Study: Doctors are becoming overwhelmed by constant visits from ‘frequent attenders’

December 23, 2021

Is there such a thing as going to the doctor too much? A new study by reearchers at the University of Manchester in England finds that family doctors are being overwhelmed by “frequent attenders”—who, they estimate, visit their practices five times more often than other patients, reports Study Finds.

Based on the recent study, these individuals make up around 40% of consultations. This isn’t a new trend either. The proportion of medical “regulars” has soared over the past two decades, years before the emergence of COVID-19.

“A relatively small number of patients are accounting for a large proportion of GP workload including face-to-face consultations,” says corresponding author Professor Evangelos Kontopantelis in a media release.

“Frequent attenders appear to be a major driver for the increase in consultations that have contributed to perceptions of increased workload in general practice,” the study author adds. “GPs should be looking at this group of patients more closely to understand who they are and why they are consulting more frequently.”

The findings come from an analysis of nearly 1.7 billion doctor’s appointments involving just 12.3 million patients over 20 years. The results also come after the pandemic has caused severe disruptions to medical practices over the last two years.

GPs have repeatedly sounded the alarm on the increasing pressures of an aging population, the complexity of care, and initiatives to shift treatment from hospitals into the community. A poll earlier this year found that doctors were working 11 hours a day on average and seeing 37 patients — a third more than what experts consider safe.

In-person care rose from an average of 38% between 2000 and 2001, to 43% between 2018 and 2019—and from an average of 38% to 40% for all practice staff.

The Manchester team drew on anonymized information in the Clinical Practice Research Database. It covered 845 surgeries across the U.K. between April 2000 and March 2019, with 113 contributing doctor’s offices throughout the entire period. Frequent attenders show up for an examination around five times as frequently as the average patient.

“While many of these patients may have comorbidities and may need to be seen regularly, research suggest that they have wider social and psychological needs,” the researchers write in the journal BMJ Open.

Who are the most frequent attenders? The evidence across Europe reveals that frequent attenders are more likely to be female, older, and have more social and psychiatric problems. They are also more likely to be taking drugs for mental illness, have more medically unexplainable symptoms, and more long-term conditions.

Among frequent attenders, all types of consultations with GPs rose from an average of 13 to 21 a year during the study. However, those consultations with other practice staff rose from an average of 27 a year to 60 between April 2000 and March 2019.

There was relatively little regional variation across the entire United Kingdom in any of the trends, but face-to-face consultations with GPs and all staff were highest in Scotland and Northern Ireland.

Typically, frequent attenders visit their family doctor between 20 to 40 times a year. Researchers note this is an observational study and can’t determine the exact cause of this trend, but health officials believe loneliness may be part of the issue.

Research contact: @StudyFinds