Keeping lists and naming names: habitual patient files for suspected nontherapeutic drug-seeking patients

Emergency departments commonly keep files of patients who are suspected of frequently visiting them and fabricating symptoms to obtain prescription drugs, usually opioids, for nontherapeutic purposes. Such files have previously been given names such as “frequent flyer file,” “repeater log,” “kook-book,” “problem patient file,” “patient alert list,” or “special needs file.” Little has been written about the ethical, legal, and regulatory considerations that should be taken into account when establishing, maintaining, and using such files. This article explores these issues. The term “habitual patient files” is proposed because it is descriptive without being judgmental. [Ann Emerg Med. 2003;42:873-881.]