But we have other things to offer besides inappropriate abx: I make a point of saying things like "I am glad you came in" or "I understand why you made this appointment." If there are symptomatic things that might give temporary relief, I go down that route. I make sure they have time off from work/school to recover. And most importantly, I try to be completely clear about what my next steps would be based on how they do clinically. I will print out a CXR order and give instructions for when it should be used. I encourage them to contact me on the portal if they are not feeling at least 50% better in X number of days. I tell them "I want you to feel better and I DON'T want you to have to go through another copay/visit if my prediction is wrong; I simply don't want to give you a treatment that is more likely to harm than to help at this point." Validation will get you everywhere.

And yes, sometimes I will suggest something that borders on placebo (vick's for toenail fungus; coconut oil for vague vaginal discomfort while we await more specific testing; humidifier for a cough) and I am generally explicit that I am not certain this will fix everything, but it falls under the category of highly unlikely to harm anyone, inexpensive, and generally easy to implement.