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June 1, 1984

Physician Visits for 'Colds'

JAMA. 1984;251(21):2793. doi:10.1001/jama.1984.03340450021013

To the Editor.—  Roberts et al1 reported on a schema that reduced unnecessary physician visits for minor respiratory illness by 44% in a family practice clinic. This is all well and good in these cost-conscious times, but I would like to relate a case wherein such an "unnecessary" visit had a profound influence on a patient's medical care.

Report of a Case.—  In January 1982, a mother brought her 20-year-old son to the Family Health Center, Bay Shore, NY, with a complaint of three weeks' dry cough. He was afebrile and denied shortness of breath, wheezing, sore throat, or fever, and the visit would have been deemed "unnecessary" by the criteria used in that study. It was the first time I had seen the boy, and I was struck by his lack of facial hair and sexually immature appearance. I apologized to his mother for temporarily ignoring his cough as