 Only adult age18 patients referred from the Appleton Clinic are eligible. All Appleton patients who are considered new patient referrals ie, have never been seen in the pulmonary, rheumatology, and endocrine clinics at the Milwaukee VA will be eligible. Appleton patients who have previously been seen by any of the nine participating endocrine, pulmonary, and rheumatology physicians at the Milwaukee VA will be eligible. These follow-up patients will be scheduled with the previously seen participating physician, so there is no disruption of the ongoing patient-provider relationship. Patients that have established care with a non-participating provider will not be eligible. Patients that have been referred to the specialist for an outpatient procedure eg, request to perform pulmonary function testing or bronchoscopy will not be eligible. Repeat visits to the same or any other participating physician will not be eligible. Adult patients who have a significant communication disability severe speech and hearing impairment, severe dementia, or mental health condition resulting in a non-communicative patient and are considered mentally competent to provide informed written consent will not be eligible. Patients with disabilities other than those mentioned will be eligible. 