Most illnesses that send adults to the doctor are short-lived: a cold, the flu, a sore throat, an earache, a sinus infection, a stomach bug, a urinary tract infection or a new rash. Many improve with rest and fluids in a few days. The purpose of a sick visit is to confirm that yours is one of those, to find the ones that need specific treatment, and to catch the uncommon illness that is more serious than it first appears.
At New York Medicine Doctors, our internal medicine physicians see adults for these acute problems at our Midtown Manhattan and Forest Hills offices. Because we also know your medical history, medications and chronic conditions, a sick visit with us can account for things an unfamiliar clinic might miss, such as how an infection affects your diabetes or which antibiotics interact with your heart medication.
When your symptoms allow, a telehealth visit can be a quick first step, and we will bring you into the office when an exam or test is needed. Call the office to ask about same-day appointments. We care for adults only; children should see a pediatrician.
Common illnesses we see
Respiratory infections are the most frequent. Colds cause a runny or stuffy nose, sore throat and cough and usually clear in about a week. Influenza and COVID-19 tend to come on faster, with fever, body aches, fatigue and cough, and can be more serious for older adults and people with chronic conditions. Strep throat causes a painful throat, fever and swollen glands, often without a cough. Sinus infections bring facial pressure, congestion and thick drainage. Ear infections cause ear pain, fullness and sometimes reduced hearing.
Outside the respiratory system, we treat urinary tract infections, which cause burning, urgency and frequent urination (see our UTI page); stomach viruses with vomiting and diarrhea; and skin problems such as rashes, cellulitis and other skin infections.
How we evaluate you at NYMD Center
What we test depends on your symptoms. Most visits start with your history, a temperature check and other vital signs, including oxygen level when you have respiratory symptoms, and a focused exam. We look in the ears with an otoscope, including a pneumatic otoscope that checks how the eardrum moves, and examine the throat, sinuses, lungs, skin and abdomen as needed.
Simple tests often settle the question quickly. A throat swab can check for strep, and a nasal swab can test for flu or COVID-19; we offer COVID-19 testing in the office. A urine test helps confirm a urinary tract infection and guide antibiotic choice. When the picture is less clear, we may order blood work, a culture, or a chest X-ray.
Treatment options
Rest, fluids and symptom relief
For most viral illnesses, the body clears the infection on its own. Rest, fluids, and over-the-counter medicines for fever, pain, congestion or cough make you more comfortable while that happens. We will tell you which products are safe with your other conditions and medications, since some decongestants raise blood pressure and some pain relievers are not suitable for people with kidney disease or on blood thinners.
Antiviral medicines
For confirmed or likely flu, an antiviral medicine can shorten the illness and is especially important for people at higher risk of complications. It works best when started soon after symptoms begin, which is another reason to call early. Antiviral treatment may also be appropriate for COVID-19 in higher-risk patients.
Antibiotics, when they help
Antibiotics treat bacterial infections such as strep throat, most urinary tract infections and some skin infections. They do nothing against viruses. The CDC is clear that antibiotics do not work on colds, flu or other viral infections, and that many sinus infections and some ear infections get better without them. Taking an antibiotic you do not need exposes you to side effects such as diarrhea and allergic reactions and contributes to antibiotic resistance. When we do prescribe one, we choose the narrowest drug that will work and explain how long to take it.
What to expect at your visit
Bring a list of your medications and note when your symptoms started and how they have changed. If you have a fever or cough, we may ask you to wear a mask in the office. Tests with swabs take a few seconds and are briefly uncomfortable but not harmful. You will leave with a diagnosis, a treatment plan, guidance on when you can return to work, and clear instructions on what to watch for. If you are not improving as expected, call us; a second look is sometimes what reveals a bacterial infection on top of a virus.
Prevention
A yearly flu shot and staying current on other adult vaccines are the most effective ways to avoid many of these illnesses or make them milder. We can check your records at a vaccination review. Hand washing, staying home when sick, and covering coughs protect the people around you.
When to seek care urgently
Call 911 or go to the emergency room for difficulty breathing, chest pain or pressure, confusion or trouble staying awake, a seizure, severe weakness, or not urinating. The CDC also flags symptoms that improve and then return with fever or worse cough, and worsening of chronic conditions, as warning signs with flu. Seek prompt care for a stiff neck with fever, a rash that spreads quickly or looks like bruising, trouble swallowing or opening the mouth, vomiting that prevents you from keeping fluids down, or a urinary infection with fever, back pain or chills.
Questions patients ask
Do I need antibiotics for a sinus infection?
Often not. Most sinus infections are caused by viruses or clear up on their own, and the CDC notes that many sinus infections do not need antibiotics. We consider antibiotics when symptoms are severe, last more than about ten days without improving, or get better and then worse again. Otherwise, saline rinses, a nasal steroid spray and pain relievers usually help most.
How do I know if it is a cold, flu or COVID?
The symptoms overlap, so it is hard to tell by symptoms alone. Flu and COVID-19 more often cause fever, body aches and fatigue, and they can come on quickly. A nasal swab test is the most reliable way to tell. Knowing matters because antiviral treatment for flu or COVID works best if started early, especially for higher-risk adults.
Can I be seen the same day when I am sick?
Call the office as early as you can and we will try to fit you in. For many problems, a telehealth visit is a quick first step, and we will bring you in for an exam or testing when needed. If you have severe symptoms such as trouble breathing or chest pain, call 911 or go to the emergency room instead.
When is a sore throat strep?
Strep throat typically causes a sudden, painful sore throat, fever, swollen neck glands and sometimes white patches on the tonsils, usually without a cough or runny nose. A cough and congestion point more toward a virus. A throat swab confirms strep, and if it is positive an antibiotic treats it and lowers the chance of complications and of spreading it to others.
When should I go back to work after being sick?
In general, wait until you have been fever-free for at least a day without fever-reducing medicine and your symptoms are improving. For strep, most people are no longer contagious after about a day of antibiotics. Specific guidance depends on the illness and your job, so we will give you advice at your visit and a note if you need one.