Following spirometry, each physician was asked, “Based on the results of this spirometry, do you plan to change any aspects of management for airflow obstruction?” The question was answered “yes” in 15.0% (154 of 1,030 patients). Of those with an FEV1/FVC ratio < 0.7, management change was planned in 52.5%, vs 7.0% in those with an FEV1/FVC ratio ≥ 0.7 (p = 0.0001). Among those with an FEV1/FVC ratio < 0.7, the likelihood of planning to change management was increased with the severity of airflow obstruction: 56.9% (82 of 144 patients) with an FEV1 < 80% of predicted, vs 34.3% (12 of 35 patients) with an FEV1 ≥ 80% (p = 0.016). Stratified by the yes/no combinations of prespirometry and postspirometry diagnoses of airflow obstruction, the proportions of planned management change within these combinations were as follows: 61.3% (no, 57/yes, 93); 10.4% (yes, 12/no, 115); 0.8% (no, 5/no, 627), and 41.0% (yes, 80/yes, 195), χ2 p < 0.0001 (Fig 1). Management changes described by physicians were usually to counsel patients to stop smoking (n = 44) or to change, add, or subtract medications (n = 98). Other described planned changes included closer evaluation and re-evaluation of patients, encouragement of compliance with medications, and counseling to lose weight.