The de-centering of the doctor-patient relationship has come into conflict with the mounting health needs of Generation X and Millennials, many of whom increasingly require longitudinal, in-person care. Our industry’s aggressive moves to offer extraordinary convenience have over-valued the role of consumer preference—and by consequence, under-valued the role of clinician expertise—in strategy and investment decisions. Ironically, the inundation of tech-first, consumer-centric care models have created a diffuse and fragmented delivery landscape in which it is harder—not easier—for patients to make health-related decisions.
Since 2020, telehealth firms, consumer-oriented primary care companies, and other disruptors have continued to grab headlines and investment dollars. In particular, funding for digital health companies skyrocketed during (and following) the Covid-19 crisis. At face value, these bets made sense a decade ago, as they were predicated on conventional wisdom about consumer trends. Millennials and Gen Z were demanding swift access from their providers; many patients were shunning doctors who offered poor digital experience; people of all ages finally became open to using telehealth; and younger generations were less concerned with health data privacy than their parents.
For many, these tech-first models offered an exciting proposition—and in truth, they have made life easier for many Gen Zers, Millennials, and even older generations. But these solutions weren’t right for everyone. In fact, they failed to meet the needs of millions—particularly those who required more traditional care. Convenience-driven models underestimated the amount of acute, in-person treatment that many Millennials and Gen X members now need, as they exhibit worse physical and behavioral health indicators than their parents and grandparents did at the same points in their lives. Specifically, major depression, hyperactivity, and type II diabetes had the largest growth in prevalence among Millennials from 2014–2017 and continued to worsen over the next decade. These deteriorating health outcomes are attributable to higher stress, poor diet, low levels of physical exercise, and growing social inequity—among other factors.
Digitally driven models also mistakenly treated younger generations as monoliths, assuming all members were able to use digital-first, self-directed care. As a result, disruptive care providers exacerbated digital inequities—especially among Millennials, who have experienced unprecedented levels of intragenerational socioeconomic inequality.
Prevalence rate comparison for top 10 conditions between Gen X and Millennials at the same age (34–36)