When Collin Czarnecki, a researcher at Harmony Healthcare IT in South Bend, Indiana, recently visited his doctor, there was a sign on the wall asking patients to kindly leave their “Google MD” at home. This reference to patients surfing the internet for medical answers is likely only partially tongue-in-cheek. A recent survey by Harmony found that 73% of millennials would rather search the Web for health information than see their doctor. Almost half of the respondents also said they trust various websites to diagnose their symptoms accurately.

This kind of Internet-assisted self-diagnosis is increasingly common among millennials, individuals now aged about 22 to 37 years. Older patients, like those over age 65, are more likely to rely solely on a doctor’s diagnosis. Generation X and baby boomers fall somewhere in the middle of that spectrum.

A new report from the Advisory Board, a healthcare technology, consulting, and management services firm based on Washington, DC, gave the findings from a survey of people from a wide range of ages and found both subtle and distinct generational differences in the way they seek and use healthcare. Being familiar with these nuances could help physicians better manage patients.  

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In general, the Advisory Board study found that millennials are highly independent. They are less likely to stick with a primary care doctor than older patients and most likely to see specialists of their choosing, as opposed to using referrals. They seek low-cost primary care and are the most likely to consider online virtual visits if it gets them an appointment more quickly.

Technology does play a bigger role in their healthcare choices than other generations. The Harmony study, for instance, found that 65% would not consider seeing a doctor who does not have an online presence. When choosing a physician, millennials want to make appointments online and get reviews and feedback from other patients on sites like Zocdoc, Czarnecki said.

This demographic also relies heavily on the internet for medical information. They visit sites like WebMD, but also seek information from peers on sites like Reddit, where they can post symptoms and get feedback.

“The big takeaway from that was almost half said they trust online resources to accurately diagnose symptoms,” Czarnecki said. “Not only are a good portion going online to seek advice, but a majority are finding it trustworthy advice.”

The Harmony survey also found that, although more than one-third of millennials have an established primary care doctor, 25% have gone more than 5 years without a physical. Another one-third said they had not had a physical within the past year. They avoided the doctor’s office because they felt healthy and did not see a reason to go, they were too busy, or they considered a medical visit inconvenient.

“That’s a big chunk that haven’t physically seen a doctor in a long time,” Czarnecki said. “Doctors need to make sure they have a good online presence and have all the tech available to make it easier in terms of communication and scheduling.”

Generation X

This group is looking for a good deal on healthcare. In fact, according to the Advisory Board survey, a price increase of $250 for an office visit would make them move to another doctor more quickly than an error in care. They are more likely to take a referral but do still shop for their own providers. They are interested in virtual care – particularly if it saves them money – but they prefer phone visits.

Lindsay Resnick, executive vice president at Wunderman Thompson Health, said one of the drivers of Gen Xer’s frugality is they are the first “out-of-pocket” generation. Their employer-provided health insurance has moved them from PPOs to high-deductible plans. “They know a doctor’s visit is going to cost $150, but if a clinic inside a big box store or urgent care advertises $69.99 for a visit, they’ll go there,” Resnick said.

To serve their Gen Xer patients better, doctors could work to accommodate patients’ preferences. For instance, specialists may say they are most comfortable with referring a patient to their affiliated hospital for an MRI, but they could also give patients less expensive options in the community or note that these options are available. “The product is the same … and that can totally change the physician-patient dynamic,” Resnick said.

According to Wunderman Thompson, another characteristic of Gen Xers is their cynicism, which can become loyalty if they are provided good service. They want good communication and expect to be informed about all aspects of their care. Gen Xers tend to be the healthcare decision-makers in the family and think they are knowledgeable enough to keep themselves and their families healthy.

Baby Boomers-plus

Physicians would be remiss to lump all their older patients into a single group. There are, most likely, distinct differences between a patient who is 65 and another who is 80. The Advisory Board study found the younger boomers (those currently ages 50 to 65) are more concerned with getting into an office quickly than they are about the cost. They are also more concerned about having ancillary services on site. This group does not like to travel to appointments, and most would prefer virtual visits.

One thing this group does have in common with older patients is their reliance on physicians as experts, according to the survey. Almost all would take a provider’s referral instead of seeking their own specialists. Patients aged 65 and up tend to be the most loyal patients and prize provider continuity.

“We have found that the oldest age group bases interaction on a model of trust in their doctor,” said Eva Kahana, PhD, the Pierce T. and Elizabeth D Robson Professor of Humanities, Chair of the Department of Sociology, and the Director of the Elderly Care Research Center at Case Western Reserve University in Cleveland. “They are not as consumer-oriented, not as likely to have joint decision making. They are more likely to leave things up to their doctor.”

A slightly more surprising statistic in the Advisory Board survey is that more than half of patients over age 65 would consider virtual visits, preferably by phone. Dr Kahana said boomers do use the internet to find medical information more than older individuals, but the elderly are slowly becoming more computer savvy. For instance, she said she manages online communication with doctors for her 85-year-old husband because she is a “spry young 78.”

Specialists should also understand they may be the only doctor their older patients are seeing. Older patients sometimes forgo primary care for the litany of specialists they visit, Dr Kahana said. Doctors should not assume that things like smoking cessation, vaccinations or weight control are being dealt with and may want to help manage these issues as well.