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With the San Diego skyline in the background, firefighter-paramedic Dave Stepp rides on his fire engine to another medical call. Stepp says that the most frustrating thing to him about frequent flyers is that often they are not facing a real emergency. "It can affect people's lives" he says. "When you have do drive your fire engine past a vehicle accident, you know somebody's hurt, and you're on your way to a frequent flyer for another minor emergency, your heart's getting ripped out".