Luc Matthew is a 17-year-old senior at Easton Area High School in eastern Pennsylvania. Young and healthy, he doesn’t think much about health care unless it’s time for the annual school physical.
When he does get sick, he sees the doctor as a last resort, grudgingly dragged to his childhood pediatrician by \his mother.
“Once I’m 18 and on my own,” he said recently, “I’m not planning on going to the doctor for annual check-ups anymore. It seems like a waste of time and money to me.”
Luc admits that if he were able to access a physician through an app on his phone, and use FaceTime to communicate with his doctor, he might be more apt to consult a physician for his health care needs.
“I don’t want to have to call an office and be put on hold,” he said, “then wait a few days or weeks for an appointment, fill out forms at the office that I could have done online, only to be rushed through a five-minute office visit and then charged $120.”
Luc’s statements echo the perspective of much of his generation regarding health care.
He is a part of Generation Z or Gen Z, the generation born between 1997 and 2012, according to the Pew Research Center, a nonpartisan research organization based in Washington, D.C.
According to this definition, the youngest members of Gen Z are turning 7 years old in 2019, and the oldest, 22.
The older members of Gen Z — the teens and young adults — are on their way into the workforce and adulthood. They are digital natives, the first generation to have grown up with easy access to the internet and smartphones.
With instant access to information and purchasing power available to them at the touch of a button, Gen Zers have similar specific expectations for their health care. Speed. Transparency. Easy Access.
Like Luc, their preferences are not due only to a tech-led lifestyle but also to finances. Rising insurance costs, high deductibles and student-loan debt all contribute to pushing young people away from what they see as costly, in-office doctor’s visits, according to Becker’s Hospital Review, a news organization for the hospital and health system industry.
And the health care systems are paying attention to Gen Z’s outlook, fueling a digital revolution in health care.
“Gen-Z sees telehealth (virtual health-care) as a better, more efficient way to get treated than dragging yourself to the doc when you are not feeling well,” said Robert McDonald, professor of health care systems engineering at Lehigh University. “If they use tech for all of their other transactions — banking, bill paying, taking classes — why not for health care?”
McDonald is quick to add that virtual health care also can be more attractive to those who are young and healthy, like members of Gen Z. They tend to not use much health care in the first place compared to Baby Boomers, who have more health care needs and may prefer to be seen by a hands-on doctor.
Gen Zers also are driving change in the health care industry because they are less likely to have a specific primary care doctor, said McDonald, and they are more likely to go to a walk-in urgent care center for things such as flu or broken bones.
“They have less stigma against walk-in care,” he said. “They just want to be treated.”
One area of health care that does appear to interest Gen Z more than older generations is behavioral health.
“The biggest thing I’m seeing among our young patients is that mental health issues are on the rise and that they are more likely to ask for help,” said Dr. Jill E. Colabray, a pediatrician with the Lehigh Valley Health Network.
Because of the increased demand, Colabray’s physician group has begun to routinely screen kids 12 and older for depression and has started training its staff on addressing patients’ mental health issues.
“Child-psych groups are struggling with the workload, it’s so much,” she said. “We even hired an in-house counselor to do short-term counseling. Things that would have been done in a psych office in the past, we are now doing in a pediatrician group.”
Convenience is key
In addition to offering increased mental health services, Colabray’s office is making a concerted effort to connect with young people through technology.
“Convenience is key in that generation,” she said. “They grew up on it. Even some of our young parents are only in their 20s. They want everything quick and easy.”
To adapt, Colabray’s office has made it possible for patients to email the office with questions or pictures, and video visits are available.
Extended office hours also are offered to accommodate patients and parents’ busy schedules, which often include multiple after-school sports practices.
“Kids are playing sports earlier and more intensely,” Colabray said. “There are a lot more serious injuries because kids are playing the same sport all year long. There is more of a need for physical therapy. There are more concussions. It’s gotten so intense.”
At Tower Health, the Berks County, Pennsylvania-based health network, hospital administrators and physicians are working diligently to adapt to the unique needs of Gen Z.
“It’s really important to look at their needs because they represent the future of health care,” said Dr. Charles Barbera, vice president of pre-hospital and unscheduled care at Tower Health.
“We have found ourselves having to look at how we deliver care, and how we might need to change,” he said. “In the past, it was the norm to take time off to see the doctor. That’s no longer true. We have had to find other ways to deliver health care.”
Tower Health is increasingly offering extended-care hours and using electronic media to deliver emails for reminder appointments, Barbera said.
“We’ve had to embrace technology to capture people in this age group,” he said.
Barbera also said that Tower Health is adding more urgent care centers, in part because for younger patients, they are used to on-demand care.
“It’s their normal,” he said. “And in the end, it doesn’t matter how their care is delivered. What matters is that they are well.”
Like LVHN’s Dr. Colabray, Barbera notices an uptick in adolescents battling depression, anxiety and sports injuries. He also added obesity-related concerns to the list.
“There is no single answer to any of these issues,” he said. “The treatment has to be tailored to the individual.”
Barbera noted that Tower Health has designed a health care program specifically for adolescents who have a higher body-mass index.
“Kids are getting better at reaching out for help, and we need to let them know that there is no reason not to,” he said. “We are all working on doing what we can — doctors, schools, all of us. We need to let kids know that there is no such thing as normal.”
For young patients whose health issues require admission to the hospital or emergency department, Tower Health has recently employed a child-life specialist. This certified counselor helps children and teens adjust to their stay and better understand their care.
“We have to recognize the specific needs of this population,” said Barbera. “You don’t treat someone in their teens in the same way as you do someone in their 60s. Even if they have the same disease, the approach must be different.”
“Every population has unique needs,” he added. “It’s up to us to meet them.