In the midst of the 21st century’s technological changes, we are also experiencing a generational shift in the United States unlike anything seen since the 1960s. Last year, and for the first time since entering their young adulthoods, Baby Boomers were supplanted in size by another generation; the Millennials.
Born between 1981 and 1996, this cohort is now the largest generational group in the United States and is the largest group in the US workforce.
Many of the early criticisms of Millennials (e.g., they are lazy, entitled, and narcissistic) had more to do with their developmental stage than their cohort, but this is not unique to Millennials. For as long as people have been able to mutter “kids these days,” older generations have been skeptical of the merits of their younger upstarts. The Traditionalists complained about the Boomers. The Boomers complained about the Gen Xers. Now, they are all complaining about the Millennials. However, just as members of the Boomer and Gen X generations have grown up and their perspectives have developed with time, so too will the Millennials.
We do not know what Millennials will think when the reach their mid-life years, but we do know that they are different from generations that came before them simply because the world in which they reached maturity was substantially different. For Millennials, terrorism on US soil is a reality but the Cold War is not. They have always had access to the Internet and e-mail. The totality of these experiences has shaped the expectations they have in their life, including the expectations they have of their medical providers.
As trial consultants specializing in medical defense, we have had the opportunity to talk with thousands people about their attitudes toward the overall health-care system, what they expect from their doctors, and what matters most to them as they evaluate medical malpractice lawsuits. While there are always individual differences, we have noticed some clear patterns in what Millennials want from their healthcare providers and how those differ from Traditionalists and Gen Xers.
MILLENNIALS AS JURORS
Analyses from five recent mock trials we conducted in Washington and Oregon revealed reassuring support among Millennials for defendants in medical lawsuits. Regardless of the specific allegations raised in these medical liability cases, Millennial jurors (currently aged 21 to 35) were significantly more likely to favor the physician defendant than were Gen X jurors (aged 36 to 51) or Boomers (aged 52 and above). Moreover, even when Millennials sided with the plaintiffs on liability questions, they awarded the plaintiffs significantly less in damages than the older jurors. In these focus groups, even the pro-plaintiff Millennials suggested roughly half the damage awards suggested by their Boomer counterparts.
Millennials are more skeptical about liability lawsuits in general, and they have positive attitudes about the quality of medical care. Boomers are more likely than Millennials to agree that medical malpractice lawsuits help ensure the responsible actions of health-care providers, that doctors today make too many mistakes, or that the quality of health care today is getting worse.
Millennial jurors (and patients) mistrust large organizational systems that appear to value profits over patients. However, when evaluating a specific case, Millennials are more focused on the individuals involved, including both the individual doctor and the patient. As long as the Millennials are not presented with faceless corporations, they are able to focus on the facts.
MILLENNIALS AS PATIENTS
As jury consultants who research the mindset and emotions of the general public in medical liability, we learn about more than just responses to a particular situation or defense strategy. We have also witnessed recurring attitudinal themes about health care among the generations we’ve studied.
Over the next two decades of the 21st century, each generation will face its own challenges and transitions in health care, but the importance of open and accessible communication with their health-care providers is a constant across the generations. Every year until 2030, three million Baby Boomers will enter retirement and will increasingly rely on their health-care providers to help them navigate the often frustrating and confusing requirements of Medicare and other services. Gen Xers, often described as the middle child of the generations, will enter their middle years. In their youthful past, they had tended to rate their health as good to excellent, but middle age has a way of changing that perspective. As these early decades of the 21st century continue, Gen Xers will be confronted with the dual problems of their own changing health and that of their increasingly elderly parents.
Like the youth of previous generations, Millennials are currently enjoying their physical primes. They are also more fitness-oriented than Boomers or Gen Xers and are much more likely to pay a premium for healthier foods and services. Millennials are currently focused more on maintaining good health than they are on health problems, so a long-term relationship with their family doctors is not particularly important to them.
Although Millennials are willing to spend more to be healthy, they tend to be frugal in medicine. Millennials perceive themselves to be “health-care consumers” rather than traditional patients, and as part of the consumer process, tend to do more independent research for their health care than do Boomers and Traditionalists. As such, Millennials are cost-conscious, rely more on social networking to search for treatment options, and are more likely to shop around for both health insurance and health-care services. They are also more likely to delay medical treatment for financial reasons than other generations—but, this could also be because their proposed medical treatments are not as urgent as they might be for older patients. With their health-care consumers approach, Millennials want to be involved in the medical decision-making process. They want to trust their doctors, but that trust needs to be earned. For Millennials, a trustworthy doctor is one who communicates openly with them, takes the time to listen and appreciate their concerns, and sincerely cares about what is in their best interests.
