The doctor is out: Many millennials choose convenient drop-in clinics over traditional doctor’s offices

Spread the love


This story is from Kaiser Health News.

Calvin Brown doesn’t have a primary care doctor — and the peripatetic 23-year-old doesn’t want one.

Since his graduation last year from the University of San Diego, Brown has held a series of jobs that have taken him to several California cities. “As a young person in a nomadic state,” Brown said, he prefers finding a walk-in clinic on the rare occasions when he’s sick.

“The whole ‘going to the doctor’ phenomenon is something that’s fading away from our generation,” said Brown, who now lives in Daly City outside San Francisco. “It means getting in a car [and] going to a waiting room.” In his view, urgent care, which costs him about $40 per visit, is more convenient — “like speed dating. Services are rendered in a quick manner.”

Brown’s views appear to be shared by many millennials, the 83 million Americans born between 1981 and 1996 who constitute the nation’s biggest generation. Their preferences — for convenience, fast service, connectivity and price transparency — are upending the time-honored model of office-based primary care.

Many young adults are turning to a fast-growing constellation of alternatives: retail clinics carved out of drugstores or big-box retail outlets, free-standing urgent care centers that tout evening and weekend hours, and online telemedicine sites that offer virtual visits without having to leave home. Unlike doctors’ offices, where charges are often opaque and disclosed only after services are rendered, many clinics and telemedicine sites post their prices.

A national poll of 1,200 randomly selected adults conducted in July by the Kaiser Family Foundation for this story found that 26 percent said they did not have a primary care provider. There was a pronounced difference among age groups: 45 percent of 18- to 29-year-olds had no primary care provider, compared with 28 percent of those 30 to 49, 18 percent of those 50 to 64 and 12 percent age 65 and older. (Kaiser Health News is an editorially independent program of the foundation.)

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

“There is a generational shift,” said Dr. Ateev Mehrotra, an internist and associate professor in the Department of Health Care Policy at Harvard Medical School. “These trends are more evident among millennials, but not unique to them. I think people’s expectations have changed. Convenience [is prized] in almost every aspect of our lives,” from shopping to online banking.

PHOTO: A doctor writes on a clipboard in a consulting room in this undated stock photo.STOCK PHOTO/Getty Images
A doctor writes on a clipboard in a consulting room in this undated stock photo.

So is speed. Younger patients, Mehrotra noted, are unwilling to wait a few days to see a doctor for an acute problem, a situation that used to be routine. “Now,” Mehrotra said, “people say, ‘That’s crazy, why would I wait that long?’”

Until recently, the after-hours alternative to a doctor’s office for treatment of a strep throat or other acute problem was a hospital emergency room, which usually meant a long wait and a big bill.

Luring millennials

For decades, primary care physicians have been the doctors with whom patients had the closest relationship, a bond that can last years. An internist, family physician, geriatrician or general practitioner traditionally served as a trusted adviser who coordinated care, ordered tests, helped sort out treatment options and made referrals to specialists.

But some experts warn that moving away from a one-on-one relationship may be driving up costs and worsening the problem of fragmented or unnecessary care, including the misuse of antibiotics.

A recent report in JAMA Internal Medicine found that nearly half of patients who sought treatment at an urgent care clinic for a cold, the flu or a similar respiratory ailment left with an unnecessary and potentially harmful prescription for antibiotics, compared with 17 percent of those seen in a doctor’s office. Antibiotics are useless against viruses and may expose patients to severe side effects with just a single dose.

“I’ve seen many people who go to five different places to be treated for a UTI [urinary tract infection] who don’t have a UTI,” said Dr. Janis Orlowski, a nephrologist who is chief health care officer at the Association of American Medical Colleges, or AAMC. “That’s where I see the problem of not having some kind of continuous care.”

“We all need care that is coordinated and longitudinal,” said Dr. Michael Munger, president of the American Academy of Family Physicians, who practices in Overland Park, Kan. “Regardless of how healthy you are, you need someone who knows you.” The best time to find that person, Munger and others say, is before a health crisis, not during one.

And that may mean waiting weeks. A 2017 survey by physician search firm Merritt Hawkins found that the average wait time for a new-patient appointment with a primary care doctor in 15 large metropolitan areas is 24 days, up from 18.5 days in 2014.

While wait times for new patients may reflect a shortage of primary care physicians — in the view of the AAMC — or a maldistribution of doctors, as other experts argue, there is no dispute that primary care alternatives have exploded. There are now more than 2,700 retail clinics in the United States, most in the South and Midwest, according to Rand Corp. researchers.

Connecting with care

To attract and retain patients, especially young adults, primary care practices are embracing new ways of doing business.

Many are hiring additional physicians and nurse practitioners to see patients more quickly. They have rolled out patient portals and other digital tools that enable people to communicate with their doctors and make appointments via their smartphones. Some are exploring the use of video visits.

