To the Editor.
—I read with great interest your two recent articles1,2 on patients leaving the emergency department prior to receiving care. While the articles dealt thoroughly with the emergency department's complex role in treating patients who lack other health care providers, they make little mention of emergency department use by patients who already have physicians either inside or outside the institution. In my experience at one urban teaching hospital, I found that many such patients, without any acute problems, often came to the emergency department for what amounted to routine evaluation of chronic ailments. In some cases they had been unable to contact their regular health care provider; at other times, they hadn't tried.Needless to say, the emergency department staff wasted much time reviewing often complex medical histories and trying to contact these patients' regular physicians. In most instances, the emergency physician would simply refer them back