No primary care doc, no problem: How millennials are changing healthcare
Do you have a primary care physician? Forty-five percent of 18- to 29-year-olds reported that they do not have a primary care physician. Read this blog post from Employee Benefit News to learn more.
Millennials, and Generation Z behind them, are changing the way they access healthcare. In fact, 45% of 18- to 29-year-olds say they don’t have a primary care physician. Instead, they’re opting for on-demand healthcare.
Traditionally, individuals and families see primary care physicians several times a year and build relationships with their doctors over time. Visiting the same primary care physician when an illness strikes, or for an annual wellness checkup, can help the doctor notice changes in a patient’s health and catch issues before they become more serious (and costly).
But for millennials, having a primary care physician isn’t necessarily a priority.
That’s in part because they seem to prefer on-demand healthcare options, such as urgent care, drug store clinics and telemedicine services, which are easily accessible and typically include shorter wait times. The number of urgent care centers reflects the trend — they’re projected to grow by 5.8% in 2018, according to the Urgent Care Association.
Then there is employers’ shift away from health maintenance organizations, which often required that each employee choose a primary care doctor at the start of the plan. HMOs also require a referral from the primary care physician to see specialists. Recent research shows that most often, employers offer preferred provider organizations (84%), while 40% offer consumer-directed health plans and 35% offer HMOs.
Finally, physician shortages are leading to longer wait times for appointments. The U.S. population continues to grow and age, which may lead to a shortage of 120,000 primary and specialty doctors by 2030, according to the Association of American Medical Colleges.
For employers, it’s important to understand the reasons behind the shift to on-demand healthcare and educate employees to ensure they can get appropriate medical attention when they need it.
One crucial part of this education is helping employees understand when they should visit urgent care versus the emergency room, and reminding them that telemedicine is available. More than 95% of large employers and just over one-third of small- and mid-size employers offer telemedicine benefits. But adoption rates among employees remain low — only 20% of large employers report utilization rates above 8%, according to the National Business Group on Health.
Ensure your employees know that the service is available throughout the year and help them understand the cost if any is associated with the service. You may consider offering $0 copays for telemedicine visits to encourage employee use.
Encourage employees to get a wellness visit each year to help uncover health issues and take steps to prevent others. One way to do this without forcing employees to wait for an appointment or commit to a doctor is to bring the service in-house. Increasingly, large employers are adding this service to help employees stay healthy. In fact, one-third of employers with more than 5,000 employees and 16% of employers with 500-4,999 employees now have onsite clinics. Another 8% of midsize employers plan to add clinics in 2019.
Providing health assessments as part of a health and wellness program is another way to get employees, especially money conscious millennials, in front of a doctor. Younger workers are likely to embrace incentives or premium discounts that are tied to a physician visit.
Direct primary care is yet another employer option to provide easy-to-access primary care. With direct primary care, employers partner with primary care physicians to offer a designated doctor for their employees. The benefit for employees is more face time with a doctor and the opportunity to get personalized care.
Importantly, employees who have known chronic issues should see a primary care doctor regularly to help monitor and manage their condition.
The trend toward seeking on-demand healthcare at alternative sites isn’t likely to reverse direction any time soon. Instead, it’s up to employers to understand why it’s happening and educate employees of all ages on their options for care.
SOURCE: Milne, J. (7 January 2019) "No primary care doc, no problem: How millennials are changing healthcare" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/no-primary-care-doc-no-problem-how-millennials-are-changing-healthcare?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001
The App Will See You Now, But May Not Get The Diagnosis Right
Originally posted by Martha Bebinger on July 9, 2015 on khn.org.
There’s a warning out today for those who go online or to apps to figure out why they have an upset tummy or nagging cough or occasional chest pain. Symptom checkers, those tools that ask for information and suggest a diagnosis, are accurate only about half of the time.
The finding is from a Harvard Medical School study that reviewed 23 sites, such as WebMD, the Mayo Clinic and DocResponse. One third listed the correct diagnosis as the first option for patients. Half the sites had the right diagnosis among their top three results, and 58 percent listed it in their top 20 suggestions.
Dr. Ateev Mehrotra, one of the study’s authors, urges patients to be cautious when using these tools.“These sites are not a replacement for going to the doctor and getting a full evaluation and diagnosis,” he says. “They are simply providing some information on what might be going on with you.” About a third of U.S. adults use the sites, although not necessarily in place of going to the doctor.
