We hear much grunting and groaning about millennials – their addiction to cell phones, social media and the tendency to hop from one job to the next – but the one thing they do very well is disrupt the status quo health care system by refusing to settle for slow, low-quality care that costs more every year.
David Goldhill points out in his book, Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong, that in our current system, millennials are projected to spend half to two-thirds of their lifetime earnings on healthcare. Refusing to accept the hand they’ve been dealt, millennials are disrupting healthcare by demanding convenience, affordability, transparency and quality for the high prices they’re expected to pay – and everyone else should follow their lead.
Millennials make up a majority of the workforce, and they’re taking a stand by being more selective about the jobs they accept. They want a career with attractive pay, but more importantly, they want one with quality health benefits. According to Aflac’s 2017 Workforces Report, 27 percent of millennials cited poor benefits as the reason they left a job, and in a survey by the American Institute of Certified Professional Accountants, respondents said health insurance would help them reach their financial goals. Once you put these facts together, we start getting a more clear picture of what jobs need to look like to keep this group interested.
When you dig a little deeper into what specific health benefits millennials are looking for, you’ll find that 34 percent would rather visit retail clinics, and 25 percent visit acute care centers, rather than visiting a primary care physician (PCP) for their needs. Not because they have anything against primary care doctors, but most PCPs are now owned by health systems who have stacked the deck so it’s difficult to spend any meaningful time with a PCP. The result is driving patients to the most expensive, rather than the most effective care. In a recent Kaiser Health News survey, 26 percent of respondents said they did not even have a PCP. In fact, the primary care system itself is dying because millennials want to be seen more quickly – and who can blame them? When we are sick or can’t self-diagnose the cause of our pain, we want to consult the experts as soon as possible to get back to work and our families and friends. Left with no choice, millennials are using sites like ZocDoc to schedule visits more quickly and efficiently. A lot of the doctors on that site offer another practical service: access to telemedicine, where they can connect with a doctor via phone, video or email. Forty percent of millennials see telemedicine as an important approach to modern medicine.
The common thread between all these preferences? They’re easier than conventional care options, which in today’s broken system, have devolved into subpar 10-minute appointments and a cascade of referrals and opioid prescriptions. Millennials like when things are easy. For example, having seen how simple it is to buy and sell items via online retailers like Amazon, millennials have kicked newspapers’ classified ads to the curb, contributing to their continued decline and revolutionizing how we get our news.
They are doing the same in health care. Most employer-provided health insurance plans – which cover approximately 155 million Americans under 65 – fail to provide access to the quality care they need and deserve. Our current healthcare system is the result of employers in the 1940s deciding to offer health benefits, without realizing what they’d cost, to attract employees after the government issued wage controls. It operates under a fee-for-service, volume-centric model. That means physicians are ordering many potentially unnecessary, expensive procedures that often result in follow-up appointments, more money spent and patients who are still sick. And with more people needing to make multiple visits, waiting rooms become clogged and making an appointment in a short period of time, especially on the same day, becomes impossible.
One solution to these issues for millennials – and the rest of the nation – is to start visiting value-based primary care centers. In a value-based care setting, physicians are rewarded for positive patient outcomes. And because they’re incentivized to keep patients healthy, physicians spend more time with patients to understand the real reason behind their visit. For example, instead of ordering pointless scans and writing an opioid painkiller prescription for lower back pain (LBP), a value-based physician may talk to the patient about lifestyle choices that could contribute to that pain – poor posture, sitting too much, etc. – and make recommendations like proper exercise, using best practices such as core strengthening to prevent back pain from recurring.
Millennials should be more inclined to find and stick with a primary care doctor in these settings because they will still be able to take advantage of telemedicine and won’t have to wait long to see their doctor. Same-day appointments are important because this means that patients can get treated quickly, before their condition worsens or becomes life-threatening. Equally important is having a doctor who will be more familiar with the patient’s history, and therefore be able to provide more collaborative and thorough treatment options and advice. Transactional, one-off telemedicine with a doctor you don’t know leads to more disconnected care.
Change may be uncomfortable, but it often leads to progress. Thankfully, millennials are helping healthcare by saying enough is enough and exploring more convenient, affordable and high-quality options. Though they’re leading the charge, real, substantial change will require a joint effort. Together, we can all benefit by following millennials’ lead in the healthcare revolution.
Dave Chase is co-founder of Health Rosetta, which aims to accelerate the adoption of simple, practical, non-partisan fixes to our health care system. He is also the author of "The CEO’s Guide to Restoring the American Dream: How to Deliver World Class Health Care to Your Employees at Half the Cost." (Health Rosetta Media, September 2017).