What actually happens at a first internal medicine visit?
At a first internal medicine visit, the doctor hears your story from the beginning, checks your vital signs, examines you by hand, goes through the medicines and reports you bring, and then decides whether a blood test or an ultrasound would answer your particular question. The visit is not a ready-made bundle of tests. It is a structured conversation plus a physical examination that ends in a written, clear plan.
Internal medicine looks at the whole body at once. If you have tiredness, abdominal pain, dizziness, diabetes, high pressure or a lab result nobody explained, the doctor ranks the possibilities from the most common to the least and requests only the investigations that could change a decision. That saves you from a pile of tests with no purpose [1, 3].
If you want to book, Dr Mohab Ashraf Fouad, a specialist in internal medicine, diabetes, liver, digestive disease and endoscopy, sees patients at the La Rose branch in New Maadi on Saturdays from 4 to 7 pm, and an abdominal ultrasound can be done in the same visit when it is useful. Call or send a WhatsApp message to 010 4066 1893, or use Book your appointment, and confirm the time when you book because schedules can change.
When is a general internist the right place to start?
Start with internal medicine when the symptom does not point clearly to one organ. Tiredness that has lasted weeks, unexplained weight loss, dizziness, repeated headaches, a general sense of not being yourself, or a mix of overlapping complaints are all examples. The NHS advises seeing a doctor if tiredness lasts several weeks or disturbs daily life [7].
It also suits people with a long-term condition such as diabetes or high pressure who need someone to follow the whole picture, and people holding a lab result outside the range who do not know what to do with it. Instead of moving from one specialty to the next, the doctor decides which path deserves attention, and if the problem needs another specialty, you hear the reason.
If you are unsure whether to start with internal medicine or another specialty, describe your symptoms when booking and ask which clinic fits. For a routine review without a specific complaint, the medical check-up in Maadi guide explains how that differs from a visit about one problem.
Some people begin with internal medicine simply to be reassured: a man in his forties with a family history of diabetes and heart disease, a woman after menopause who has noticed a change in her energy, or someone preparing for long travel or an operation. In those cases the first visit sets a baseline to measure against later, and decides which investigations are done now and which can wait a year, so you are not chasing every test advertisement you see.
What will the doctor ask you?
Most of the diagnosis comes out of the questions. The doctor will ask when the symptom began, what makes it worse and what eases it, whether it comes at a certain time of day or all the time, and whether anything changed before it, such as a new medicine, travel or work pressure. Noting when the problem began and what improves or worsens it makes a real difference [4].
Then comes your medical history: old illnesses, operations, allergies, family history of diabetes, pressure, heart and liver disease, and your habits with food, sleep, smoking and movement. In Egypt these questions also touch late heavy meals, a lot of tea and coffee, intermittent fasting and night shifts, because each of them affects digestion, sleep and blood sugar.
Do not be bothered by the number of questions or by personal ones, because each question removes one possibility or moves closer to another. A frank answer, even about something awkward like constipation or the herbal drinks you take, saves you investigations. If a question is unclear, ask the doctor to put it more simply.
Before the appointment, write your main symptom in one line, when it began, how often it returns and whether it disrupts work or sleep. Note whether pain follows meals or activity. Bring dated home blood-pressure or glucose readings rather than relying on the last number you remember. Prepare two or three questions you want answered, such as what is most likely and when you should follow up. Writing questions and medicine details before the visit helps you use the consultation well [4].
The clinical examination and vital signs
Vital signs are blood pressure, pulse, temperature, breathing rate and weight, and sometimes oxygen level. A clinic reading of 140/90 or higher counts as high, while the threshold for a home reading is 135/85 [6]. A single reading is not a verdict, though, and the World Health Organization expects confirmation on two different days before a diagnosis is made [6, 14].
Then comes the hands-on examination: listening to the heart and chest, pressing on the abdomen to locate pain, enlargement or tenderness, checking the neck and lymph glands, looking at the skin and eyes for paleness or yellowing, and looking for swollen ankles. Simple checks like these sometimes say more than an expensive test, and they shape what the doctor requests next.
The examination is usually painless and takes only a few minutes. If you feel shy about being examined, say so, because a good examination depends on speaking freely. Wear comfortable clothes that make it easy to expose the abdomen or chest when needed.
Medicines and previous reports: what to bring and why
The most useful thing to bring is a list of every medicine you take, from doctors' prescriptions to pharmacy painkillers, vitamins and herbs. The US National Library of Medicine advises writing down every medicine, herb, vitamin, supplement and allergy [4]. Some medicines cause dizziness, constipation or tiredness, and sometimes the doctor finds the cause in the prescription itself.
The easiest method is to photograph the boxes with your phone before you come, as explained in photographing medicine boxes. That way you avoid forgetting, and the doctor can see the active ingredient and the manufacturer when needed.
Old reports matter too: recent blood tests, any ultrasound, scan or endoscopy, and hospital discharge papers. Bring the original report when possible because reference ranges differ between laboratories [5].
