“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? 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...