Emergency room visits are up throughout Florida, and officials say "professional patients" who go from hospital to hospital seeking help they may not need carry some of the blame. A case in point was a recent visitor to AMI Medical Center Orlando.
The man had real heart problems and needed heart medication and fewer cigarettes, said Brenda C. de Treville, the hospital's chief marketing officer.
What he asked for was a bus ticket to Titusville.
The patient was more panhandler than emergency case, said Ms. de Treville. He had made his way to Orlando from Louisiana using bus tickets bought by hospitals.
AMI refused him the ticket, and after his third visit and treatment alerted other hospitals by placing a notice in a statewide newsletter.
The man's bills at AMI have not been paid.
While the number of professional patients is small, they represent a financial burden that hospitals can ill afford. Treating people who don't need medical care is particularly wasteful in emergency rooms loaded with expensive equipment and a highly trained staff.
Nor do the emergency rooms have time. Emergency visits to Florida hospitals rose 30 percent from 1984 to 1988, more than twice the 11 percent rise nationally.
The Local Health Council of East Central Florida has begun surveying hospitals in Brevard, Orange, Osceola and Seminole counties to find out how many emergency room patients should be getting care elsewhere. The results are expected in January.
Statistics show that emergency room care in the four counties has been rising faster than hospital admissions, a signal that some patients may be seeking unnecessary hospital care. From 1986 to 1990, first-quarter admissions to Orange County hospitals rose 13.5 percent, but emergency visits rose 24.5 percent, according to the council.
Some unnecessary visits arise from patients' misunderstanding of medicine and from a lack of all-night health care, said Cheryl Popeck, manager of the health services department at Cigna Healthplan of Florida Inc. in Orlando.
But "professional" patients fit a different description.
Some, such as AMI's recurring visitor, are drifters or homeless people. Their numbers increase during colder months.
Most are drug addicts, said Jo Loomis, assistant nurse manager of the emergency room at Florida Hospital Orlando. Ms. Loomis, who has worked in the emergency room for 17 years, said several patients a night visit the hospital seeking something other than medical care, usually prescription drugs.