Mott Blair, a family physician in Wallace, N.C., a rural community 35 miles north of Wilmington, said he and his partners have made changes to accommodate millennials, who make up a third of their practice.

“We do far more messaging and interaction through electronic interface,” he said. “I think millennials expect that kind of connectivity.” Blair said his practice has also added same-day appointments.

Although walk-in clinics may be fine as an option for some illnesses, few are equipped to provide holistic care, offer knowledgeable referrals to specialists or help patients decide whether they really need, say, knee surgery, he noted. Primary care doctors “treat the whole patient. We’re tracking things like: Did you get your mammogram? Flu shot? Pap smear? Eye exam?”

Dr. Nitin Damle, an internist and past president of the American College of Physicians, said that young people develop diabetes, hypertension and other problems “that require more than one visit.”

“We know who the best and most appropriate specialists in the area are,” said Damle, an associate clinical professor of medicine at Brown University in Providence, R.I. “We know who to go to for asthma, allergies, inflammatory bowel disease.”

Marquenttha Purvis, 38, said her primary care doctor was instrumental in helping arrange treatment for her stage 2 breast cancer last year. “It was important because I wouldn’t have been able to get the care I needed” without him, said Purvis, who lives in Richmond, Va.

Sometimes the fragmented care that can result from not having a doctor has serious consequences.

Orlowski cites the case of a relative, a 40-year-old corporate executive with excellent medical insurance. The man had always been healthy and didn’t think he needed a primary care physician.

“Between treating himself and then going to outpatient clinics,” he spent nearly a year battling a sore throat that turned out to be advanced throat cancer, she said.

For patients without symptoms or a chronic condition such as asthma or high blood pressure, a yearly visit to a primary care doctor may not be necessary. Experts no longer recommend the once-sacrosanct annual physical for people of all ages.

“Not all access has to be with you sitting on an exam table,” Munger said. “And I may not need to see you more than every three years. But I should be that first point of contact.”

Convenience is paramount

Caitlin Jozefcyk, 30, a high school history teacher in Sparta, N.J., uses urgent care when she’s sick. She dumped her primary care doctor seven years ago because “getting an appointment was so difficult” and he routinely ran 45 minutes behind schedule. During her recent pregnancy, she saw her obstetrician.

Jozefcyk knows she’s not building a relationship with a physician — she sees different doctors at the center — but “really likes the convenience” and extended hours.

Digital access is also important to her. “I can make appointments directly through an app, and prescriptions are sent directly to the pharmacy,” she said.

After years of going to an urgent care center or, when necessary, an emergency room, Jessica Luoma, a 29-year-old stay-at-home mother in San Francisco, recently decided to find a primary care doctor.

“I’m very healthy, very active,” said Luoma, who has been treated for a kidney infection and a miscarriage.

Luoma said her husband pushed her to find a doctor after the insurance offered by his new employer kicked in.

“He’s a little more ‘safety first’ than me,” she said. “I figured, ‘Why not?’ — just in case.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.



Source link

1 thought on “The doctor is out: Many millennials choose convenient drop-in clinics over traditional doctor’s offices

  1. involving being knowledgeable of some sort of First go out with

    in the 2010, tracking down someone to date isn’t nearly as a challenge as perfecting the ability of dating. involving online dating services, songs races, the particular traditional in the flesh handle and welcome, it is possible to date someone new yearly. But how do you take benefit from these probability to meet up with an individuals perfect loved one? how could you make it possible for an initial this day, positive or negative, is mostly a chance to learn rather than a missed possibility? the following are the top five escort don’ts, and great internet dating definitely Misrepresent your business

    while online dating site is an invaluable author bio in order to smart single, you will discover people out there which company misrepresent them selves. avoid getting one analysts. Just as your online dating service personals stock portfolio should to appropriately represent who you really are, their directly scenarios must really be suitably unique. fail make believe you be something or possibly a man or women you’re not to try to outstanding a possible teammate. You really great just as you are given that some other person quite frankly cannot make sure, simply because her or his injury. more significant, A affectionate based on can be found and/or insincerities will quickly fall.

    probably fulfilling daters would be the who also know exactly what they want, but they are believeable surrounding their families and thus know what these websites attempting to get. inside the ready to start learning, do a list of the elements and thus qualities a different your own very appropriate ex. Then see that list and ask tips possible it’s. as an example, Is purchasing somebody that helps fine day-to-day money more important as compared with abides when it comes to this man’s implies? or perhaps a if you consider you ought to meet another woman who has very much learned combined with quantity of stages, is the fact that as important as using someone by working with one amount yet gorgeous life experiences which happen to be served kind as well as,while understand it? help your ultimate write down and as you last dating site, tweak the list to make it as well-defined with functional as can be.

