why do people go to the doctor for a cold?

I’m a practicing physician and have been one for years, and I take the time to try and educate my patients, and to listen so I can hear what they’re really asking with their questions, but the one thing that has eluded me all these years is why people repeatedly come in on day one or two or three of a standard upper respiratory infection (ie cold) and say to me, “I’ve just come down with a cold, and I came in because I want to nip it in the bud” (or butt, depending on the patient). I can understand coming in for prolonged symptoms, or concerns about whether it’s bronchitis, influenza, pneumonia, strep throat, ear infection, etc. But why on earth do so many people who know it’s a cold that they have expect me to be able to cure their colds? Some get quite angry when I refuse to give them antibiotics, some want narcotic cough syrups, but most just expect me to whip something out that will fix their infection. And many of these are otherwise intelligent-seeming people who have heard my cold “talk” before. I hear the same thing from my colleagues, so it doesn’t seem to be my bedside manner.

Any thoughts from the teeming millions?

Most people know that a cold will cure itself in a week, but if you go to a doctor it will only last seven days.

A guy with a real Type A personality hacked his way into his doctor’s office and demanded a cure. The doctor mentioned several over-the-counter products the man could take to relieve his symptoms, but pointed out that there was no way he could treat the cold.

The patient continued to insist on treatment, escalating from insistence, through demanding, to an outright temper tantrum.

Finally, the doctor gave in: “I want you to go home, put on your running shorts and a tank top, get in the shower for three minutes, then, without drying off, run down to the park in this 20° weather for half an hour, and walk home.”

Astonished, the man asked. “That will cure my cold?”

“No,” replied the doctor, “but it will probably give you pneumonia, and that I can treat.”

I think I saw that guy in my office last week!

Dr.Q,
how old are these patient, in other words, are they employed? Could it be that they come just for your note and the rest is …

<<Dr.Q,
how old are these patient, in other words, are they employed? Could it be that they come just for your note and the rest is …>>

Feel free to lose the Dr. part, Peace. Here I’m just plain old Qadgop. I only add the MD part if my answers need heft.

Anyway, yeah, I’m familiar with the ones that need slips for work, they’re usually apologetic for “wasting my time”, but their employer insists they see a physician if they take off work sick. Ridiculous, but I’m used to it.

No, the people of whom I speak really seem to think there’s a cure out there that I can give them. I once rather playfully suggested an enema ( I knew the guy pretty well and had an otherwise good relationship with him) and when he asked if that would help, I shrugged and said “couldn’t hurt”.

OK, Quad, it’s better without ties…
I do not want to be cynical, but does it cost them anything out-of-pocket to see you? Personally, I always try to avoid any doctor’s visits, as I hate waiting rooms, etc., but some people are in need of compassion…etc.

no, perhaps that’s part of the problem. In our system, most of the patients have no copay, and they have 24 hour access to a doctor, and people wonder why HMOs are filing for bankruptcy.

I’m just impressed that they can get in to see you before the cold goes away.

According to an article I was just studying for my Family Practice exam next Friday, people go to the doctor for seven reasons.
1.) Sick-role legitimization
2.) Administration/paperwork
3.) Prevention
4.) Intolerable anxiety
5.) Problem of living/inability to cope
6.) Sanctioning (“my wife made me”)
7.) Intolerable pain

I think #'s 1 and 2 are the big ones here. These people feel lousy, and somehow going to the doctor gives one a license to feel lousy. (They’re “sick enough to go to the doctor”.)

As for those who expect a cure, that would be basic lack of information about what is and what is not a cold. Most such patients I’ve seen are afraid that they have either a sinus infection or strep throat. Others honestly think that some amoxicillin will make it all better.

Here’s a good question back at you, though (as a more experienced physician than I am)–what are some guidelines that you would give to a patient regarding when a URI merits a trip to the doctor’s office? Obviously, I think a high fever, sinus pain, or symptoms for two weeks or so would be good. What else?

Dr. J

Qadgop the Mercotan, probably for the same reason they had as children, bring it to the attention of an adult, maybe they can make you feel better.

I go if I have a lot of trouble breathing, am coughing up blood, or if after a week the cold was starting to get better instead gets much worse, or if my fever gets to 103. If a doctor will not see me under those circumstances, i find another. I have a had bronchits, pnemonia, and asthma attacks. If i can’t breathe well, I see someone about it.

