At what point do you involve doctors

Kendra • Married Mom of 💝2013,💙2015,💝2017,💙2019, 💝2021 and 3 Angel's 👼👼👼!

My 2 nearly 3 year old son has gotten out of hand. I don't know what to do. We have done empathy, time outs, spankings. He is just out of control. He is destroying things, hitting his big sister who is 4 (he hit her with a rock in the back of the head and made her head bleed) and little sister who is 9 months . His tantrums are 0 to 100 real quick. Time outs he just goes nuts and throws things, hits things or hits himself. It takes on average 45 minutes to get him to calm down. I am at my wits end. My oldest daughter was never like this and my youngest is only 9 months so I haven't experienced any thing of this sort yet obviously. Do I call his doctor? Any advice would help. This is not normal terrible 2s. Thanks for any help.