Colds make me uncomfortable. Yes, I am uncomfortable when I have a cold, but that’s not what I am talking about. I am uncomfortable when people come to the office for a cold. It’s a very difficult situation for a doctor.
Are you kidding? What could be easier than a person with a cold?
When a person comes to the office with a cold, it leads to the obvious question: why? Why would someone come to the office for something that everyone knows is nothing serious. Immediately in the visit I start searching for clues: are they looking for an antibiotic? Are they looking for an excuse from work or school? Are there other symptoms that the person is not telling?
It’s awkward. When I first started in practice 15+ years ago, 99% of these visits were to get an antibiotic (“my mucous is green, so it’s an infection.” - I thought everyone knew boogers are green), so I got used to giving my “no antibiotics for a virus” talk. People were not receptive back then, so it was always a fight to get them to be satisfied being told to just wait and let nature take it’s course. Fortunately, that’s gotten better with the unfortunate advent of multi-drug-resistant bacteria. Still, there are a fair number patients that want an antibiotic because: a. Green = bad, b. Last time they got a cold, it ended up as a sinus infection and so they wanted to catch it early; c. They were around someone with “bronchitis.” d. They have a “weak immune system.” I still get mad people at times because of antibiotic refusal, but most of the time I can avoid it.
So if they are not begging for bug-juice, why would they be here for a cold? When the person comes in with 1-2 days of runny nose and sore throat, what are they looking for? They often even say “I’ve got a cold,” and I am left asking to myself, “so why are you here then?” It happens a lot. I end up fishing for explanations. I don’t want to confront them with, “so why the heck are you here for a condition your mom would’ve treated with soup?” I think that would seem rude.
The common reasons for coming in for colds are:
- They need a work/school excuse.
- Their spouse/parent is bugging them to come in.
- They want a narcotic cough medication.
- They are hot and have heard our exam rooms are freezing.
- They want to mystify their doctor.
Seriously, I am often left with the mystery of: “I think it’s just a virus and will go away on it’s own.” To which the patient responds, “OK, thanks doc.”
Why does this matter to me? It doesn’t much, after all, I do get paid for stating the obvious. But I find myself wanting to get to the bottom of this mystery. I suspect it has to do with UFO’s or the Bermuda Triangle.
Bigfoot came to my office last week with a runny nose.
Weird.This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.