Engaging Millennials: The Shifting Doctor Patient Relationship
There has been a lot of discussion in healthcare recently on how to best inform and engage patients of the Millennial generation. Rather than speak for young Millennials our CMO, Dr. Stuart Hochron, thought it would be good to sit down with a Millennial, Nadia James, and address her biggest healthcare concerns:
As an entry level worker I have very limited vacation and sick days. I’d much rather communicate with my doctor while I’m at home or work when I know I most likely have a common cold. I can’t tell you how frustrating it is having to spend so much time scheduling an appointment and in a waiting room before actually seeing my doctor who tells me to either a) wait my sickness out or b) take a drug I could’ve ordered over the counter. Surely a physician should be able to help me diagnose what I know is a minor illness if I email or text message them?
You may be surprised to learn that access to your doctor is determined, for the most part, by the type of health insurance you have. There are basically two types of health insurance in America, “fee for service” (FFS) and “non-FFS”. If you have FFS insurance then your doctor is paid only if you visit the office. I suspect that you have FFS insurance, and understand your frustration. If you had non-FFS insurance, then the doctor would be paid to keep you healthy at a low cost, which would drive care out of the office and onto your smartphone. And you are right, most common illnesses can be diagnosed and treated by phone or email. You’ll probably gain greater access to healthcare through apps and texting over the next few years as non-FFS insurance systems grow nationwide.
How can I find out if I have a fee for service insurance plan?
Does my insurance type effect the price I have to pay?
If your insurance card says “HMO” on it then your insurance is not FFS. If your insurance card does not include these three letters then the only way to know for sure is to call your insurance company and ask what type of coverage you have. Your doctor’s office may be able to tell you, but don’t count on it. The cost of fee for service plans tend to be higher than non-FFS plans, but FFS plans with very high deductibles (the amount you are responsible for paying before insurance kicks in) may cost the same as less costly non-FFS plans. The cost of your plan depends on a variety of factors including whether or not you have any “out of network” coverage, the size of your deductibles, and the services that are covered. Unfortunately, recent changes in American healthcare system have not simplified health insurance plans.
Thanks for the explanation. I’m still a bit concerned about communicating with my doctor though. Hypothetically, if I were able to email my doctor my symptoms, there’s always a chance that I could have a more serious illness than I thought. I think my doctor should also be responsible for following up on whether my symptoms changed for the better or worse. If he/she didn’t then I think that I’d probably question how much care they’re really taking when prescribing my medicine.
It makes sense for you to expect your doctor to be pro-active, and to follow-up with you, even after an email or text communication. By all means DO NOT expect this to happen. Primary care doctors are stretched to their limits, are required to see more patients in less time, need to routinely write and call insurance companies to appeal care denials, and have more paperwork to do than ever before. Only critical problems will generally prompt them to call patients, so you need to take an active role in your care. You have one doctor while your doctor probably has 3000 patients. It is more important than ever for you to ask questions, take notes, and follow-through with recommendations. If you have concerns about not hearing from your doctor, then I recommend contacting the office and/or showing up with questions.
Considering that I only receive 15 minutes of my doctor’s time during a visit I, on principle, can’t agree with the notion that I also need to chase their office to give me the care I’m paying for. It sounds like the only solution is to pay for a doctor out of pocket. I barely see a doctor 3x a year, but it seems as if that is too much. I guess I’m struggling to understand how this added paperwork is benefitting me? I barely get to speak to my doctor now before they have to rush to their next patient.
Doctors across the nation are struggling to meet the expectations of young Millennials like Nadia. With new mobile apps Millennials can instantly perform practically any task and manage all aspects of their life, including their health. Recent patient satisfaction and physician workload surveys reflect a growing chasm between the expectations of young patients and real constraints physicians face. A recent survey of over 1,000 adults found that Millennials are nearly 2x less likely to say they have a good relationship with their doctors. And it doesn’t look like this chasm will get any better— physicians are experiencing greater demands on their time.
Luckily mobile technologies are emerging that help physicians more efficiently manage patient health data, internal communication streams and patient communication. Only when these mobile technologies are integrated with EHRs and designed to filter through the noise can physicians manage the demands for greater accessibility from young patients.
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