Gen Z vs. Millennial: How Two Generations Decide on Primary Care
Mediate.ly’s Field Signals team conducted new primary research on how Gen Z and Millennial consumers make, delay, and abandon the decision to establish primary care - and what it means for how health systems should market, direct, and communicate with each audience. Mediate.ly surveyed 500 insured U.S. consumers: 250 Gen Z and 250 Millennials. The report moves from the paradox and its barriers to decision moments, media opportunities, marketing activation, and measurement.
Primary care is widely valued, but the people without it are divided on why. While 81.4% of all respondents call having a PCP essential or very important, that falls to 50% among respondents without one.*1 Some do not feel a strong need; others intend to act but get stuck on where to start. The opportunity is not one universal message. Health systems need to build relevance for some consumers and make the path to care simpler for others.
Methodology: Mediate.ly Primary Care Trends Online Survey, fielded September 2026 among 500 insured U.S. consumers (250 Gen Z and 250 Millennial). paired with Nielsen Scarborough syndicated media research (New York DMA, 2025 Release 2 & 2024 Release 2 Total) and published research from KFF, Aflac, EMARKETER, McKinsey, PwC, and AAMC.
The Barriers Behind the Paradox
1. The Mindset-Action Gap
81.4% of all respondents call a primary care doctor essential or very important. Among respondents without one, however, only 50% do. Among respondents without a primary care physician, their reasons split between perceived need and inertia:
- 26.6% say they “didn’t feel a strong need based on my health” and
- 26.6% say they “never got around to it.
- Cost concerns (18.8%) and insurance complexity (12.5%) are lower, and
- 43.8% of respondents without a PCP describe finding one as overwhelming.*1
These data points create two jobs for marketing: make primary care relevant and make establishing it easier.
2. Two Patterns, not two Absolutes
Gen Z is more likely than Millennials to describe finding a PCP as “indifferent, not a priority” (32.8% vs. 26.4%) or “overwhelmed, don’t know where to start” (27.2% vs. 22.4%). Confidence in finding a new PCP is also lower (30.8% vs. 40.8%). Both generations face these barriers. Health systems should test messages that explain why primary care matters and messages that show how to get started.*1
3. The Decision Moments: Moving, Coverage and Disruption
Primary care becomes a decision again at transition moments. Moving to a new location (26.2%) is the most common trigger in our survey; insurance-related changes also create opportunities, including a plan requiring a PCP (19.0%) and getting new health insurance (17.2%).*1 Health systems can respond by making in-network status, location, availability, and scheduling clear. When an existing PCP relationship breaks, Gen Z is nearly twice as likely as Millennials to default to urgent or virtual care in the short term (26.9% vs. 15.7%).*1
That does not necessarily signal rejection of primary care. Among those who defaulted to urgent or virtual care after losing a PCP, 76.9% still call a PCP essential or very important.*1 Help these consumers find an in-network replacement and book before a temporary workaround becomes routine. 2x Gen Z is nearly twice as likely as Millennials to default into urgent or virtual care after losing a PCP. 26.9% vs. 15.7% - a transition window to intercept with in-network options, availability, and simple booking.
4. The AI Discovery Gap
AI is part of health-information discovery, but it is not most respondents’ primary doctor-finding resource. Aflac reports that 76% of Gen Z and 63% of Millennials turn to AI before consulting a medical professional;*5 KFF also documents AI use for health information.*6 In our survey, 29.2% of Gen Z report asking an AI chatbot about symptoms six or more times a year. But when asked which one resource they rely on most to find a doctor, just 4% select AI, versus 39.4% selecting insurance directories and 22.6% search engines.*1
The Media Opportunity: Reach Meets Relevance
Use audience concentration and scale to plan message tests
What type of media are these audiences consuming
Both generations under-index sharply in the heaviest TV-viewing quintile (Gen Z Index 7; Millennials Index 26) and over-index for digital video display (147 and 141). That makes digital video a shared test environment, while the channel charts above show where each audience is concentrated and how much of each audience is actually there. Use both index and composition when allocating spend: a high index signals concentration; comp signals usable audience scale.*7
The Media Opportunity on Social Platforms
Index reflects how skewed a platform is toward a generation; percent composition says what share of that generation is actually on that platform. The two tell different stories: Facebook reaches more of both generations than anything else (71% Gen Z, 74% Millennial) but indexes at just 96 and 100, statistically the general population's platform, not a lever for reaching one generation over the other. Snapchat is the opposite case: lower reach, but the sharpest generational skew in the set.*7
The Action Plan: Turn Findings into Booked Care
Two ready-to-use activation tools for health-system marketers
ACTIVATION 1 | Barrier-to-Action Planning Matrix
ACTIVATION 2 | Two Creative Briefs to Test in BOTH Generations
The Measurement Opportunity: Proof of Advertising Impact
Healthcare advertising is already driving measurable behavior: 37.8% of Gen Z respondents (index 117) and 35.0% of Millennial respondents (index 108) report making a doctor appointment as a result of health advertising in the past year.*1 The open question is not whether the media works. It is whether your measurement can tell you which specific touch, an insurance-renewal-timed placement versus a generic retargeting hit, earned that lift.
Multi-touch attribution assigns credit across a journey; it wasn't built to weight a trigger-aligned touch differently from a coincidental one. Incrementality testing answers a sharper question: would this booking have happened anyway? Healthcare measurement specialists increasingly argue it fits this category better than attribution alone, precisely because primary care is trigger-driven rather than steady-state.
