When to visit a doctor and when to go to hospital
When you feel sick or get an injury, it is important to know when to see a medical doctor and when to go to the hospital. Understanding the difference ensures you are getting the right care and that you are not experiencing unnecessary wait-times. Australia has a high-quality healthcare system and as an nib member, you have access to a range of services. Here is a guide to knowing when to see a doctor and when to go to the hospital’s Emergency Department.
Doctor vs Emergency Departments
In Australia, there are two main pathways for accessing medical care: a telehealth or local doctor (General Practitioner, also known as a GP) and the hospital Emergency Department (ED).
A GP is your first point of contact for any non-emergency and general health issues. The most convenient way to reach a doctor is through telehealth. If your health cover includes out-patient GP services, you have direct free access to health.hub, where you can reach medical doctors or nurse practitioners from wherever you are in Australia.
GPs can help with diagnosing and treating pain, illness, and other health concerns, as well as mental health support, vaccines, referrals for tests or scans, and prescriptions. They can also refer you to specialist doctors if needed. Think of your GP as your home base for healthcare, a familiar face who gets to know your health history over time.
When a doctor visit is the right choice
For most day-to-day health concerns, booking an appointment with a doctor is the way to go. If you feel unwell but do not need to go to hospital, you should get in touch with a GP.
This includes, but is not restricted to:
cold and flu symptoms
stomach aches
fevers
skin concerns
ongoing conditions
mental health support
standard health checks.
Hospitals in Australia prioritise patients based on the severity of their symptoms, so if you arrive at an ED with a minor illness or injury, you may wait a long time to be seen. For non-urgent concerns, a doctor appointment will usually be faster and more comfortable.
When to head to the Emergency Department
The ED is for urgent or potentially serious situations. If you have a major injury or life-threatening illness, call 000 immediately. This number is a free-of-charge call and will put you in touch with qualified emergency services operators who can send an ambulance.
This can be for things like:
chest pain
loss of consciousness
difficulty breathing
severe bleeding
a serious accident.
If you are sick or injured, and it is not life threatening or urgent, there are instances where it is better to go to the hospital. This can be for:
Urgent but not life-threatening - You need same-day assessment and treatment that a GP cannot provide, such as X-rays, IV fluids, blood tests or stitches
After hours - Your GP is closed and the issue cannot wait until the next available appointment
Moderate injuries - Broken bones (suspected), deep lacerations, dislocations, moderate burns
Sudden illness - High fever with stiff neck, severe abdominal pain, kidney stones, severe vomiting/dehydration
Mental health crisis - Acute psychiatric episodes where you or someone else needs immediate assessment
Eye or ear emergencies - Sudden vision or hearing changes, foreign objects
Paediatric concerns - Children who are unwell in ways that feel serious but are not immediately life-threatening.
If you are ever uncertain whether something is an emergency, seek help. It is always better to call and not need it than to delay when seconds matter. Remember, in a genuine emergency, call 000 for an ambulance.
Helpful options in between
Australia also has handy resources for those moments when you are not sure what to do:
Telehealth - nib partners with hub.health for telehealth consultations, which is a great option if you are not feeling well enough to travel to a GP or prefer to remain in the comfort of your own home.
Pharmacies - Open during business hours, some evenings and weekends. Pharmacists can provide advice and recommend over-the-counter medications without a prescription.
What this means for your cover
Your private health cover is designed to support you across these different pathways. GP visits are generally covered (check that your policy includes outpatient GP services) and hospital treatment for emergencies is included. Using the right service for your situation not only gets you better care, but it also helps you make the most of your cover.
A few things worth doing now
A little preparation goes a long way:
Find a GP near you with our Find a Provider tool
Save key numbers in your phone like 000 for emergencies and nib at 13 16 42
Download the nib App to book telehealth appointments, gain access to your digital card, use the Symptom Checker tool and for easy claiming.
nib is here to support you. Get in touch with us if you are ever unsure about what your cover includes or how to access care.