealth makes it easier to get advice, review lab results or discuss chronic conditions without leaving home. According to Harvard Health Publishing, telehealth provides cost savings and convenience, allows patients in rural areas or with mobility limitations to access care, enables remote monitoring of vital signs, and facilitates coordination between providers[6]. However, it cannot replace imaging tests or hands‑on examinations and may involve privacy concerns or out‑of‑pocket costs[6]. Telemedicine should be used for non‑emergency consultations; urgent symptoms still require in‑person evaluation.

5 Signs You Should See an Online Internist

1. Persistent or Severe Abdominal Pain and Digestive Issues

Abdominal discomfort can stem from indigestion, gas or menstrual cramps, but persistent or severe pain warrants medical evaluation. The Cleveland Clinic advises seeing a healthcare provider if abdominal pain is unexplained, persistent or severe, especially if you have been injured or are pregnant[1].

If your belly pain is persistent, affects your appetite or is accompanied by these red flags, book an appointment. Through telemedicine, an internist can review your symptoms, order basic tests and advise whether you need in‑person evaluation.

2. High Fever or Fever Lasting More Than Three Days

A fever is your body’s response to infection. Most fevers resolve on their own, but sustained high temperatures can signal serious illness. Healthline recommends calling your doctor immediately if you have a high‑grade fever ≥ 103 °F (39.4 °C)[2]. You should also seek medical help if you have any fever lasting longer than three days[2].

Emergency fever signs: Severe headache, dizziness, stiff neck, difficulty breathing, seizures, confusion or hallucinations require urgent care[2]. Telemedicine is suitable for discussing mild fevers or COVID‑19 concerns, but high fever or associated red flags need in‑person evaluation.

3. Unexpected Weight Loss

Unintentional weight loss can be alarming. The Cleveland Clinic defines unexplained weight loss as losing more than 5 % of your body weight or at least 10 pounds within six to 12 months without trying[3]. This symptom may indicate metabolic disorders, endocrine problems, gastrointestinal diseases, malignancies or mental health conditions[3].

If you notice a significant drop in weight, schedule a consultation. An internist can evaluate potential causes, perform blood tests and imaging, and coordinate specialist referrals. Telemedicine can be a good starting point for discussing symptoms and arranging further tests.

4. Chronic Fatigue or Extreme Tiredness

Feeling tired occasionally is normal, but fatigue that lasts longer than a few days, interferes with work or daily activities, or has no obvious cause warrants medical attention[4]. The Cleveland Clinic recommends calling your healthcare provider if you’re tired all the time, if fatigue comes on suddenly, or if you’re over 65 and feel exhausted[4].

Seek immediate medical care if fatigue occurs along with shortness of breath, chest or back pain, irregular heartbeat, vision problems, nausea, muscle weakness or suicidal thoughts[4]. An internist can assess for anemia, thyroid disorders, heart or lung disease, sleep problems or mental health conditions. Telemedicine appointments allow your doctor to review your history, order laboratory tests and recommend lifestyle changes.

5. Severe Shortness of Breath or Chest Discomfort

Shortness of breath (dyspnea) may result from exercise or anxiety, but severe or persistent breathlessness can indicate heart or lung problems. According to the Cleveland Clinic, you should contact a healthcare provider if shortness of breath is severe or interferes with daily activities[5]. Go to the emergency room if you have sudden difficulty breathing, severe breathlessness that persists after resting, blue lips or nails, chest pain or heaviness, or a high fever[5].

Telemedicine consultations can help differentiate between minor causes (like anxiety or mild respiratory infections) and concerning conditions. However, sudden or severe shortness of breath always warrants in‑person evaluation.

Diagnosis and Telemedicine Evaluation

When you consult an internist—whether online or in person—the physician will take a detailed medical history, ask about the onset, duration and severity of your symptoms, review your medications and allergies, and perform a physical examination when feasible. Telemedicine visits can facilitate this history‑taking and allow review of remote monitoring data (blood pressure, glucose or oxygen saturation readings). They can also be used to order laboratory tests, imaging or referrals. However, certain assessments—such as a hands‑on abdominal exam, auscultation of the lungs or heart, and procedures like endoscopy—cannot be performed virtually.

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Routine preventive care remains important. The U.S. Preventive Services Task Force recommends screening all adults 18 years or older for hypertension using office blood pressure measurement, with annual checks for adults ≥ 40 years or those at increased risk and every 3–5 years for younger adults[7]. Blood pressure, cholesterol, diabetes and cancer screenings often require in‑person visits, but telemedicine can help coordinate and interpret results.

