How Coordinated Care Can Ground Frequent Fliers

At the Spectrum Health Medical Group Center for Integrative Medicine, Waller told me, in an extensive interview, that he sees many patients who were dismissed by primary care doctors. "A vast majority of these patients have been fired from their primary care physician and sometimes from a federally qualified health center," Waller says.

Often, the patients have chronic pain, or have psychiatric or addiction issues. The clinic works to treat those patients and provide care to thwart the possibility that they may return to the emergency department, where many of them often end up after being dismissed by their doctors, Waller says.

Waller says he has checked with physicians' offices about why these patients were "let go."

"When I call the (physician) offices, and ask for the reasons (patients) are being fired, they say, ‘Well, they missed three appointments," Waller explains. " I say, ‘You are telling me these people who have no general transportation, no money for a bus, [so] they miss appointments … are going to get fired?''

"OK, they need to take responsibility for themselves, but what if they have an IQ of 70?" Waller asks rhetorically.

"And I see this every day," Waller says. "Most of my patients have been fired from physician practices at some point."