Sir.—I believe that Drs DeAngelis and Fosarelli1 have made a number of unwarranted assumptions regarding follow-up appointments. First, their methodology is open to question, in that reviewing emergency room charts completed by residents demonstrates that documentation, especially of follow-up plans, is often incomplete and varies between house officers. It has been my experience that this variation in documentation tends to be situational, with deterioration during busy periods and after midnight. Interpretation of the data reported in the article thus becomes more difficult.
Second, although pediatric texts and many academicians do in fact advise follow-up visits for all children with ear infections, this policy is questionable with respect to older children who have not had frequent recent infections. At our institution, we generally do not reappoint school age children with uncomplicated otitis, but instead tell them to call or return if symptoms persist or recur after therapy is completed.