Treatment and Management Options

Treatment depends on the underlying cause of your symptoms:

• Abdominal pain/digestive issues: Your doctor may recommend diet changes, antacids or stool softeners for minor issues. Persistent pain or red‑flag symptoms may require imaging, endoscopy or referral to a gastroenterologist. Avoid self‑diagnosing or overusing pain relievers.
• Fever: Over‑the‑counter medications like acetaminophen or ibuprofen can reduce fever. Stay hydrated and rest. Seek medical advice for fevers that are high or prolonged[2].
• Weight loss: Address underlying medical conditions such as thyroid disease, diabetes or malabsorption disorders. Nutritional counseling and psychological support may be necessary.
• Fatigue: Lifestyle modifications (adequate sleep, balanced diet, hydration, stress management and regular exercise) can reduce fatigue[4]. An internist may investigate anemia, infections, endocrine disorders or mental health issues.
• Shortness of breath: Treatment ranges from breathing exercises and anxiety management to medications for asthma or heart failure. Severe cases may require emergency interventions or oxygen therapy[5].

Telemedicine visits can help monitor chronic conditions, adjust medications, discuss test results and provide referrals. Always keep a list of your symptoms and their duration to share during the virtual consultation.

Safety Considerations and Contraindications

Telemedicine is suitable for non‑emergency concerns and follow‑up care. It cannot replace urgent in‑person evaluation when you experience severe symptoms. Always seek immediate medical care if you have:

• High fever with severe headache, stiff neck or confusion[2].
• Sudden or severe abdominal pain with vomiting, bleeding or jaundice[1].
• Rapid weight loss accompanied by weakness, dizziness or fainting[3].
• Fatigue with chest pain, shortness of breath, irregular heartbeat or suicidal thoughts[4].
• Sudden difficulty breathing, blue skin or chest heaviness[5].

Always discuss new medications, supplements or lifestyle changes with a healthcare professional. Telemedicine may not be appropriate if you have limited internet access or difficulty communicating via video.

Lifestyle and Prevention Tips

To stay healthy and reduce the likelihood of serious symptoms, consider the following evidence‑based practices:

• Maintain a balanced diet rich in fruits, vegetables, whole grains and lean proteins. Adequate nutrition supports immunity and helps prevent weight fluctuations.
• Stay physically active with regular aerobic and strength‑training exercises, which improve cardiovascular health and energy levels.
• Prioritise sleep by establishing a consistent bedtime routine, avoiding screens before bed and aiming for 7–9 hours of sleep per night[4].
• Manage stress through mindfulness, meditation, yoga or deep‑breathing exercises[4].
• Limit alcohol and avoid tobacco; these substances can contribute to weight changes, fatigue and cardiopulmonary problems.
• Keep up with preventive screenings, including blood pressure, cholesterol, diabetes and cancer checks as recommended by your internist[7].

Telemedicine Fit and Doctors365

Telemedicine enables you to consult with experienced internists without leaving home. At Doctors365, you can schedule a virtual visit with licensed practitioners such as Dr Andreas Mussigbrodt MD, Prof. Michael Akbar Dr. med., Dr Chritos Tzivinikos and Dr Helena Class. During an online appointment, they can:

• Review your symptoms and medical history.
• Evaluate remote monitoring data (blood pressure, blood glucose, oxygen saturation).
• Order laboratory tests and imaging.
• Provide guidance on self‑care, medications and referrals for in‑person evaluation.

Telemedicine is ideal for managing chronic conditions like hypertension, diabetes or asthma, discussing test results, adjusting medications and receiving lifestyle counselling. It is not appropriate for emergencies such as severe chest pain, sudden shortness of breath, high fever with confusion or suspected stroke. In those situations, call 112/911 or go to the nearest emergency department[2].

Ready to talk? Book an online consultation with a Doctors365 internist today. You can also browse our Specialties, learn more about internists, preventive health services and common conditions treated via telemedicine.

Evidence at a Glance

• Abdominal pain: See a doctor if pain is unexplained, persistent or severe, or accompanied by fever, vomiting, bleeding, jaundice or breathlessness[1].
• Fever: Call your doctor for temperatures ≥ 39.4 °C (103 °F) or fevers lasting > 3 days; emergency symptoms include seizures, confusion, stiff neck and difficulty breathing[2].
• Weight loss: Losing > 5 % of body weight or ≥ 10 pounds unintentionally in 6–12 months warrants medical evaluation[3].
• Fatigue: Persistent fatigue without an obvious cause, especially if accompanied by weight loss or interfering with daily activities, should prompt a doctor visit[4]. Seek emergency care for fatigue with chest pain, breathlessness or suicidal thoughts[4].
• Shortness of breath: Contact a provider for severe or activity‑limiting breathlessness; sudden dyspnea with chest pain, blue lips or swelling requires urgent evaluation[5].
• Telemedicine: Offers convenience, remote monitoring and coordination of care, but cannot replace physical exams or imaging and may have privacy or insurance limitations[6].
• Preventive screening: The USPSTF recommends routine blood pressure screening for adults 18+; annual checks for those ≥ 40 years or at risk and every 3–5 years for younger adults[7].

