According to the National Ambulatory Medical Care Survey, patients in the U.S. made 27 million doctor visits in 2006 for cough—that’s just 3 percent of total visits, but it’s the most common reason for a doctor visit behind a general medical exam or a non-specific progress visit. Otolaryngologists, though, saw just 17 million patients that year—for any reason. “There’s a big lapse in the amount of care that we provide to cough patients,” Dr. Altman said. “Most care provided to cough patients is performed by primary physicians, pulmonary physicians and other subspecialists—not otolaryngologists.”
There is opportunity here, he said. In 2006, there were $3.6 billion in sales of over-the-counter cough and cold medications, meaning that the public is often self-treating with no clear diagnosis.
The American College of Chest Physicians offers a scientific, evidence-based list of chronic cough causes, and the American Academy of Otolaryngology–Head and Neck Surgery Foundation is partnering with them to help forge upcoming recommendations. Common reasons include tobacco use, post-nasal drip syndrome, GERD and laryngoesophageal reflux, bronchitis, asthma and the use of ACE inhibitors. Reasons occurring less commonly include bronchiectasis, carcinoma, cystic fibrosis, congestive heart failure, and interstitial pulmonary disease.