Frequent Flyers in Healthcare | What Should Doctors Do?

Frequent Flyers in Healthcare | What Should Doctors Do?

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“This patient has been here four times in three months,” Janet, an emergency department physician, told her coworker. “I don’t know what to do. We can’t deny him care, but he doesn’t even seem to be injured.” Does this situation sound familiar to you? Whether you’re familiar with the term or not, frequent flyers in healthcare are becoming a big issue in today’s hospitals. So, why do some patients come to the emergency room so often, and what should hospitals do to help them?

Frequent Flyers in Healthcare | What Doctors Should Know

What are Frequent Flyers in Healthcare?

These days, hospitals are starting to see more and more “frequent flyers,” and we’re not talking about an airline’s loyalty program. In a healthcare setting, frequent flyers, also called “super-utilizers,” are patients who show up repeatedly to a hospital’s emergency department. Instead of seeing their own doctor, these individuals choose to seek care in the emergency room. According to a survey conducted by the American College of Emergency Physicians, 3.1 percent of a San Diego hospital’s emergency patients accounted for 16.5 percent of the total visits. So, what is causing these patients to visit the emergency room so often? Are they actually ill, or is there something else at play?

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What Makes Frequent Flyers so “Frequent?”

There are a number of reasons that these patients overuse the emergency department, but here are a few of the main ones:

  • Insurance. In some cases, a patient doesn’t have insurance and can’t afford to see a regular doctor. The Emergency Medical Treatment and Labor Act (EMTLA) of 1986 requires hospitals to screen and stabilize patients, regardless of their ability to pay.
  • Mental health. A study from the Agency for Healthcare Research and Quality found that around one-third of a hospital’s frequent patients had a history of bipolar disorder, schizophrenia, or psychosis. In addition, some patients had suicidal or homicidal ideations.
  • No primary care physician. The same study from the AHRQ found that 14.3 percent of frequent patients across three hospitals did not have a primary care physician. Some of the patients said that they preferred the convenience and accessibility of the emergency department.
  • Substance abuse. Individuals that suffer from drug/alcohol withdrawal, drug overdose, or alcohol intoxication made up for almost ten percent of a hospital’s frequent users.
  • Chronic illness. Occasionally, a hospital’s frequent patients are chronically ill individuals who experience regular flare-ups from their condition.
  • Attention seekers. Sometimes, a frequent flyer is simply an attention seeker. You may have heard of the slang term “GOMER” (get out of my emergency room). This refers to individuals who frequent the emergency room but don’t require emergency care.

How to Treat Frequent Flyers in Healthcare

It’s important to identify what is causing a patient to frequent the emergency room. Once the cause is identified, hospitals should work with these patients to direct them to better care. A hospital in Maryland identified 318 patients who had four or more emergency room trips in four months. Then, they linked these patients to primary care physicians, insurance, and mental health and substance abuse programs. In this case, the staff connected patients with a coordinator who worked with them for several months to ensure fewer emergency room visits. The staff members made appointments for the patients, arranged transportation for them, and even met them at the doctor’s office. The hospital reported that, after going through the programs, many of the frequent patients stopped going to the emergency room.

Hopefully you’ve learned some valuable information about frequent flyers in healthcare. At the end of the day, what’s important is directing them to the proper care and help they need! Do you have any experience dealing with super-utilizers? Feel free to share your thoughts in the comments below!

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1 Comment

  1. I have periferal artery disease. I had a angioplasty done in the ER and the surgeon refused to see me after the surgery caused complications. I went back to the ER 2x because of horrible pain. The surgeon has refused to see me in the ER or in the office he practices and sees patients.he made inappropriate remarks to get amputation. Thanks

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