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USMLE® Question of the Week

A 34-year-old man calls the office requesting an urgent appointment due to cough and cold symptoms. His temperature is 37.2 C (99 F), but he feels "miserable" and is unsure if he should go to work the next day. The patient has a history of seasonal allergies and knee pain from a past sports injury. He has no other medical problems but does have a history of frequent office visits. The receptionist informs him that the physician is preparing to leave as it is near closing t me but that an appointment is available for the next morning. The patient declines the offer of an appointment and hangs up. As the physician leaves the office 30 minutes later to make evening rounds at the hospital the patient arrives and insists on being seen immediately. He sounds congested and coughs occasionally but is breathing normally. He has no other symptoms. He again asks to be examined. Which of the following is the most appropriate response?

A. "Although I understand your concern, we should address it tomorrow because it is not an emergency."
B. "I am sorry. I would normally see you, but I have another appointment that can't wait."
C. "I am sorry you drove all this way, but your problem can wait until tomorrow."
D. "I insist that you go to the nearest emergency department for evaluation."
E. "I regret that I cannot see you now; didn't my staff inform you that it is closing time?"
F. "Let me take a quick look; it's probably nothing to worry about."

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