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Provider specialties

Healthcare has hundreds of provider types. Here is a plain-language map of who treats what, when to see them, and how referrals usually flow.

Primary & preventive care

Your first stop for most non-emergency care. PCPs coordinate referrals, manage chronic conditions, and handle preventive screening.

  • Family Medicine

    Treats:
    All ages — newborns through seniors. Routine illness, preventive screening, chronic conditions like diabetes and hypertension.
    When to see:
    Annual physicals, vaccines, sore throats, blood pressure follow-ups, basic mental health check-ins.

  • Internal Medicine

    also: Internist
    Treats:
    Adults 18+. Complex multi-system conditions, preventive medicine, chronic disease management.
    When to see:
    You're an adult and want a PCP comfortable managing multiple conditions at once.

  • Pediatrics

    Treats:
    Infants, children, and adolescents (typically birth–21).
    When to see:
    Well-child visits, immunizations, developmental concerns, school physicals.

  • OB/GYN

    also: Obstetrician-Gynecologist
    Treats:
    Reproductive health, pregnancy, childbirth, menstrual and menopausal issues, contraception, pelvic conditions.
    When to see:
    Annual exam, pregnancy care, abnormal bleeding, pelvic pain — many plans allow direct access without a referral.

  • Nurse Practitioner (NP) / Physician Associate (PA)

    Treats:
    Wide range of primary and specialty care depending on training and supervision rules in your state.
    When to see:
    Often available sooner than an MD for routine visits, refills, and acute non-emergencies.

Medical specialists (internal medicine subspecialties)

These doctors completed internal medicine training plus extra fellowship in one body system. Usually requires a referral on HMO plans.

  • Cardiology

    Treats:
    Heart and vascular conditions — chest pain, arrhythmias, heart failure, high cholesterol, post-MI care.
    When to see:
    Persistent chest pain, palpitations, abnormal EKG, family history of early heart disease.
    Usually referred from:
    PCP, ER, or after an abnormal stress test or echo.

  • Endocrinology

    Treats:
    Hormones, diabetes, thyroid, adrenal, pituitary, osteoporosis.
    When to see:
    Hard-to-control diabetes, thyroid nodules, suspected hormonal imbalance.
    Usually referred from:
    PCP, OB/GYN.

  • Gastroenterology

    also: GI
    Treats:
    Esophagus, stomach, intestines, liver, pancreas, gallbladder. Performs endoscopy and colonoscopy.
    When to see:
    Persistent reflux, unexplained abdominal pain, blood in stool, screening colonoscopy at age 45+.
    Usually referred from:
    PCP.

  • Nephrology

    Treats:
    Kidney function, hypertension related to kidneys, dialysis management.
    When to see:
    Elevated creatinine, protein in urine, chronic kidney disease staging.
    Usually referred from:
    PCP, cardiology.

  • Pulmonology

    Treats:
    Lungs and breathing — asthma, COPD, sleep apnea (with sleep medicine), pulmonary nodules.
    When to see:
    Chronic cough, shortness of breath, abnormal chest imaging.
    Usually referred from:
    PCP, ER.

  • Rheumatology

    Treats:
    Autoimmune and inflammatory joint conditions — RA, lupus, psoriatic arthritis, gout.
    When to see:
    Multiple swollen joints, positive ANA, unexplained inflammation.
    Usually referred from:
    PCP.

  • Hematology / Oncology

    Treats:
    Blood disorders, cancers, chemotherapy and immunotherapy management.
    When to see:
    Cancer diagnosis, abnormal CBC, clotting disorders.
    Usually referred from:
    PCP, surgeon after biopsy.

  • Infectious Disease

    Treats:
    Complex or persistent infections, HIV, hepatitis, post-travel illness.
    When to see:
    Fever of unknown origin, infections not responding to standard antibiotics.
    Usually referred from:
    PCP, hospital.

  • Neurology

    Treats:
    Brain, spinal cord, nerves — headaches, seizures, stroke, MS, neuropathy.
    When to see:
    Recurrent severe headaches, numbness/tingling, suspected seizure.
    Usually referred from:
    PCP, ER.

  • Dermatology

    Treats:
    Skin, hair, nails — acne, eczema, psoriasis, skin cancer screening and removal.
    When to see:
    Changing mole, persistent rash, suspected skin cancer.
    Usually referred from:
    PCP — many plans allow direct access.

  • Allergy & Immunology

    Treats:
    Environmental and food allergies, asthma, immune deficiencies.
    When to see:
    Recurrent sinus infections, suspected food allergy, allergic asthma.
    Usually referred from:
    PCP.

