When your throat feels scratchy, your sinuses are clogged, or your ears ache after a flight, you might wonder: Should you call your doctor—or go straight to an ENT (ear, nose, and throat) specialist?

According to Dr. Elise Striebich, a primary care physician (PCP), the answer is to start with a PCP.

“Primary care physicians understand your personal medical history and are very good at narrowing down the diagnosis,” says Dr. Striebich. “We can diagnose and treat many common issues, and if it is something that is beyond our skill, we can refer you to the right specialist.” 

What ENT concerns a PCP can treat

Primary care providers like Dr. Striebich want to make sure you get the right care at the right time. Sometimes that means coordinating with a specialist. But many ENT issues can be treated right in your PCP’s office—or at least traced back to their root cause.

Common issues PCPs often see and help with include

• Ear pain: Often caused by sinus drainage or fluid behind the eardrum; your PCP can check for infection or inflammation and recommend treatment.
  

• Sinus pressure and congestion: Typically managed with over-the-counter medication, nasal sprays, or saline rinses; a PCP can help identify triggers and rule out infection.
  
• Hoarseness or voice changes: Frequently tied to post-nasal drip or reflux; PCPs can assess how long symptoms have lasted and recommend treatment or further testing if symptoms persist.
  
• Vertigo and dizziness: These symptoms can stem from various causes, such as inner ear imbalance, dehydration, or migraines. PCPs can perform simple in-office assessments, like the Dix-Hallpike test, to narrow down the cause.
  
• Hearing issues: Hearing loss doesn’t always mean permanent damage. Sometimes, it’s due to earwax impaction, fluid buildup, or a temporary infection. PCPs can remove earwax and prescribe medication if needed.
  
• Allergy-related symptoms: Seasonal congestion, itchy ears, or sneezing may point to allergic rhinitis. Your PCP can provide treatment or refer you for testing if needed.

Rather than treating symptoms in isolation, PCPs also consider how ENT concerns may relate to underlying health issues. For example, frequent sinus infections could be linked to uncontrolled allergies, immune conditions, or anatomical blockages.

Dr. Striebich emphasizes that starting with a PCP often leads to faster, more cost-effective care. Because they already understand your medical history, they can evaluate whether other medications or conditions may be contributing to your current symptoms—and in many cases, they can address the issue without the need for a specialist referral.

“My goal in evaluating my patients first is to save them both time and money,” she says. “And when a referral is needed, I can help prioritize the urgency and even facilitate an earlier appointment if it’s a more serious concern.”

When your PCP refers to an ENT specialist 

Sometimes a referral is the right next step. Your PCP may recommend seeing an ENT if

• Your symptoms last more than two or three months.
• You have nasal polyps or structural concerns.
• You experience repeated or chronic sinus infections.
• You need allergy testing or immunotherapy.
• Your PCP identifies a thyroid nodule or other abnormal finding.

In children, referrals are more common, especially for small airway concerns, frequent ear infections, or tonsil issues. But even then, your PCP plays a key role in determining when a referral is necessary.

Sometimes it’s about simple prevention, too. For example, Dr. Striebich says that chewing gum or sucking on a lollipop while flying can help your ears adjust to pressure changes. 

Starting with your PCP means faster answers, clearer next steps, and care that’s focused on your whole health. “Always start with your PCP,” says Dr. Striebich. They can help figure out what’s causing the problem—and what you really need to feel better.