• Emergency Care Systems

It was Greg Henry, that preeminent emergency physician from Michigan, who once said “The ED has become the bottom of the societal birdcage…. All social problems have become diseases. If your mother no longer loves you and the police don't want you, you can always come and see us”. In truth it often feels that way when we arrive onto a shift, and especially feels that way when we have a visit from one of our ‘friends’ of the emergency department (ED). It is recognised that a small number of patients make frequent use of the ED and account for a disproportionate amount of the total ED workload.1 Recent press coverage has highlighted the problem of frequent attenders with the public by identifying those Emergency Departments in the UK who rank highest in having a frequently attending patient.2 The study by Vinton3 et al has shed more light on the profile of these patients through a large population-based study in the USA. The study used the US National Health …