Yes, Millenials. You, Too, Can Benefit from Preventive Care
Care Coordination for Young Adults
By George Martin, MD – Senior Medical Director for Health Integrated
Last week, we got you through the challenges of care coordination up to age 18. Now we will look at the needs of the 18 to 35 year old group. The problem here, so to speak, is that this group needs little intervention but they can most certainly still benefit from it. After all, to quote the old adage, an ounce of prevention is worth a pound of cure.
This group is young, active and vibrant. Interested in career and family, the opportunities to affect change here are limited. Yet this is a crucial time in their lives to influence beneficial habits as they are cementing lifestyle behaviors that will have a major impact in later years.
Based on nothing other than personal observation there are opportunities to make and impact:
1. Family planning – Historically, it has been unusual to see a man joining a woman in an obstetric office and pre-planning a pregnancy is often an afterthought. Once a woman is expecting, the current recommendation is for ten prenatal visits to monitor a normal pregnancy. Some health care professionals advocate the addition of an eleventh visit that is not only prenatal but pre-conception. This visit and other key visits, such as when the infants sex can be determined, can and should involve the father. Not only is this likely to be good for the family but also it would allow a care coordinator to interact with the father to assess his potential needs and to provide the parents-to-be with education specific to the pregnancy as well as to general issues.
2. Injuries – This demographic group is active and many minor injuries including sprains, contusions etc. tend to occur. Some of these are treated in the emergency department but most of these injuries do not require that level of care and are treated elsewhere. Urgent care centers have been a recent development. These walk in clinics are designed to treat simple acute illnesses and injuries. They generally do not provide follow up but rather send the patient back to their primary care physician or to the appropriate specialist, such as an orthopedist, for additional care. The presence of a virtual care coordination function at these sites would ensure that the patient got active continuing care and provide an opportunity for education.
3. Psychoactive drugs – Unfortunately, there is a darker side to this age group. Psychoactive drugs from narcotics to the atypical anti-psychotics are routinely prescribed by physicians without specific training in their use. The typical response of a physician treating an acute injury is that the narcotic prescribed is not addictive if used for acute pain or that they are required by regulation to treat pain with narcotics. Wrong on both counts, but they are an easy and fast fix.
So even though this group does not access routine preventive care, there are opportunities for both intervention and education. There are those who would advocate for routine preventive care for this group. I have two comments for them. First, there is little, if any, evidence that preventive care such as the routine physical, as currently constructed provides medical value in this age group. And second, good luck. This customer group finds no value and has no desire in wasting their time or money. Trying to force them into a preventive solution reminds us that “Control is an Illusion.” Get over it.
Are there other ways to intervene effectively for this age group? What are your thoughts?
You can reach me directly at healthexecforum@healthintegrated.com, or comment directly in the blog.
As always, thanks for reading and for your input.
George Martin, MD
