Frequent flyers

[surgblumm]

And What Do You Think of Frequent Flyers

Bob Blumm, MA, PA-C, DFAAPA

Most of us belong to some type of frequent flyer program and have discovered that some are better than others. We have learned about black-out dates and scores of other penalties that do not favor the advantaged people who have frequent flyer membership. However, there is a commodity that had frequent flyers and they have 24 x7 accesses to their place of destination. Their destination is usually and emergency department and their reasons are not always an emergency venture or problem. Some come just in time for lunch or dinner and I applaud their planning. Some come by ambulance with family members as once the “ill patient” is waiting for their treatment the remainder of the family has access to the nearby beaches and other places of amusements. Does this create a poor image of our business in the eyes of the reader or the clinician? Unfortunately, this is a true scenario and happens too often and at great cost for a health care system that is going broke. I believe there are emergency patients and that they deserve immediate care but I have also had decades of experience seeing malingerers who know the system better than the attorney and the administration and use their knowledge for personal gain and satisfaction . how long can this continue?

The July,2012 issue of Annals of Emergency Medicine had an article from a group of researchers in Manitoba and the article was directed to Frequent Flyers. The authors divided the FF into two groups (7 to 17 visits per year) and Highly frequent flyers (HFF)which consisted of more than 18 visits per year. The FF group consisted for 2.1% of patients and and almost 10% were not elderly patients. These others had mental health issues and lived in the vicinity of the hospital and used their services. The HFF group was only 0.2% of patients but 3.6% of the visits. These individuals were extremely poor, had drug dependence and were much younger. The question seems to surface concerning the need of facilities that can take these patients and render the care and referrals that are needed? I used to see this is a large ER where a patient waited for five hours and could only receive 24 hours of pain medication and perhaps an antibiotic because they has dental caries and needed the services of a dentist and this hospital did not have a dental service.

Dr. Ellen Weber from ED Leadership Monthly wrote a companion editorial on this subject and penned the words;”Though we have expanded the technical abilities of medical care, how we deliver care has not kept pace. These are the issues that the administrators and the medical boards and institutions must study and make clear concise decisions upon as the problems and the costs are ever rising for the institutions, only 2.2% of the medical costs of this nation are going to physicians and the rest are being eaten up by outdated policies that must be changed