Surgical specialties

Surgeons perform procedures and also manage non-operative care of the conditions they treat. Most surgeries require prior authorization.

  • General Surgery

    Treats:
    Gallbladder, hernia, appendix, breast, thyroid, abdominal procedures.
    When to see:
    Referred for surgical evaluation after imaging or biopsy.

  • Orthopedic Surgery

    also: Ortho
    Treats:
    Bones, joints, ligaments, tendons. Knee/hip replacements, fracture care, sports injuries, spine.
    When to see:
    Joint pain not responding to PT or injections, fractures, suspected ligament tear.
    Usually referred from:
    PCP, urgent care, ER.

  • Neurosurgery

    Treats:
    Brain, spine, peripheral nerve surgery — tumors, herniated discs, spinal stenosis.
    When to see:
    Imaging-confirmed spinal cord/nerve compression, brain lesion.
    Usually referred from:
    Neurology, ortho, PCP.

  • Cardiothoracic Surgery

    Treats:
    Heart and chest surgery — bypass, valve replacement, lung resection.
    When to see:
    After advanced cardiac or thoracic workup.
    Usually referred from:
    Cardiology, pulmonology, oncology.

  • Vascular Surgery

    Treats:
    Arteries and veins outside the heart — aneurysms, blockages, dialysis access.
    When to see:
    Leg pain with walking, abnormal vascular study.
    Usually referred from:
    PCP, cardiology, nephrology.

  • Urology

    Treats:
    Kidney stones, prostate, bladder, male reproductive system.
    When to see:
    Blood in urine, kidney stones, prostate concerns, vasectomy.
    Usually referred from:
    PCP, ER.

  • ENT (Otolaryngology)

    Treats:
    Ear, nose, throat, sinuses, head & neck cancers.
    When to see:
    Chronic sinusitis, hearing loss, hoarseness lasting >2 weeks.
    Usually referred from:
    PCP.

  • Ophthalmology

    Treats:
    Eye disease and surgery — cataracts, glaucoma, retinal disease, diabetic eye care.
    When to see:
    Vision changes, eye pain, diabetic eye exam.
    Usually referred from:
    PCP, optometrist — many plans allow direct access.

  • Plastic & Reconstructive Surgery

    Treats:
    Reconstruction after injury, cancer, or congenital differences; some cosmetic.
    When to see:
    Post-mastectomy reconstruction, hand injury, cleft repair, burn reconstruction.
    Usually referred from:
    Oncology, ortho, trauma, PCP. Cosmetic procedures usually not covered.

Mental, behavioral & rehabilitative

Many plans cover these under separate behavioral health benefits — confirm in-network status separately from medical.

  • Psychiatry

    Treats:
    Mental health conditions requiring medication management — depression, anxiety, bipolar, ADHD, schizophrenia.
    When to see:
    Need medication for a mental health condition or have complex psychiatric needs.

  • Psychology / Therapy

    also: LCSW, LMFT, LPC, PsyD, PhD
    Treats:
    Talk therapy — CBT, DBT, family therapy, trauma-focused care. Does not prescribe (except some PsyD in certain states).
    When to see:
    Looking for counseling, coping skills, or therapy without medication.

  • Physical Therapy (PT)

    Treats:
    Movement and function — post-surgery rehab, injury recovery, balance, chronic pain.
    When to see:
    After orthopedic surgery, injury, or as conservative treatment before surgery.
    Usually referred from:
    PCP, surgeon — most plans require a physician order even if direct access is allowed.

  • Occupational Therapy (OT)

    Treats:
    Activities of daily living — fine motor skills, return-to-work, hand therapy, pediatric developmental support.
    When to see:
    Difficulty with daily tasks after stroke, hand injury, or developmental delay.

  • Speech-Language Pathology (SLP)

    Treats:
    Speech, language, swallowing — pediatric speech delay, post-stroke aphasia, swallowing studies.
    When to see:
    Speech delay in a child, trouble swallowing after stroke, voice changes.

  • Pain Management

    Treats:
    Chronic pain — injections, nerve blocks, medication management.
    When to see:
    Chronic pain not controlled with primary care or after surgery.
    Usually referred from:
    PCP, ortho, neurology.
Important: AuraCode is an educational tool. It does not provide medical, legal, or insurance advice, claims decisions, or approval guarantees. Final coverage depends on your specific plan, eligibility, diagnosis, submitted documentation, and your insurer's review.