Why do I need an appointment? Can’t I just have an antibiotic?

Here at OFD, we are in the thick of cold and flu season, or at least that’s what we used to call it. Now we’re also talking about the latest COVID variant, RSV, Strep and a host of circulating stomach bugs as well. Unfortunately, these days many of our patients are waking up feeling terrible, or just can’t shake the illness that they’ve had for a few days or longer.

In many cases, our patients call the office, frustrated with their symptoms, and request antibiotics be called to the pharmacy to just “knock the infection out”. This request, may lead to additional frustration when our office staff advises patients to make an appointment with either their personal physician, or one of the other physicians at OFD. There are many reasons why these telehealth or in-person visits are necessary, shared below.

  • There is a good chance that the infection that has our patients feeling badly is a viral infection, and not bacterial. Viral infections do not respond to antibiotics. It is far easier for a physician to differentiate a viral from bacterial infection after examining our patients in person. Sometimes specific testing needs to be done.
  • Both bacterial and viral infections can cause physical exam findings that cannot be appreciated over the phone, which is why we ask that patients come to the parking lot for a physical exam and a set of vital signs.
  • Sometimes anti-viral medications (such as Tamiflu or Paxlovid) are appropriate when certain viral infections are diagnosed in time. An influenza or COVID test is needed to make the diagnosis for these particular medications.
  • Additionally, a detailed discussion of the risks/benefits of these anti-viral meds is needed, including any drug interactions that exist between the anti-viral and the patient’s routine medications.
  • In cases of influenza or COVID (as well as other viruses), physical examination further helps us to determine if it is safe to manage these viral infections in the outpatient setting, or if hospital evaluation is needed.
  • It is not uncommon for patients to “misdiagnose” their symptoms as infections – when in fact an alternative explanation might explain the symptoms such as Asthma, Allergies, Food Poisoning, or a more complicated diagnosis.
  • While there are many medical requests that can certainly be managed with a simple request of office staff (routine medication refills, referral status questions, general health advice etc..), the doctors at OFD feel that the standard of care for managing infections requires a visit (telehealth or in-person) to best care for our patients.

The good news, is that each OFD Physician begins his/her day with 5 same-day appointments, and we can almost always schedule a same-day appointment for our patients who find themselves acutely ill, or not getting better from a persistent illness. It is quite common for our clinical team to begin these visits on the phone with our patients using the reserved parking spots toward the back of the building. After an initial conversation, the physician will determine if it is safe for the patient to come inside the building wearing a mask, v.s. being examined “car-side” in the parking lot. There are some cases when physicians will be comfortable doing telehealth visits for patients who become ill while out-of-town and are not able to come to the office.

As always, we appreciate OFD patients being willing to work within our clinical protocols, which are evidence-based or evidence-informed, and always have the best interest of our patients in mind.

MW