You should go to the doctor at least once a year. They can check you out in a physical, and order blood work, and see how things change over time. It's also easier for them to deal with other routine illness when you've been seeing them regularly, and they can make sure you're getting your routine vaccinations. It doesn't matter if the symptoms have passed. You can still describe them to the doctor and they should still consider them.

Regarding how to know if the doctor you're seeing is competent, a lot of that is how you feel when you're with them. How do they treat you? Do they remember what you told them last time? Have they been thinking about it, reading about your symptoms, looking up possible causes?

Regarding a psych referral, it depends on how that was brought up. If they mentioned that some of your problems sounded like depression, then they might be suggesting that there's something there for you to deal with. However, if you think there's a medical problem, and the psych referral feels to you like they're not trying, that's a bad sign.

"To a hammer, everything looks like a nail"

A medical doctor should be looking for medical causes for symptoms. The way they come to a diagnosis is by identifying possible causes and ruling them out one by one. If they jumped to psychological causes without ruling out medical causes, I'd be concerned that they aren't really trying.

When I started seeing my current doctor, I already had two issues that had been diagnosed: Hashimotos Thyroiditis, and gout. When I came to him, I wanted to avoid taking meds for the gout, so he recommended drinking coffee to prevent flare-ups. In that first visit he also gave me a referral to see a sleep specialist because he thought I had sleep apnea.

I ended up having a sleep study and got a CPAP machine. That allowed me to have actually restful sleep for the first time in years.

Each time I returned, he had done more research into what my issues were and he had new things to try. He also has my family medical history, so he's watching out for issues that I might be prone to because of genetics.

I'm on medicine to reduce uric acid for the gout now because he had done additional reading and in one of my appointments he explained that new research showed that the high uric acid that causes gout flare-ups could also cause other issues due to causing general inflammation. Even though the coffee was preventing severe flare-ups, he convinced me to try allopurinol to reduce the uric acid.

He's also been concerned about the weight I gained due to the thyroid issues, so he's been working with me to help me lose weight.

What I'm saying is, after every visit, I leave feeling like my concerns have been addressed. He listens to what I'm telling him, and responds to what I say.

If you're not happy with the doctor you've seen, you should seek out someone who you feel comfortable with. My current doctor isn't the first doctor I've seen. There were probably five or six doctors I've seen over the years that were underwhelming before I found him. One good way to find a doctor is to talk to friends, family, or coworkers and find out if they have a doctor they like.