Are people who pay through the nose more demanding than those on the dole?

[Emergent, RN]

So, do you all think people who pay premiums and big copays are more difficult and demanding patients than those who get healthcare Scott free? Do they seem to feel entitled to better care than the medically indigent? Is there any difference in your experience?

I know in the ER, the poor and uneducated are definitely the ones who clog up the system with nonsense, and expect fast food service. People paying their bills seem to think twice before checking in for a pimple or after having vomited twice. The non-payers are more likely to be accompanied by a hoard of friends and relatives who reek of cigarettes and unwashed bodies, and leave a trail of junk food wrappers in their wake.

What about the setting where you work?

[TheCommuter, BSN, RN]

I tend to have fewer problems with patients and families who are solidly in the middle. It's the extremes (affluent people and poor people) that are problematic.

However, if I had to pick a problem patient, I'd rather deal with the poor guy. The wealthy tend to be more knowledgeable about dealing effectively with bureaucracies such as hospital management, so their concerns are escalated.

On the other hand, poor patients often struggle to escalate up the chain of command, so those of us at the bedside can often de-escalate their issues and address their concerns before it reaches upper management.