You know the visit. It’s squeezed into a same-day slot, wedged between a sore throat and a med refill. The patient is excited (maybe a little overwhelmed) and says something like:
“I’m going to Thailand next week… do I need anything?”
And just like that, you’re practicing travel medicine (and dreaming of going to Thailand 🙃).
Travel medicine isn’t only offered at dedicated travel medicine clinics. It is incorporated into urgent care medicine, primary care, peds and more. These are quick but high-stakes opportunities to prevent illness, reduce risk, and help our patients enjoy the trip they’ve been planning for months (or years). It’s also one of those areas where a little preparation goes a long way — for both you and your patient.
Let’s walk through how to approach these visits in a way that’s practical, evidence-informed, and, most importantly, feasible in the fast-paced environments we work in.
Travel medicine is one of those specialties that quietly grew alongside modern air travel. As global mobility increased, so did our exposure to infectious diseases and our responsibility to help patients navigate that risk.
At its core, travel medicine is about two things:
Because here’s the reality: when patients travel to regions with diseases their immune systems have never encountered, they’re vulnerable. And when they come home, they can bring those illnesses with them, sometimes with significant public health implications.
The good news? Most of what we need to do falls into three buckets:
And in urgent care, medications are often where we live.
If you remember nothing else, remember this: most travel-related medication visits boil down to four key categories.
1. Malaria prophylaxis
2. Traveler’s diarrhea treatment
3. Altitude sickness prevention
4. Motion sickness management
Think of malaria as the headliner and the rest as your “add-to-cart” items.
Before you reach for UpToDate or the CDC site, pause and ask a few targeted questions. These will shape everything that follows:
This is your clinical GPS. Without it, you’re guessing.
If you’re not already using the CDC Yellow Book, now is the time to start. It’s the closest thing we have to a one-stop shop for travel medicine.
It helps you answer:
Malaria is the big one. It’s also the one where under-treating carries real consequences.
A few practical takeaways:
There’s also no strict maximum duration for malaria prophylaxis per CDC guidance, which can be reassuring for longer trips.
One important clinical pearl: Mefloquine carries a black box warning for neuropsychiatric effects. If your patient has a history of anxiety, depression, or other psychiatric conditions, it’s worth choosing an alternative.
You don’t have to be summiting Kilimanjaro to get altitude sickness.
We tend to see two types of travelers:
That distinction matters because dosing strategies differ:
Acetazolamide is your go-to, but don’t forget:
And yes, many patients will come in already asking for it. Sometimes, the visit is less about convincing and more about confirming safe use.
Traveler’s diarrhea is incredibly common and incredibly misunderstood.
Most cases are:
Here’s where patient education matters more than the prescription pad.
Key counseling point:
Antibiotics are not for prevention.
Instead:
When you do prescribe:
Also worth noting: fluoroquinolone resistance is high in parts of Africa and Asia, so ciprofloxacin isn’t the reliable go-to it once was.
And if your patient casually mentions:
…your index of suspicion should go up just a bit.
Motion sickness seems straightforward, until it isn’t.
Scopolamine patches are effective, but they come with baggage:
That last point is key. A patch that lingers for three days may not be ideal for someone doing a one-day safari or intermittent car travel.
Sometimes, the best move is recommending a simple OTC option instead.
Every travel visit eventually lands here:
“Can you just give me everything in case I need it?”
It’s a reasonable ask. Travel can feel unpredictable, and patients want control.
But this is where we can reframe the conversation.
Instead of overprescribing, consider this:
The U.S. has hundreds of embassies and consulates worldwide, many with 24/7 emergency lines that can help travelers:
Encouraging patients to save that contact information before they leave is one of the most practical, empowering things we can offer.
For longer trips, it’s also worth discussing the reality that:
And one small but important pearl: Advise patients to keep medications in their original prescription bottles.
Travel meds aren’t prescribed in a vacuum.
A few quick reminders:
These are easy to overlook in a quick visit, but they matter.
Travel medicine isn’t about memorizing every endemic disease or medication regimen. It’s about helping patients step into the unknown with a little more confidence — and a lot more safety.
It’s also a reminder of something we don’t always get to see in clinic: Our patients have lives beyond our exam rooms. They’re climbing mountains, visiting family across the world, going on honeymoons, taking bucket-list trips.
We get to be a small part of that story.
And sometimes, the best thing we can offer is reassurance, preparation, and a sense that someone’s thought this through with them.
When it comes to travel medicine, you don’t need to know everything. You just need a framework, a reliable resource (hello, Yellow Book), and a willingness to meet patients where they are — excited, uncertain, and about to board a plane.
That’s more than enough to make a difference.
For more information, subscribe to the Urgent Care Reviews and Perspectives podcast and listen to our segment "Travel Medicine 101."