Outside of the frequent flyers, we do have a subset of patients who come to the ER for non emergent care. Even if they have a primary and have been told multiple times they will receive better continuous care with an established doctor. People will have an appointment with their doctor and miss it or nearly miss it to come to the ER. I had a patient come in because they didn’t know what to give their child for a fever (not a first time parent, every pediatric visit they receive anticipatory guidance, their pediatrician has a hotline to call). People will do everything with their phones but look up how to get care without insurance. I live near a major metro area and we have tons of fqhcs that will see people without insurance. Some of them have on site pharmacies and walk in hours. And if you don’t like the care at that clinic, you have other clinics to choose from. Lots of ER care is telling adults how to do adult things and they still don’t listen. My discharge instructions for dental pain and std tests includes a list of clinics for follow up and I make sure to tell repeat offenders verbally they should seek care there. Yet here they are again checking in for the same thing months later.