Last night was Chest Pain Jane's 21st visit in the past month. She had been seen at Another Hospital earlier that morning for the same pain. And the day before both at her primary care doctor, and the Big City ED. When I asked why she hadn't gone to her PCP again, she became suspicious and upset, and begged me not to call him.
Twenty-one visits in thirty days. All workups negative. It may not be the biggest contributor to the healthcare problem, but it certainly isn't helping.