Calling a doctor isn't so easy for nearly half of the nation's millennials who don't want, or don't have, a primary care physician.
It might be a sickening thought to some, but the reailty is that 45 percent of Americans aged 18-29 forgo a personal doctor, instead opting for urgent care clinics when a medical need arises.
Critics of this practice, however, say it drives up costs, and also drives a wedge between a traditional health care alliance — a doctor and a long-time patient.
The data comes from a recent survey by Kaiser Family Foundation, which also noted that 26 percent of the U.S. adult population also does not have a primary care physician.
The findings seem to mirror a 2017 study from the Washington, D.C.-based Employee Benefit Research Institute, which stated that 33 percent of younger U.S. adults didn’t have a primary care physician, compared to 15 percent of Americans aged 50-to-64 who said the same thing.
Convenience key for millennial health care
Why are so many millennials ditching their doctors and relying instead on urgent care clinics?
In a word, it’s all about convenience.
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“Millennials have come to expect services on demand at times convenient for them,” says Crystal Bowe, a primary care physician in Belmont, N.C.
Yet “convenience” often does not fit in the traditional primary care model, where patients often have to schedule appointments weeks in advance, and have to schedule appointment during regular business hours. “Urgent care centers offer walk in appointments, so there is no need to schedule in advance, and also offer evening and weekend appointments,” says Bowe. “Some urgent care providers are offering telemedicine services (virtual visits), where patients can be seen from the comfort of their own home, a service few primary care practices provide.”
That doesn’t mean prioritizing urgent medical care is a good idea.
“The use of urgent care centers drive up the cost of care,” says Bowe. “I believe that patients receive the best care when they have a provider who knows them and their medical needs, rather than seeing a different doctor who doesn't know them each visit.”
As an example, Bowe cites a young person who sees a different doctor at the urgent care three times for a yeast infection. “In that case, the patient will likely be treated for three times” Bowe notes.
“However, if they see their own doctor three times for a yeast infection, that doctor will be able to look deeper into the underlying cause of the recurrent infections. I have found diabetes in patients who I see with recurrent yeast infections, something that is often missed in the urgent care.”
Too busy to schedule a doctor's appointment
Some health care experts say the reason millennials opt for urgent care is that doctor’s already having a full slate of clients, while millennials don’t have the time to schedule a visit to a primary care doctor.
“Many primary care doctors have a full panel and are no longer accepting new patients,” says Dr. Jasmine Lew, a pediatrician at Heal, a leading doctor-on-demand mobile app. “As a result, some patients may not have even established care. So, when they have a health issue, they go to the nearest urgent care clinic.”
Many young people work long hours and aren’t able to see a doctor during regular office hours. “Yet urgent care clinics are open in the evening and on weekends,” Lew notes. “It makes it easier to go see a doctor after the work day is over.”
Even so, depending on urgent care clinics for general health care is problematic, Lew says.
“Urgent care clinics exist for a reason – it’s urgent care,” Lew states. “If someone has an acute medical issue that is not severe enough to require emergency care, urgent care is obviously the best place to go. However, urgent care clinic doctors generally will address only that acute issue. And it’s often not the same doctor who will see the patient.”
Relying on urgent care clinics also makes it difficult to establish a patient-doctor relationship.
“The role of a primary care doctor is to take care of both the preventive and acute care needs of a patient,” Lew says. “That’s why a primary care doctor will do an annual physical - to screen for disease, and to manage active ongoing chronic health issues. If an increasing proportion of people use urgent care clinics to replace their primary doctors, it may not be able to support that load.”
Millennials, however, don’t see it that way.
“I'm a 35-year-old millennial and don't have a primary care doctor, and I haven't had one for over three years,” says Miguel A. Suro, a Florida-based attorney. “However, I do use urgent care clinics quite frequently.”
4 ways urgent care better than primary care physician
Suri lists four big reasons why he’s foregoing a primary care physician and opting instead for an urgent care clinic when he needs professional medical care:
- No continuity. “Nowadays a lot of primary care doctors work for large organizations anyways, and get moved from location to location,” he says. “Therefore, continuity of care is not assured.”
- Faster wait times. To see a primary care doctor tends to require an appointment, and therefore a wait (of sometimes days). “At an urgent care clinic, by contrast, I'll usually be seen within an hour (at least where I live in Miami),” says Suro.
- Overlap of functions. “In my view, an urgent care physician can treat a cold or other non-emergency condition just as well as a primary care doctor,” he says.
- Options abound. If Suro is worried something serious is wrong medically, he’ll skip straight to a specialist. “Why see a primary care doctor for a referral, unless my insurance requires it?” he says. “You might as well go straight to the specialist, especially in a large city with good specialist availability.”
While the trend may tip the traditional balance between primary medical care and emergency care out of whack, that’s okay with Millennials. “There's little need for a primary care doctor,” says Suro. “If I have a minor complaint, I'll be seen quickly at an urgent care clinic. If it's an emergency, I'll go to an emergency room. If it's a major complaint (but not an emergency), I'll go to a specialist.”
Primary care practices and hospital systems can recruit younger patients, but to do so, they’ll have to alter their practices to be more flexible to meet the needs of a non-traditional demographic.
“Primary care practices need to offer more same day appointments so patients can call with a problem and be seen in the same day (similar to urgent care),” says Bowe. “Primary care offices need to provide extended hours (after 5 p.m. and on the weekends) to make it easier for millennials to be seen when it is convenient for them.”
Additionally, primary care practices need to offer more virtual visits. “By changing the traditional model, and providing the enhanced care that a continuity provider can give, millennials will get the care they need in a manner they want,” Bowe says.