MDNews - Minnesota

Be mindful of memory! Obviously Patients Are Consumers. Cam Marston, president of Generational Insights, isn't buying it. Of course patients are consumers, he argues, with medical consumers exhibiting generational nuances in their decision-making. Generation Xers and Millennials, Marston says, "want to hear about the individual and the future. Matures and the Baby Boomers prefer to be told about the product, its history and background." For the younger cohorts, he believes expertise is earned by performance in the moment, while Matures and Boomers look at credentialing and experience as markers of authority. In a speech to the American Hearing Aid Association, Marston told the audience of audiologists: "The more senior the patient, the more they're willing to take advice and assume the doctor is the most knowledgeable source of information. The doctor is the shaman, the expert. The younger they get, the more they're questioning the advice of the doctor. They will do an extraordinary amount of research on the doctor's advice." Other advisors besides the physician influence younger consumers, Marston told the audiologists. "The younger they get, the more they make decisions in a herd or a social mentality. 'What do I need, what do you all think I need, how does this mirror what the doctor is telling me I need?' They view the doctor or treatment as a consultant to their problem, versus the final word on the problem." What does this mean for the practitioner in the room with a young patient? "They have to budget time to sit down and go through options with their younger patients," Marston advises. This advice cuts across specialties, even geriatrics and pediatrics, where the patient and consumer roles may be divided between the person receiving treatment and a caregiver. Marston elaborates, "The average hearing aid user is 69. The average [caregiver] is in his or her 50s. The provider needs to know who the final decision maker is, who the primary influencer is, and speak to both of them but give favor to the primary influencer." Does this mean older customers don't think critically? Not at all, says Marston. Instead, physicians have the formal credentialing that gives them authority with more senior cohorts. Seniors will raise questions just as younger customers will, but they'll respond better to different answers. "The doctor needs to be able to bridge the gap very adroitly," says Marston, "to say to the Mature, 'Here's the history of this treatment, here's the history of me, of my practice, here's what's worked in the past, here's what's worked for people like you historically.' "(Matures) will be interested in what other people are hearing and People of different age groups process information in different ways, writes Valerie Reyna, PhD, in the FDA's Communicating Risks and Benefits: An Evidence-Based User's Guide: Verbatim memory Children and adolescents rely on word-for-word memory. While stored verbatim memory remains strong, the ability to form new verbatim memories wanes across adulthood. Gist memory Memory based on meaning grows stronger throughout adulthood and remains powerful throughout healthy old age. What does this mean for health messages? Children and adolescents will respond well to repetition, which plays to their retentive verbatim memories. Keep in mind that even very young people are consumers of health messages. Every day they make choices like whether to buy a milkshake or a fruit smoothie, or whether to skip an insulin shot when they're late to class. Older adults may not remember facts or instructions word-for-word. Explaining the meaning of instructions will link the information to gist memory, increasing retention and compliance. For details, take-home communications will give the older adult an aide-memoire. Alerts and reminders can supplement instructions. MDNEWS.COM I MD NEWS Twin Cities | 35

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