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The purpose of this study was to better understand providers’ perspectives of and experiences with frequent users of medical services. Focus group interviews were con¬ducted with physicians in San Diego, California, and Omaha, Nebraska. Indicators of problematic patient overuse of medical services were identified as well as the common physician experience of overuse that is troublesome and problematic. Qualitative data analysis revealed that physicians did not consider patient overuse, by itself, to be problematic. Overuse became problematic and troublesome when patient behavior violated the physician-patient relationship of trust. All participants described a distinct negative physiological reaction to these patients.