| October 17, 2018

Millennials skip primary care and this affects the healthcare system

Anca Spanu

Anca's career in journalism spans over 2 decades. She has served as staff writer, editor and deputy chief editor at... Anca's career in journalism spans over 2 decades. She has served as staff writer, editor and deputy chief editor at various media outlets all over the world. At Healthcare Weekly, Anca writes about current events, innovations in the healthcare space and events/ conferences with a focus on investing & startups.

Millennials, the 83 million Americans born between 1981 and 1996 who constitute the nation’s largest generation are changing every industry in the country. The healthcare system is not escaping that change. Millennials are impatient, always in a hurry, constantly on the move, uprooting far more easily-and the healthcare system is struggling to keep up with them.

A 2017 survey by the Employee Benefit Research Institute, a Washington think tank, and Greenwald and Associates showed that 33 percent of millennials did not have a regular doctor, compared with 15 percent of those age 50 to 64.

What do millennials want from every type of service?

Millennials have some very obvious preferences when it comes to services. Everything needs to be convenient, fast and connected, and prices must be transparent. Millennials are used to every type of technology, so they want to use it when searching for healthcare services, too. As it turns out, the primary care system is not always adapted to take their needs into consideration. Family doctors rarely have flexible schedules, appointments need to be planned in advance, and they sometimes involve waiting, which millennials are not happy to do in the doctor’s office.

They prefer to deal with health issues the same way they deal with almost every other aspect of their lives: quickly.

What do young people do when they have a minor health problem?

Until recently, the after-hours alternative to a doctor’s office for treatment of acute problems was a hospital emergency room. The ER is always packed, so going there often meant a really long wait. Plus, the cost is elevated, even with medical insurance.

Now, there is a choice, and most millennials will take it. Rather than go to emergency rooms for after hours care, young people go to urgent care clinics and minute clinics such as the Advocate Clinics at Walgreens. These clinics are also the choice during regular business hours, rather than setting up appointments with a primary care doctor-if they even have one. Making a call only to find out the doctor will be available sometime in the next two or three days is not the younger generation’s cup of tea. They would rather get their healthcare issues solved nearby and in a few hours. And they have options. Even though there is a shortage of primary care physicians, primary care alternatives have exploded. Millennials, and not only them, can now choose between more than 2,700 retail clinics in the U. S., although most of them are in the South and Midwest, according to Rand Corp. researchers.

Why do millennials prefer walk-in clinics?

Many young people prefer a walk-in or urgent care clinic when they are sick because these are open after hours and on weekends, so access to care is easy. Millennials also resort to online telemedicine sites for virtual visits, and use companies such as myLab Box, Nurx, and 23andMe to get items such as birth control, blood analysis and genetic testing from the comfort of their home.

There are many reasons millennials opt out of primary care, price transparency being one of them. While in a doctor’s office you usually find out prices after the visit, many clinics and telemedicine sites post their prices.

Another reason millennials skip family doctors, besides wanting rapid access to care, might be the fact there are indeed fewer such physicians to go to, in the first place. Although, as previously mentioned, millennials are the nation’s largest generation, primary care doctors aren’t so many. Actually, there is not only a shortage of primary care doctors in the U.S. right now, but in other specialties as well.

What are the disadvantages of skipping primary care?

For decades, patients had the closest relationship with family doctors. Whether they were called  internist, primary care specialist, general practitioner etc., family doctors coordinated care, ordered tests, presented treatment options, helped patients decide upon further treatment or surgeries, and made referrals to specialists.

Now, this trust bond seems to be losing ground, with the younger generation moving around so much that establishing any kind of relationship becomes difficult, if not impossible.

Maybe modern solutions, like the one proposed by Embleema, will make sharing medical data with new physicians easier, enabling patients to “carry” their medical history with them every time they move. This might prove useful, since experts are worried that the tendency of younger generations to ditch primary care might have undesired effects in the long run.

Healthcare costs are going up and fragmented or unnecessary care, including the misuse of antibiotics, are real issues to take into consideration.

One must be aware, when going into a walk-in clinic, that prices are to be weighed carefully. It is important to know whether the insurance provider covers urgent care visits, and if so, the amount of the copay. In the case of a PPO plan, the copay is often more than a regular office visit copay (e.g. $75 urgent care copay vs. $50 specialist copay vs. $25 primary care copay). However, an emergency room visit copay is usually $100 or more.

Another danger is that of misusing antibiotics.

A recent report in JAMA Internal Medicine showed that almost half of patients who suffered from a cold, the flu or other similar respiratory issue and went to an urgent care clinic for treatment, received an unnecessary and potentially harmful prescription for antibiotics, compared with only 17 percent of those seen in a doctor’s office.

Antibiotics don’t work against viruses, patients can even develop allergies, and other side effects. Even worse, after prolonged use, when the antibiotics are really needed, they might not work anymore. Another unwanted issue is that fragmented care might not discover problems that even young people develop, like diabetes, hypertension and other illnesses which may require more than one visit to spot and address.

How are primary care offices changing to accommodate younger patients?

What millennials want to avoid in the primary care system is waiting. Waiting for appointments to be possible, then, once in the office, waiting for the doctor to be done with the previous patient.

According to available data, the waiting could be for weeks. A 2017 survey by physician search firm Merritt Hawkins proved that in 15 large metropolitan areas the average wait time for a new-patient appointment with a primary care doctor went up, from 18.5 days in 2014, to 24 days.

To attract young patients and make them stay, primary care practices have been forced to find new ways of doing business. A very important part of the new practice is represented by digital solutions. Whether it is patient portals, video visits or other communication enabling tools, every app that can be used via smartphone has become a way to convince patients. Besides the tech solutions, more nurses and physicians are hired to see patients more quickly. Practices do not have too much time, though. They need to adapt now because, as was said in the beginning of this article, millennials are the largest generation in the States. The bet is to keep it healthy.

 


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