It is important to note that Millennials’ questions regarding health care do not demonstrate lack of respect, but instead evidence a true curiosity and desire to know more about their health and available treatment options.
One of the most important expectations they have is immediate access to information and health-care choices. Being the first generation to grow up with the Internet, Millennials are unfamiliar with any delay in knowledge or contact. Because connecting with someone or getting a question answered is always just a few clicks away, Millennials become frustrated when it takes days or weeks to schedule a medical appointment or test. In fact, a joint survey by Salesforce and Harris Poll revealed that 71 percent of Millennials would like the use of a mobile app to help them manage their health-care information, share health information, and schedule appointments. Millennials also expect efficiency, which in many ways is the goal of modern technology. As they have entered the workforce, Millennials have helped streamline systems reducing redundancy and unnecessary steps. They have the same expectation of the health-care system and have shown preferences for acute-care treatment centers that can address their concerns as needed and have tests (e.g., x-rays, laboratory studies, etc.) conducted at the same location.
Millennials expect their doctors to be skilled and competent with medical technology. For these patients, rapid change in the state of the art is not simply a reality; it is an expectation. Health-care providers must keep up.
Millennials will be substantially less forgiving for mistakes in an electronic record simply because learning a new system is challenging. Millennial patients expect physicians to take the time to become proficient with new software and technology, or to at least hire someone to do it for them. Additionally, Millennial patients are so used to quick and efficient communication among themselves that they expect the same from their health-care providers. Doctors’ failure to communicate with each other is particularly vexing to Millennials.
Personal Choice And Responsibility
Departures from convention and tradition have come to define Millennials, for whom individual freedoms and personal choices immensely matter. This is evident in their widespread advocacy for gay marriage, marijuana legalization, transgender rights, and immigration. They generally believe people should have the right to make decisions for themselves and that there is not just one way of being or behaving.
Their emphasis on personal choice is also evident in Millennials’ perceptions of the doctor-patient relationships. While younger jurors and patients do not revere physicians like their grandparents did (or do), they respect doctors and also believe patients are largely responsible for their own health care.
Millennials grew up surrounded by health warnings on a vast array of products ranging from tobacco to peanuts. They have not known life without seatbelts, bicycle helmets, and were raised seeing signs in restaurants warning about the dangers of drinking and driving. Thus, they fully understand that their personal choices come with risk. That is not to say they always make the right or healthy choice, but they are at least making informed choices. When deliberating issues in a medical liability suit, Millennials consistently want to know the patient’s role in the outcome—i.e., did the patient have a healthy lifestyle, follow the doctor’s advice, or consent to the treatment at issue? When evaluating medical care, the patient’s personal responsibility matters just as much as the actions of the physician.
Just as generational cohort effects will impact how patients approach their health care as the 21st century continues to unfold, these same effects will also be important considerations when people are asked, as jurors, to assess the health care provided to others. Like the Millennials, the 21st century is still young, and there is reason for optimism as we look ahead.
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During the past 10 years, ANDREA BLOUNT HUNTER, PhD and GEORGE HUNTER, PhD of Mind Matters Jury Consulting have consulted on hundreds of cases across the United States on virtually every type of legal matter. To help shape and present the best case possible, they work with their clients to understand how jurors think.
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1 The Council of Economic Advisors, “15 Economic Facts about Millennials,” Executive Office of the President of the United States, October 2014, accessed June 5, 2016, https://www.whitehouse.gov/sites/default/files/docs/millennials_report….
2 National Institute on Aging, “Aging in the United States—Past, Present, and Future,” US Department of Commerce, accessed June 23, 2016, http://www.census.gov/population/international/files/97agewc.pdf.
3 Nielsen, “We Are What We Eat: Healthy Eating Trends around the World,” Global Health and Wellness Report, January 2015, accessed June 23, 2016, https://www.nielsen.com/content/dam/nielsenglobal/eu/nielseninsights/pd….
4 Paul Keckley, “What Do Millennials Want from the Healthcare System?” The Health Care Blog, March 18, 2014, accessed June 5, 2016, https://www.nielsen.com/content/dam/nielsenglobal/eu/nielseninsights/pd….
5 “Five Ways Tech-Savvy Millennials Alter Health Care Landscape,” PNC Healthcare, March 23, 2015, accessed June 5, 2016, http://pnc.mediaroom.com/2015-03-23-Five-Ways-Tech-Savvy-Millennials-Al….