What You Can Do Now

1. Track your symptoms: Keep a diary of any abdominal pain, fever episodes, weight changes, fatigue levels or breathing difficulties, including when they occur and what makes them better or worse.
2. Monitor vital signs: Use a home blood pressure cuff, thermometer, scale and pulse oximeter to record readings; share these during your telemedicine visit.
3. Schedule a consultation: Book an online consultation with a Doctors365 internist to discuss your concerns and receive personalised advice.
4. Review your medical history: Gather information on your medications, allergies, past illnesses and family history to help your doctor make a thorough assessment.
5. Prepare for emergencies: Save local emergency numbers and the 988 Lifeline on your phone. Tell a trusted friend or family member about your health plan.
6. Adopt healthy habits: Eat a balanced diet, exercise regularly, stay hydrated, get enough sleep and manage stress to prevent or reduce many symptoms.
7. Stay up to date on screenings: Follow your internist’s recommendations for blood pressure, cholesterol, diabetes and cancer screenings.

Frequently Asked Questions

What is an internist and how is it different from a family doctor?

Internists are physicians trained specifically in adult medicine. They focus on diagnosing and managing diseases that affect adults and often serve as primary care providers for complex medical needs. Family doctors care for patients of all ages, including children, and provide more generalist care.

Can I treat abdominal pain at home?

Minor indigestion or occasional cramps may improve with diet changes, hydration and over‑the‑counter antacids. However, you should see a doctor if the pain is persistent, severe or accompanied by fever, vomiting or blood[1].

When is a fever dangerous?

A fever becomes concerning when your temperature reaches 39.4 °C (103 °F) or higher, or if any fever lasts longer than three days[2]. Emergency symptoms—such as stiff neck, confusion, seizures or difficulty breathing—require immediate medical care[2].

How can I tell if my weight loss is a problem?

Unintentional weight loss of more than 5 % of your body weight or at least 10 pounds within six to 12 months without changes in diet or exercise is concerning[3]. Consult an internist to investigate potential causes.

What causes chronic fatigue?

Fatigue can result from lifestyle factors (poor sleep, stress, inactivity), medications or underlying medical conditions such as anemia, thyroid disorders, heart or lung disease and mental health issues[4]. Persistent fatigue should be evaluated by a healthcare provider.

When should I worry about shortness of breath?

Seek medical advice if breathlessness is severe, interferes with daily activities or is accompanied by chest pain, blue lips, a high fever or swelling[5]. Sudden difficulty breathing requires immediate emergency care.

Can telemedicine replace all doctor visits?

No. Telemedicine is ideal for routine follow‑ups, medication adjustments and discussing test results. It cannot replace physical examinations, imaging, blood work or emergency care[6].

How often should adults have their blood pressure checked?

The U.S. Preventive Services Task Force recommends screening adults ≥ 18 years for hypertension. Adults ≥ 40 years or those at increased risk should be screened annually; those aged 18–39 with normal blood pressure can be screened every 3–5 years[7].

References

1. Cleveland Clinic. Abdominal pain. 2022 Apr 18. https://my.clevelandclinic.org/health/symptoms/4167-abdominal-pain (accessed 2025‑09‑01).
2. Fowler A. Fever in adults: characteristics, types, and when it's serious. Healthline. 2023. https://www.healthline.com/health/fever-in-adults (accessed 2025‑09‑01).
3. Cleveland Clinic. Unexplained weight loss. 2023 Apr 13. https://my.clevelandclinic.org/health/symptoms/unexplained-weight-loss (accessed 2025‑09‑01).
4. Cleveland Clinic. Fatigue. 2023 Apr 13. https://my.clevelandclinic.org/health/symptoms/21206-fatigue (accessed 2025‑09‑01).
5. Cleveland Clinic. Dyspnea (shortness of breath). 2022 Nov 11. https://my.clevelandclinic.org/health/symptoms/16942-dyspnea (accessed 2025‑09‑01).
6. Moore J. Telehealth: the advantages and disadvantages. Harvard Health Publishing. 2023. https://www.health.harvard.edu/staying-healthy/telehealth-the-advantages-and-disadvantages (accessed 2025‑09‑01).
7. US Preventive Services Task Force. Hypertension in adults: screening. 2021 Apr 27. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening (accessed 2025‑09‑01)
   
   Written by Diellza Rabushaj, Medical Writer & Researcher.