Many millennials don’t have primary care doctors, and don’t see much value in finding one.
Nearly half of the younger portion of the generation said they don’t see a general practitioner, in response to a Kaiser Family Foundation survey published this summer.
Millennials may be increasingly wellness-conscious, but when it comes to their health care – and most things – young Americans tend to prioritize speed and convenience over routine visits to a trusted physician.
Instead, 22- to 37-year-olds favor the Googling their symptoms or visits to ER or urgent care clinics where they can drop-in when they feel ill without scheduling ahead.
Some policy analysts suggest that the health care system need to shift to accommodate millennials needs and expectations. Others think telemedicine could help fill the gaps, and still others say there’s simply no replacement for primary care.
Less than half of millennials see a primary care physician, a recent survey found. Young people opt for convenience over consistency – but that may present problems down the road
Millennials, the first generation to grow up with computers and, for most of their lives, the internet, are sometimes called the convenience generation.
Now, it seems there’s an app to meet every need, instantly. Hungry? Seamless. Need a ride? Uber. Out of toilet paper? Amazon.
In fact, even psychology has gone digital and on demand, with apps like the Michael Phelps-endorsed Talkspace.
Medical research may give us futurist technologies, but hospitals and doctors’ offices are notoriously slow to change.
So the gap between traditional models of foundational health care, which takes place in a primary care physicians office, and the needs of fast-moving, convenience-oriented millennials.
What millennials perceive as more convenient care may be at the expense of better care for them and higher financial costs to these young adult patients and the health care system alike.
According to Debt.org, the average urgent care visit for common infections will cost a millennial between $71 and $125.
By comparison, insured patients pay an average of $49 out of pocket for a primary care visit.
The financial costs is apparently worth the convenience of a same-day appointment to millennials, but they may not realize what they are missing in terms of care.
Traditionally, primary care physicians have the long-standing and trusting relationships with their patients.
The longevity and quality of this relationship can have real and measurable benefits.
A Harvard study published in 2014 compared patient-doctor relationships, common preventive treatments (like daily aspirin to lower heart attack risks), and health outcomes.
Good relationships came with benefits on-par to treatments, and the longer a doctor and patient know one another, the better their mutual understanding, communication and trust are.
Millennials won’t find that at the ER or the local urgent care.
It seems unlikely that millennials who are used to seeing doctors at their own convenience will be happy to switch to a model where they have to book four weeks in advance and take time of work to see doctors
Dr Sherry Glied, Dean, NYU Wagner Graduate School of Public Service
However, they also may not find primary care physicians at all.
That’s one of two difficult questions to answer about millennials and health care, says Dr Sherry Glied, Dean of the New York University Wagner Graduate School of Public Service.
Formerly a professor of public health at Columbia University, Dr Glied says she’s observed an anecdotal decrease in younger patients seeing primary care doctors, leaving her to wonder ‘if they are going to the doctor at all, or if they are switching away from the primary care doctor.’
For now the model might work for the young generation, which is ‘more likely to have an acute problem that can be treated in a single visit to an urgent clinic,’ says Dr Glied.
‘If they have a cold today, a urinary tract infection tomorrow and strep throat the next day, and then strep the day after that, they don’t car if they see a different doctor for each of those problems.’
Millennials are generally healthier than their older counterparts, so they may not need the same consistent care, but it also may be harder for them to find one.
Broadly speaking, the US has a shortage of primary care doctors and generalists.
A report published by the Association of American Medical Colleges earlier this year estimated that, by 2030, the US will fall short by between 14,800 and 49,300 primary care doctors.
The American medical community is composed disproportionately of specialists. In the US, about a third of doctors are generalists and two-thirds go into specialties like cardiology, dermatology or oncology (which tend to come back with better hours and higher pay).
In other countries, its closer to half and half, according to a Agency for Healthcare Research and Quality study.
Add to that shortage the increasing cost of health insurance that covers fewer and fewer providers and access to good primary care becomes harder to come by for millennials.
Coincidentally, the NYU medical school is now offering free tuition to all students who complete medical degrees, under the auspices that it wants to encourage students to go into primary care – though the university has put no restrictions in place to that effect.
Limited to fewer options at higher costs, millennials may be more likely to only seek medical attention as needed, on-demand.
Market research company Advisory Board surveyed thousands of Americans on their health care preferences. Tech-savvy millennials were the most likely to do thorough research in search of the highest quality, lowest cost health care.
Something has got to change in this market
Plus, they were the least likely group to stay loyal to the same primary care physician.
These factors combined, the traditional model of a family doctor seems a poor fit.
The same market study found that 18- to 29-year olds (millennials span the middle of the two age groups) are ‘ready for virtual’ healthcare.
Virtual health care is gathering momentum, but it still falls short of the capabilities of a doctor conducting an in-person physical – especially compared to a physician who knows what is ‘normal’ or not for each individual patient over time.
Much as they might like to deny it, millennials will some day age into the older population, so that they will be more likely to see doctors for the management of chronic conditions, at which point ‘familiarity’ may become more important to them, says Dr Glied.
But they may also find themselves between a rock and a hard place.
‘It seems unlikely that millennials who are used to seeing doctors at their own convenience will be happy to switch to a model where they have to book four weeks in advance and take time of work to see doctors,’ says Dr Glied.
‘So something has got to change in this market.’