Evidence-Based Care
Bidwell Health clinicians follow published peer-reviewed guidelines from national professional societies. This page lists the specific protocols, first-line medications, and referral criteria we use for every condition we treat.
Guidelines
ICD-10: N39.0 · Primary source: Infectious Diseases Society of America (IDSA)
For uncomplicated lower UTIs in non-pregnant adult women with classic symptoms, IDSA guidelines support empirical antibiotic treatment without requiring a urine culture. Our nurse practitioners follow this empiric-treatment pathway, selecting first-line agents based on local resistance patterns and patient history.
We refer patients to in-person care with any of: fever over 101°F, flank pain, visible blood in urine, nausea or vomiting, pregnancy, recurrent UTIs (>3 per year), history of stones or urologic surgery, immunosuppression, or male patient. These situations require urine culture and often imaging.
ICD-10: B37.3 · Primary source: CDC STI Treatment Guidelines · American College of Obstetricians and Gynecologists (ACOG)
For uncomplicated candidiasis in patients with classic symptoms, CDC and ACOG guidelines support empirical treatment. Our intake screens for recurrence (>4 episodes/year), pregnancy, diabetes, and immunosuppression — any of which changes the treatment pathway.
We refer for in-person evaluation if the patient is pregnant, has >4 episodes per year (recurrent VVC), is immunosuppressed, has uncontrolled diabetes, has unusual discharge suggesting a different diagnosis, or has failed prior empiric therapy.
ICD-10: N76.0 · Primary source: CDC STI Treatment Guidelines
CDC recommends treatment for all symptomatic BV. Our intake uses the patient-reported symptom pattern (thin grayish-white discharge, fishy odor worsening after intercourse, minimal itching) as the basis for empirical treatment in symptomatic non-pregnant patients.
We refer for in-person care if the patient is pregnant (different dosing considerations), has concurrent STI symptoms, is post-gynecologic surgery, or is experiencing recurrent BV (>3 episodes/year) requiring suppressive therapy.
ICD-10: F52.21 · Primary source: American Urological Association (AUA)
AUA guidelines call for cardiovascular risk assessment before prescribing PDE5 inhibitors. Our intake screens for nitrate use, recent cardiovascular events, uncontrolled hypertension, and significant comorbidities before any PDE5 inhibitor is prescribed.
We refer for in-person urology or cardiology workup if the patient has new ED under age 40, chest pain or shortness of breath on exertion, known cardiovascular disease with uncontrolled status, Peyronie's disease symptoms, priapism history, or has failed maximum-dose PDE5 trial.
ICD-10: L64.9 · Primary source: American Academy of Dermatology (AAD)
AAD clinical materials support first-line pharmacotherapy with finasteride and topical minoxidil for men, and topical minoxidil (with consideration of oral minoxidil or spironolactone) for women. Diagnosis is primarily clinical based on pattern and family history.
We refer for in-person dermatology evaluation if there is patchy hair loss (alopecia areata), scarring alopecia, sudden-onset telogen effluvium following illness or medication, scalp inflammation, or signs of autoimmune disease that would change the differential.
Not a diagnosis · Primary source: American Academy of Family Physicians (AAFP) continuity-of-care standards
AAFP continuity standards recognize that short-term bridge refills are appropriate when a patient with a stable chronic condition is temporarily without access to their regular prescriber (travel, insurance gap, primary-care transition). Bridge refills are short, documented, and explicitly time-limited.
We require the patient to establish or re-establish a primary care relationship for ongoing management. We refer back to primary care or specialty care for any dose change, any new or uncontrolled symptoms, any medication outside the bridgeable list, or any sign that the underlying chronic condition needs reassessment.
Process
Every intake is read by a licensed nurse practitioner — not auto-approved by a rules engine. The intake form is designed around the decision criteria above: it asks the specific questions a clinician would use to determine whether a patient fits the empirical-treatment protocol, or whether they need to be referred out.
If anything in the intake falls outside protocol (a symptom pattern that suggests something we don't treat, a contraindication, a red-flag finding, a medication interaction) the provider messages you inside your portal or refunds the visit. We don't prescribe outside protocol to force a fit.
Conditions, medications, and red flags — all handled per the protocols above.
Start Your Visit →