Targeted tests and ultrasound: when do they help?
A test is requested to answer a question, not to fill a sheet of paper. If the symptom is tiredness with paleness, a blood count makes sense. If it is thirst and frequent urination, blood sugar. If it is feeling cold with constipation and weight gain, thyroid function. The NHS says blood tests are done to check health or find the cause of symptoms, and that some require fasting [3].
Ultrasound may help when symptoms and examination point to an abdominal problem, such as upper-right pain or abnormal liver or kidney tests. It can image the liver, gallbladder, pancreas, kidneys and major vessels, usually takes under half an hour and uses no ionizing radiation [2]. Gallstones may be visible, but the appropriate test depends on the clinical situation [2].
Not every visit needs an ultrasound. The decision depends on symptoms and examination, and a normal scan does not exclude every cause. Ultrasound uses sound waves rather than X-rays; the abdominal ultrasound in Maadi guide explains the organs it can show [1, 2].
Read also: ultrasound uses sound, not X-rays
The follow-up plan and warning signs
By the end of the visit, ask what diagnosis is most likely, what still needs confirmation, why each investigation is requested and when to return. If results will take days, agree on who will contact you and what to do if symptoms persist even when tests are normal.
Some signs do not wait for an appointment: pressing chest pain that may spread to the arm or jaw with sweating or breathlessness [8]; weakness or numbness on one side of the face or body, or difficulty speaking [10]; sudden severe abdominal pain, vomiting blood or black stools [9]. These are emergencies. Call an ambulance or go to the nearest hospital, and do not drive yourself.
Other situations need prompt assessment even when they are not emergencies, such as unexplained weight loss, or intense thirst with frequent urination, which are signs of diabetes [11], or high pressure with headache and blurred vision. If any of these appear, do not wait for Saturday and speak to a doctor straight away.
If a test is ordered, ask whether you need to fast, when to have it and who will explain the result. If you are referred to another specialty, ask why and take a copy of the plan. At home, monitor symptoms as agreed. If new symptoms appear or you worsen before follow-up, contact a clinician rather than waiting for the scheduled visit. A useful plan also tells you whom to contact with questions after the appointment [4].
Food, heat and fasting: everyday context in Egypt
A large part of symptoms is tied to how we live. In summer heat, dehydration can cause dizziness, headache and tiredness, and the NHS lists dehydration and heat exhaustion among the causes of dizziness [12]. Drinking enough water in hot weather matters, and it is something to raise with the doctor as well.
During Ramadan or intermittent fasting, medicine timings change, and you should tell the doctor if you take diabetes or pressure tablets so the timings can be arranged with you. As for food, late heavy meals add to acidity and bloating, and tea straight after eating can reduce iron absorption in some people.
Shift work and short sleep are among the commonest causes of tiredness, and 6 to 9 hours of sleep is the usual recommendation for most adults [7]. Long-standing insomnia has treatments beyond tips [13]. Describe your real day to the doctor rather than the ideal one, so the plan fits it.
Common mistakes before a first visit
The first mistake is ordering a big panel of tests yourself before the visit in the hope of saving time. The result is often a pile of paper unrelated to your question, and the doctor may need to repeat some of it or request something else entirely. It is better to arrive with your symptoms, medicines and old reports, and leave the choice of investigations until the doctor has listened to you and examined you.
The second mistake is stopping a medicine on your own before the visit so the doctor can see you without it. Some medicines are risky to stop suddenly, and only certain tests call for pausing a particular medicine, which is the doctor's decision and not yours. The NHS notes that some medicines may need to be paused before specific tests, on medical advice [3].
The third mistake is hiding a detail because it seems unimportant: a supplement, herbs, a medicine borrowed from a relative, smoking or long late nights. The doctor is not judging you, and every detail corrects the direction. The fourth mistake is arriving expecting an instant prescription, when it is better to understand the plan, ask about what is unclear, and request written instructions you can return to [4].
Finally, do not compare yourself with a relative or with what you read on social media. The same symptom in two people can have completely different causes, and the right plan is built on your own case.
Booking with Dr Mohab Ashraf at the Maadi branch
Dr Mohab Ashraf Fouad is a specialist in internal medicine, diabetes, liver, digestive disease and endoscopy, and he receives patients in Maadi only. The clinic is at 14 El-Mokhtar Street, off El-Nasr Street, with QNB Bank behind it, in New Maadi. The session runs on Saturdays from 4 to 7 pm.
An abdominal ultrasound can be performed in the same visit when the doctor finds it useful after the examination, so you do not need to book another step or go elsewhere. You can call or write on WhatsApp to 010 4066 1893, or book from the booking page on the website. Make sure of the day and hour when you book.
Bring your ID, the medicine photos and your latest tests and reports. For more detail on how to choose and how the consultation runs, there is more in the article on internal medicine doctor in Maadi.
