Evidence-Based Care
Bidwell Health clinicians follow published peer-reviewed guidelines from national professional societies. This page lists the protocols, first-line medications, and referral criteria currently documented for Bidwell Health's core online visit types.
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 clinicians 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.
Read the CDC Candidiasis guideline → Read the ACOG Vaginitis bulletin →
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.
ICD-10: H02.729 · Primary source: DailyMed/FDA prescribing information for Latisse (bimatoprost ophthalmic solution) 0.03%
DailyMed labeling describes bimatoprost ophthalmic solution 0.03% as a prescription treatment for hypotrichosis of the eyelashes, increasing eyelash growth including length, thickness, and darkness. Bidwell reviews eyelash growth visits for eligible adults ages 18-64 and does not guarantee treatment.
We refer for in-person eye care or primary care if the patient has glaucoma or elevated eye-pressure history requiring ophthalmology management, active eye redness or pain, vision changes, eye infection, eyelid inflammation, recent eye surgery, uncertain diagnosis, pregnancy or breastfeeding, or any symptom pattern suggesting the visit is not cosmetic eyelash hypotrichosis.
ICD-10: B00.9 · Primary sources: CDC STI Treatment Guidelines and DailyMed valacyclovir labeling
CDC guidance supports antiviral therapy for recurrent genital herpes and describes episodic and suppressive treatment approaches. Bidwell treats only adults ages 18-64 who already have a prior oral or genital herpes diagnosis from a healthcare provider. Bidwell does not diagnose new herpes infections online and does not provide STI testing.
We refer for in-person care for a first-ever outbreak, uncertain diagnosis, lesions near the eye, eye redness or vision changes, severe illness, neurologic symptoms, immunocompromising conditions, pregnancy or breastfeeding, severe genital pain, urinary retention, suspected STI exposure needing testing, or any presentation that requires exam or lab confirmation.
Read the CDC Herpes guideline → Read the DailyMed Valtrex label →
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 clinician — 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.
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