More than 25% of Gen Z patients don’t have doctors. Experts weigh in on the cost of skipping care

By Amen Galinato, CNN

A yearly physical is the standard preventive measure for adults, but many Gen Z patients are forgoing regular doctor appointments.

More than 1 in 4 young adults don’t have a primary care provider, according to a recent national survey by the Ohio State University Wexner Medical Center.

For Gen Zers who do have a physician, most skip scheduled checkups or don’t schedule them: Only 47% of 18- to 29-year-olds said they have had an annual wellness visit in the past year, according to the survey findings, released June 29.

Skipping doctor visits in early adulthood could have severe consequences, experts say, noting that missed prevention opportunities earlier in life can lead to greater chances of developing later-in-life diseases and conditions. In recent years, colorectal cancer rates have skyrocketed in younger adults, becoming the leading cause of cancer deaths for people younger than 50.

“An annual visit isn’t just about today’s health — it helps identify future risks, keeps preventive care on schedule and gives you a trusted clinician who knows your medical history and can help navigate health concerns, be they physical health or mental health concerns, as they arise,” said CNN wellness contributor Dr. Leana Wen, an emergency physician and clinical associate professor at George Washington University, in an email to CNN. Wen was not involved in the study.

Finding the right doctor for you

The poll queried 1,006 respondents across several age groups about their medical habits. Out of all the age groups, older adults were most likely to have a primary care doctor, with 97% of respondents age 65 and older saying they had a regular provider compared with 71% of younger adults.

Many Gen Zers instead turn to their local urgent care clinic for non-emergency-related health issues, with 36% looking first to an immediate care facility, the survey found. However, the doctor-patient relationship is essential to staying healthy.

There are lost opportunities “to build a relationship of trust with somebody who can potentially keep you out of the emergency room or help support you in ways that help maintain your health over the long-term,” said Dr. Russell Phillips, senior adviser on innovation in the primary care division of general medicine at Beth Israel Deaconess Medical Center in Boston. Phillips was not involved in the survey.

Younger adults may be less worried about health risks than older generations, since they are generally less likely to develop age-associated diseases such as cardiovascular and neurodegenerative disorders.

But that doesn’t mean Gen Z and millennials aren’t at risk of developing severe diseases earlier in life.

“We lowered the age for routine colon cancer screening for everybody from 50 to 45, but that age can be even lower if our family history is more complex,” said family medicine physician Dr. Zachary Bittinger, a clinical assistant professor at Ohio State University Wexner Medical Center who was not directly involved with the survey.

If the first doctor you see isn’t a good match, experts say that it’s perfectly acceptable to keep searching until you find one that you’re comfortable with.

“If we have an initial visit or two with somebody, and we’re still just not quite sure that you’re speaking the same language as your doctor … it’s OK to see somebody new,” Bittinger said. “That might be also where we take some opinions from trusted family members, friends or people that know us well to make sure that … our relationship is right.”

Challenges within healthcare

For Olivia Hall, finding a physician she could trust and rely on has been no easy task. Over the course of six years, Hall, a 27-year-old living in Las Vegas, has seen seven primary care providers. Doctors often dismissed her high heart rate as a symptom of stress. Later on, a specialist finally diagnosed her with postural orthostatic tachycardia syndrome, a blood circulation disorder also known as POTS.

“I find especially in the community that I’ve built around chronic illness and people in their 20s and 30s that are getting these syndromes and not getting diagnosed is they had similar experiences to mine,” Hall said. “They get dismissed so many times that they start to believe themselves that it’s not real, or that they’re making it worse than it actually is.”

After Hall advocated for herself, a primary care provider referred her to a specialist who helped validate her concerns.

“A trusted doctor who truly listens and helps make steps can save people years of hardship, self-doubt,” Hall said.

Rural areas and overcrowded cities are especially stretched thin when it comes to accessing affordable and quality healthcare.

The survey’s findings are “consistent with results from other studies about young adults being less likely to have a primary care doctor,” said Phillips, founding director of the Center for Primary Care at Harvard Medical School.

“Access is getting increasingly difficult for primary care,” he said.

Healthcare staffing challenges will likely worsen, according to a 2025 US Health Resources and Services Administration projection, with the agency predicting a shortage of 70,610 primary care doctors by 2038.

“We just don’t have enough primary care physicians,” Phillips said. “It’s difficult to find one who is taking new patients into their practice.” For people who already have a primary care physician, “sometimes getting appointments can be challenging.”

Rising healthcare costs can also have some Gen Zers debating whether medical appointments are worth the expense.

“Young adults might be more wary of incurring those bills or are accessing care when they’re not sure of how their insurance might cover it,” Bittinger said.

Doctor visits vs. urgent care walk-ins

One challenge may be that under the Affordable Care Act, adults older than 26 are no longer eligible to stay on their parents’ health insurance. For some young adults priced out of health insurance when they strike out on their own, it could mean forgoing checkups or appointments.

Relocating to new environments can also leave some young adults unsure where to look for medical guidance as they outgrow pediatric care.

“For some, urgent care has become their default because it’s convenient and doesn’t require an ongoing relationship with a physician,” Wen said.

While urgent care clinics are meant for patients who need immediate medical attention, a significant number of young adults choose to use their services for issues that are less pressing. But experts say that regular appointments with a trusted doctor can spot conditions that may go unnoticed in an urgent care setting.

“They’re excellent for treating minor illnesses and injuries, but they aren’t intended to replace ongoing primary care,” Wen said. “A primary care provider can recognize patterns over time, coordinate specialty care when needed and focus on prevention, not just treating today’s problem.”

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