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Do You Really Need a Primary Care Doctor?

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As breakups go, it was a pretty boring one. After Chloe Cahir-Chase, 24, moved from Colorado to New York City, she knew the long-distance relationship wouldn't have worked. The person she dumped? Her doctor—and she's been single ever since. "I haven't had a primary care physician since I left my hometown years ago," she says. "I'll go to specialists, like the dermatologist or ob-gyn, but I tend to go to urgent care for anything else."

Her choice to fly (somewhat) solo through the world of health care is becoming more common. According to a 2016 report by the Transamerica Center for Health Studies, over a quarter of millennials don't have a primary care doctor, with many indicating they go to an urgent care facility or retail clinic instead. A separate study by FAIR Health came to the same conclusion—53 percent of millennials reported turning to the emergency room, urgent care, or a retail clinic when in need of medical treatment for a non-emergency. (Related: When You Should Think Twice Before Going to the Emergency Room) "Millennials find sitting in a doctor's office as archaic as Gen Xers do about walking into a bank," says Elizabeth Trattner, A.P., an integrative medicine specialist in Miami.

But is it really okay to skip seeing a GP on the regular? We spoke to the experts.

Why Fewer Young People Have Primary Care Doctors

Call it modern medicine. "Female millennials want to get medical answers quickly, either from tele-medicine or at an urgent care where no appointment is required," Trattner says. "If they do see a doctor, it's usually their ob-gyn, so it's more of a one-stop shopping experience." (Here's what your ob-gyn wishes you knew about fertility.)

Convenience, Trattner explains, is more important than being on a first-name basis with your physician. (The Transamerica Center for Health Studies report did cite "convenience" as millennials' top reason for foregoing their GP.) Cahir-Chase agrees: "Going to urgent care on my lunch break or after work is easy." (Related: These Delivery Companies Are Changing the Health World)

There are other factors that come into play. Millennials change jobs at a higher frequency than the generation before them, and bouncing from insurance plan to insurance plan makes it tricky to keep the same doctor. There's also cost (over half of millennials in the TCHS study responded that they could not afford or had extreme difficulty affording their health care) and quality of care.

So it's not that millennials DGAF about their health, it's that they're tired of poor health care. "I walked away from a number of bad experiences when I tried to find a general practitioner," says Cahir-Chase. "Practices overbooked the number of patients being seen so I would wait hours to see a doctor, or when I did get to talk to someone, I felt like they weren't taking the time to dig into my health history."

While health apps and drive-by doctors can seem like more of a Band-Aid, and even a gamble—the life-or-death kind—Shoshana Ungerleider, M.D., a hospitalist physician at Sutter Health California Pacific Medical Center in San Francisco, says being GP-free isn't necessarily a bad thing. "It's fine for young, healthy women to seek general medical care outside of traditional primary care, such as using an ob-gyn as your main doctor," she says. There are even pros to using a digital doc or urgent care facility, including not having to wait days to be seen if you're sick, Dr. Ungerleider adds. (This $149 at-home fertility test is changing the game for millennial women.)

And the higher standards that millennials are looking for from the white coats may even be a prescription for positive change. "Millennials are a sophisticated group who aren't interested in the inefficiencies in our health care system," she says. "My hope is that they will help push our health care system to focus more on customer experience, person-centered, accessible care, and a seamless flow of information." 

The Downside of Breaking Up with Your GP

Not everyone in the medical community is keen on the doctor-only-when-I-need-it rule. "It's very important to have a primary care physician," says Wilnise Jasmin, M.D., a family medicine physician in Baltimore. "People who visit their primary care doctor are more likely to receive preventative services—such as screenings for depression and certain cancers—better management of chronic illnesses, and a decreased chance of premature death."

That's because aside from an annual physical that gives you a top-to-bottom health check, the continuity of care is beneficial for catching certain health conditions that may not present obvious symptoms, Dr. Jasmin adds. "Seeing your doctor yearly also creates a baseline reference point in times of illness to help with medical decision making."

It's something Christine Coppa, 37, from Riverdale, New Jersey, learned firsthand. "I've always had a primary care doctor, but was in between doctors when I started to feel tired, my throat grew hoarse, my ears hurt, and I had shortness of breath," she says. "I went to an urgent care doctor and he was extremely flippant. He prescribed me an inhaler for allergies." Coppa wasn't convinced, and when her symptoms prevailed, she went to a GP recommended by her friend. "When she examined me, she felt a lump, and that ultimately set into motion what would eventually be a diagnosis of thyroid cancer."

Of course, there are good and bad doctors everywhere. But the problem with urgent care, in this case, is that you're getting a doctor you didn't choose—unlike a permanent GP you've researched and feel comfortable with—and with whom you haven't established a continuity of care. But as Coppa's case proves, it's crucial to listen to your body and demand proper care, wherever it may be.

 

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