When Patients Cry Wolf

Monday, October 24th, 2016 @ 12:00PM

As children we all learned the story of the boy who cried wolf and its underlying message warning of the dangers of being dishonest. The simple story teaches a powerful lesson that most of us carry with us throughout our lives. There are those, however, who seem either to have missed the story’s meaning or choose simply to ignore it altogether. Regrettably, I see many of these people every time I go to work in the emergency room.

The majority of patients that present to the ER have genuine problems (not necessarily emergencies, but bona fide medical issues nonetheless) and are in need of at least some level of advice and or treatment to remedy the situation. Generally, these patients play by the rules and find themselves with medical issues for reasons beyond their control – automobile accident, work-related injury, fall, a chronic disease process that has worsened acutely, etc. These are the patients for whom modern ERs were created.

Unfortunately, many patients visit the ER not because of a true medical issue but, rather, for secondary gain – in essence, these people want something other than bona fide medical treatment and have learned that they can go to the ER to get it – inappropriate prescriptions for narcotics (a widespread and often deadly problem in Georgia and across America that I have written about previously), work excuses after partying all night, free pregnancy tests, free ultrasounds to determine the sex of an unborn child (another abuse I’ve written about), a means of getting out of jail for a few hours merely to break the monotony of incarceration, attempts to avoid apprehension by law enforcement or to avoid incarceration in the first place, a free meal, a place to sleep – the list goes on and on. Many patients treat the ER like a doctor’s office and go there simply because they prefer not to make an appointment with their regular physician because, to them, it’s easier.

But why should the average citizen who doesn’t misuse the emergency room be concerned about this growing problem? Because such inappropriate utilization of Georgia’s and America’s ERs costs US taxpayers like me and you billions of dollars a year. And the problem continues to get worse year after year after year. Even more immediately dangerous is the fact that when patients visit the ER inappropriately (or call an ambulance for non-medical emergencies) we are all placed at risk of being unable to access emergency medical care when we need it which, in the end, can and does cost lives.

Thankfully, some within the medical community are taking this problem seriously. As I wrote recently, a hospital in north Georgia recently instituted a policy in which its ER physicians no longer write prescriptions to refill narcotics nor do they provide original prescriptions for narcotics for minor problems such as a toothache (which, of course, should be managed by a dentist), chronic pain syndromes like osteoarthritis, or acute back pain (likely the most common complaint offered by those seeking inappropriate narcotic refills).

However, this is only a first step. So much more needs to be done. For instance, I once worked in an emergency room in which a patient visited more than 80 times in three months. On several occasions he visited the ER multiple times the same day (usually transported by ambulance). We later discovered he had submitted a claim for disability benefits but had no qualifying medical condition. He later claimed he was told to visit the ER as often as possible to support his claim. Legislation should be put in place granting authority to hospitals to effectively deal with such serial abusers of their emergency departments.

The time has come when we as a society must put our foot down and say the “buck stops here” with regard to ER abuse. Inaction in this regard will result in increased tax burdens borne by all taxpaying Americans while diminishing the quality of, and access to, healthcare resources for those of us who play by the rules. Solutions to this burgeoning problem of ER abuse are available for those communities possessing the determination to make meaningful change. And the time for change is certainly upon us. Eventually, we will all need access to healthcare. With that in mind, we must remember that when patients cry wolf, we all pay.

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