At 83 million strong, millennials now make up the largest segment of the U.S. population. Currently in their 20s and 30s, they are making health care decisions not only for themselves, but for their children and, increasingly, their parents, too. Understanding and respecting patients in this age group can help attract and retain them in your practice—and help ensure future generations’ access to high-quality, continuous care.
Common Patterns Among Millennials
Like many generations before them, millennials differ from older adults in many ways, from the ways in which they access information to their shopping preferences. The first generation to grow up with technology and instant access to information, millennials check online reviews before going to restaurants and have retail purchases delivered to their doors. They are comfortable sharing information, more worried about work-life balance, and more likely to move or switch jobs.
It stands to reason that they follow a similar pattern when seeking health care, says Tochi Iroku-Malize, MD, a family physician in Bay Shore, Long Island, and board member of the American Academy of Family Physicians. “They get their health care recommendations by ‘word of social media,’” she says. By the time they decide to see a health care provider, they have already looked up their symptoms, talked to friends or family members, posted on social media, and checked the practice’s website and ratings—and compared them with the retail clinic down the road in terms of convenience and price.
And they may well choose the retail clinic over a traditional primary care physician. A Kaiser Family Foundation survey in July 2018 showed that 45% of adults ages 18 to 29 did not have a primary care provider, compared with 26% of all adults. Younger generations are also more likely to report dissatisfaction with traditional health care on measures of convenience, cost, transparency, effectiveness, and wait times. In the Accenture 2019 Digital Health Consumer Survey study, 14% of millennials and 20% of “Generation Xers” (born 1965-1980) reported that they would like to have a primary care physician but had not found one who meets their needs.
This is not good news for patients, the health care system, or primary care physicians. Having a regular source of primary care is associated with better overall health outcomes at a lower cost. Indeed, a 2018 study in JAMA Internal Medicine found that retail clinics were more likely to prescribe unnecessary antibiotics. Although retail clinics are less expensive per visit than ED visits, a 2016 study found that they increased health care spending overall.
Rising health care costs and the increase in antibiotic resistance may not be top of mind when deciding whether to go to a retail clinic or try to be seen at a traditional primary care practice. With many types of retail clinics available to patients, physicians must work hard to ensure that millennials understand the importance of having a regular primary care physician.
A Doctor Who Listens
“[Young patients] are confident, self-assured, and used to coming up with solutions. That’s not going to change at the doctor’s office,” says Iroku-Malize. Millennials have grown up with the knowledge that exercise and nutrition are important for healthy living. They “live the talk,” she adds. They are already shopping in the organic aisle, going to the gym, and trying the latest meal delivery service that caters to their wellness approach, whether it’s vegan or paleo or another diet. Ask them what they know, take their knowledge seriously, and allow them to be part of the decision-making process. “Be willing to listen,” she says.
This message should come across from their first point of contact, which is usually the practice website. Because millennial patients prioritize cost and convenience, consider including information about insurance coverage, hours, and maybe even basic pricing data. The site should be mobile friendly so that it is easy to navigate on a smartphone or tablet. A poorly designed site is likely to be a turn-off—even if everything else in place. To find ideas, research websites for other practices and hire a web designer who has experience designing sites for medical practices.
The practice website and portal should make it as easy as possible to continue communication between visits. That means including features such as online appointment scheduling and prescription refills, secure text messaging, and video conferencing for virtual visits, all of which make it easy for patients to establish and maintain a continuous relationship with the practice.
Iroku-Malize points out that retail clinics work because there is a market for them; people are looking for convenient health care where they are in and out quickly. Iroku-Malize suggests developing relationships with the urgent care and retail clinics in the area, so that when patients need ongoing care, providers will refer to you. Creating walk-in hours or after-hours appointments and reducing wait times can also encourage patients to return to your practice, rather than visiting a retail clinic next time the need arises.
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