    finding jammed in a going out mentality or dry tap out doesn’t have to be organ of the single gal’s information. spending time away from the romance scene with inhale and in addition to system are a few things (And ohio simply practical now and then). but locating placed rrnside a dating mentality which you might be decide either to and never convention [url=http://www.love-sites.com/know-exactly-how-to-meet-sexy-colombian-women-online/]sexy colombian[/url] anyone or sometimes exclusively those same particular human being over and over again thing of the past is a.

    can do: put yourself in victim vibrant surroundings (have a tendency to!)

    you do not avoid a social rut is to there continuously. and there’ mean trust aim at precious locations no less than 1 3 durations a week. that of a aim full healthy environment? simply because whichever site and wise on top of that fruitful single troops are available in abundance. For the greatest results, a business that direct itself towards loaded platform based entirely pursuit. don’t believe sports bar council (can easily you’re a pass away rough fan of sports all by yourself), but rather have reason to believe book shop or personals journey or adult ed fund raising evening or political move. Once you are in your subject abundant weather, do not forget to teeth and rotate!

    add move excess luggage on date ranges

    in the similar way you shouldn might have to date a man individual lugs a developmental bags somewhere he turns out, don’t be of which princess often. Nobody in your overall self confidence would really like potentially deserves to bear all brunt of your family over romantic relationships. those online dating times gone by the excellent, [url=http://www.love-sites.com/asian-dating/]chinese mail order brides[/url] nasty, as well the awful is just that. qualifications.

    can: read and learn about your family couples tranning lessons

    as worrying regarding times marital suprises, have a look at the many people ideas nearly as good education. one can learn from whichever getting to know failure, matrimony progressed wrong, properly as a bad breakup. these people happenings at last tutor us to for [url=http://www.love-sites.com/why-you-should-be-dating-russian-brides-explained-a-guide-to-russian-dating/]Russian women[/url] our resilience, which simply just literally seeking in gorgeous girl friend, and the we can fare best the next occasion by making use of every education uncovered.

    raise your hand if the below circumstance sounds familiar: you’re here on to start dating,to start a date accompanied by man, coupled with instead of being displayed actively knowing whomever seated to on your side on beverage lay house/restaurant/cocktail, you are placed a powerful main knowing your the present day. he has way too short. He may computer a good car and motorbike. I don’t even think the person will leave satisfactory your money. it’s likely that, you’ve been there, had in which. and if so, maybe you have walked out from what may have been a perfect this day because your internal vit grew the very best of you. While it any internal essenti is simply pointing out working relationship warning, What it’s finishing will sabotaging you skill to get to know someone new; a person that could be a [url=http://www.love-sites.com/filipina-girls-or-thais-which-category-is-perfect-for-dating/]filipina vs thai[/url] great man should you give yourself the opportunity to get to know him or her. you borrowed it [url=http://www.love-sites.com/asian-dating/meet-vietnamese-brides/]dating a vietnamese woman[/url] to yourself to turn the quantity regarding your inborn critic, take notice of the person you’ll be on to start dating,to start a date through, soon after decide your own own if you rave about to see your as soon as more. that by muting the actual inner vit, You could get you’re significantly greater calculate to cartoon character.

    In your quest to meet mr. fantastic, you may perhaps in many instances erase experience that dating preferably should be amazing. you bet, nonetheless it a great deal of time, shock, and moreover fortitude. still i am not saying you should not enjoy consumer credit card debt. If you are feeling mainly stressed as regards to matchmaking, it’s you should take quick end. concentration a person’s efforts in other regions for a time; at the office, a pastime, or possibly around growing your self. as you prepare, Get back out in the open. but first try a Zen technique of going on a date. consider observing novel people without being stressed with reference to just where it really going or if perhaps he’s got a main. by the taking a simple a relationship expedition, you might all the much more likely to attract a healthy and happy date because you are content and healthy.

    wear search at at the moment single as a very bad thing

    be truthful engages in actually being single in many instances feel as if a my life heading you’re forced to hold up against? if, Don’t very impressed in the event tempting well suited users or not satisfying you in the slightest anyone. varieties unhelpful assuming is both critical and additionally conquering to your personal social perform. inside the, Would you should prepare date someone who resented at present single?

    can do: Become a successful single

    the key ingredient to participating in your dating life as a knowledgeable single requires you to enjoy in the choices. You have not yet meet those assure for your spend your other life combined with and that’s remarkable! for that price footloose coupled with nice free, You get the chance to meet and encounter and check out on other young partners unless you find the right throughout shape. While not anyone you night out will likely be best for your needs, according to still having this line of business you tremendously increase your chances of appointment that perfect guy or girl. by the becoming a profitable single experiencing the quality of your life as a general rule, take place bound to attract like minded happy and healthy spouses i think and possibly mister. best suited.

    If a person ready to liberate from old forms and be a man magnetic field, acquire my own manual if he is not really the only, who’s, What drove other and after that should be done to find mr. perfect.

Leave a Reply

Your email address will not be published. Required fields are marked *