Some of the diagnostic questions are also used by nurse triage phone services and, Mehrotra says, these online tools are about as accurate as the call-in lines offered by many insurers and physician groups. “[They are] better than just a random Internet search,” he said.
Researchers entered the symptoms of 45 patients from vignettes used to train medical students. The Mayo Clinic’s first online diagnosis was right only 17 percent of the time, but had the correct diagnosis on a list of 20 in 76 percent of cases. Dr. John Wilkinson, who works on Mayo’s symptom checker, says the tool directs patients to medical research and prepares them to talk to their doctor.
“We’re always trying to improve but if most of the time the correct diagnosis is included in the list of possibilities, that’s all we’re attempting to do,” he says.
The diagnosis accuracy rate for physicians is 85 to 90 percent. But Jason Maude, who runs a high performing tool called Isabel, says he does not want a Web versus doctor showdown.
“The whole point is not to set the patient against the doctor or replace the doctor, but to make the patient much better informed and to ask the doctor much better questions, and then together they should do a much better job,” he says.
Isabel ranked well in the study, showing the correct answer more than 40 percent of the time in the first diagnosis and 84 percent in the top 20 answers. Those high results, Maude says, may be because the site lets patients type in their own description of symptoms. They might describe a “tummy ache” or “stomach cramps” rather than the more clinical choice of “abdominal pain” used by many online symptom checker tools. And Isabel asks just two or three questions before patients describe their problem, as compared to sites that ask patients to click through 20 questions — steps Maude said may discourage use.
Clarifying how and why patients use these tools is critical, say the study’s authors. They could reduce unnecessary office visits or inform patients as they talk with their doctors. But for some, the tools may encourage people to seek unnecessary care.
Mehrotra says patients used symptom checkers more than 100 million times last year, a fact that may stun some physicians.
“While most doctors know patients are going to the Internet to search for medical advice, in terms of these symptom checkers, I’ve been surprised that few of my colleagues even knew they existed,” he says.
Communicating With Your Doctor On Facebook May Be The Future Of Healthcare
Originally posted by Carolyn Gregoire on June 20, 2015 on huffingtonpost.com.
We communicate with our friends, our families and our coworkers via email and Facebook, and apparently, most Americans also wish that they could keep in touch with their health care providers this way.
A national survey of 2,252 pharmacy customers conducted by Johns Hopkins University's Bloomberg School of Public Health highlights the gap between what patients want from their health care providers in terms of communication and engagement, and what they're actually getting.
"This study tells us that for most patients, healthcare isn’t quite ready for the future," Joy Lee, a post-doctoral fellow at the university, told The Huffington Post.
In fact, there's something of a patient engagement paradox in healthcare, Lee said.
"On the one hand, doctors, policymakers, and researchers often talk about the need to engage patients," she explained. On the other hand, many patients are already engaged -- in Facebook and other online communities. Yet instead of embracing this connection, medicine is preoccupied with confidentiality and drawing professional boundaries.
Fifty-seven percent of respondents -- who were generally educated, healthy and regular users of Facebook -- said that they were very interested in using Facebook and email to communicate with their physicians and to manage their health. More than half of respondents also said that they wanted to use their physicians' websites to access health information.
More than a third said that they already communicated with their doctors via email, and 18 percent said they connected with their doctors on Facebook, a surprising finding considering that many health care providers have rules barring this mode of interaction with patients due to privacy concerns and ethical guidelines for physicians.
Young adults -- as well as caregivers, patients with chronic conditions, and regular Facebook users -- were more likely to communicate with their doctors via email and Facebook.
Lee emphasized that of course, it's critical to safeguard patient information. But "Health care organizations need to figure out how to take advantage of resources like Facebook," she added.
They're already on the way. As part of the growing telehealth movement, many doctors and health care organizations have electronic systems that patients can use for things like messaging, accessing test results and personal information, and health tracking.
"Many patients are interested in [these services] but few are actually using them -- possibly because patients don’t know they’re available," Lee said. "Doctors and health care organizations should take steps to publicize and educate patients of these opportunities. Either way, it starts with a conversation between patients and doctors on how they prefer to communicate online."
The study was published this month in the Journal of General Internal Medicine.