We do it to keep you docs properly humbled. And we know that there IS a cure, you’re just selfishly hoarding it for yourselves.

However, I keep reading about a medicine which will shorten the duration of either the cold itself or cold symptoms, if it’s taken within 24 or 48 hours of the onset of symptoms. What I want to know is why hasn’t my doctor given me a prescription for this stuff, and just told me to take it when I start coming down with a cold? I’ve got asthma, and the last time I had a cold I wound up in the ER because I was experiencing what they called “air hunger”. Not at all pleasant. I’m changing doctors next month, I’ll probably ask my new doc for this stuff.

And yes, I’ve had my flu shot for this year, and I’ve had a pneumonia shot fairly recently.

Quad:

My bestest buddy is an ob/gyn. He told me that when he comes down with a bad cold, he gets himself an IV full of good stuff to keep himself hydrated and relieve the symptoms. It enables him to work through the cold (sometimes he can’t take off.)

He offered me this treatment when I was down last year with a cold, and told me that it was something the Doctors at the hospital commonly did for each other.

Those patients want the secret Doctor cure that you’ve been jealously hoarding :slight_smile:

It’s simple. These people have been getting colds off and on for years. And whenever they have gotten a cold, they have gone to a doctor. And every time they went to a doctor (before the hardass Dr. Q) they got something. And every time they got something, they got better.

(It’s like believing that the “door close” buttons on elevators are really wired to something. If you always wait for a minute or so after you press your floor before you get impatient and press the “door close” button you will notice that not long after your press the button, the door will close. People prone to superstitious thinking will become convinced that pushing the “door close” was instrumental, just like people prone to superstitious thinking will believe that taking something prescribed by the doctor cured their cold when their symptoms start to abate a week to seven days after they started.

There are also hypochondriacs who always want to make sure it’s just a cold and nothing more serious.

Also, some people may go because the last time they had similar symptoms, it turned out to be something serious and/or easily treatable. One time I came down with strep throat and when I finally went to the doctor after 3 or 4 days of high fever, I was astonished at how fast and effective the antibiotics were.

I am a firm believer in a “free” health care. But some minimal co-pay is necessary. $5-$10. More symbolic than a hurdle, but you’d be surprised, how good a filter it can be. It can be waved in some cases, of course.
I realise that all causes mentioned by DoctorJ apply. I am talking about the “overflow” mentioned in the OP.

I work as a medical coder, and I can tell you that most, if not all insurance companies, will NOT cover a visit if the chief complaint is listed as acute nasopharyngitis (i.e. common cold, ICD-9-CM code 460). Usually, this is cited as “lack of medical necessity”.

Billing the patient for the visit after it’s denied (which you can do under certain conditions) is a good way to discourage visits for colds. So is patient education.

Robin

You doctors seem to forget about the kids that get dragged in for colds and the like. I had to visit the doctor because of a minor pain when I coughed. It ended up being an upper respiratory tract infection, exactly what I told the world. Yet my PE teacher, the other coaches and most importantly the soccer coach told me to go to the doctor before they let me out onto the field to play anything. Now when my grade depends on going to the doctor then I’m sorry if I waste your time but what can I do in the face of authority? Adults might have had this done to them when they were younger and just gotten into the habit. I promise you I won’t I can’t stand hospitals or doctors’ offices, I don’t think my doctor likes me. I have the tendency to pass out when I see needles.
Oh by the way, if you want to keep them away don’t give them so many meds if they don’t really need them. I had a cold and I got antibiotics, an inhaler and prescription cough syrup. A bit much don’t ya think?

Kitty

They want reassurance, and because you’re the expert. Patients are like children. They can be unreasonable, have unrealistic expectations, etc. If you’ve been in practice for years, I’m surprised that you don’t know the answer to your question already.

thanks for the insights and responses, all. They all fell into the categories I was expecting; 1)because they can, 2)because they have to, 3)because they want to. I guess those categories also cover most human actions.

As for secret cures, we still lack them. iv fluids can reduce symptoms, but its easier to just drink more fluids. And medicines that shorten the course of the illness are for influenza, not a cold.