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.