Millennials and Patient Compliance-Where’s the App For That?

June 15, 2015 by Todd Christman

By Kembra Mathis, MEd, ATC, LAT, Bentonville High School

“Kids these days”. If you’ve ever uttered those words you are likely not alone. It’s no secret that the latest generation of young people, fondly known as millennials, is the topic of discussion in the work place. The rehabilitation environment is certainly not exempt from this discussion. Most complaints include but are not limited to a lack of work ethic, sense of entitlement, irresponsibility and co-dependence. Certainly these millennials are well meaning but their view of life is very different from the older generation which makes for disgruntled employees of all ages in the workplace and non-compliant patients in a secondary school athletic health care facility.

Imagine for a moment, that growing up you never had to learn what waiting was. For example, when going to the library to do research, you open the card catalog and BOOM! The research you needed appeared instantaneously. What about when you forgot something at home and needed to call someone to bring it up? What if instead of having to locate a pay phone or office landline you could just whip out this little rectangular box, press a button and BOOM! Instantly there is someone there at your beck and call. And if that person wasn’t there, you could just keep calling/texting others until your need was met. Instead, you searched for a land line to place a call and beg for mercy in hopes of someone at home being kind enough to bring said article to you. If no one answered the phone you just had to manage without it. Do you remember wishing for a way to do research that was faster? Do you remember imagining a world where you could call anyone from anywhere? Well, these kiddos are a product of our dreams. Our generation created the world they live in and have given them everything we ever thought would be cool…and now, we have young people who struggle to wait for information, don’t always believe what you tell them unless they can find evidence online to support it, or become impatient when they aren’t somehow healed miraculously from one treatment. Surprisingly, the human body’s speed of healing hasn’t really changed much. That leaves us with good old fashioned rehab and a lesson in patience for all generations.
The fact is, today’s athletes are a different breed. Put yourself in their shoes for a moment. They have never known a time without a cell phone, or instant information available via the internet. They have been on computers since kindergarten and have learned to navigate the digital world flawlessly. Unfortunately, the physical world still holds many mysteries. You see, where most of us learned from experience, i.e. touch, taste, smell, feel etc., they read about it online. They are inquisitive with a tremendous knowledge base but have very limited communication skills and social filters. The generation of “speak when spoken to” who listened to all adults, observed life around them, and learned from it has been replaced by the generation of “Googling Skeptics” who no longer need human interaction to observe because they can instantly access information in seconds. Additionally, these athletes have been bombarded with a wide variety of resources all their lives.  They are conditioned to believe everything they hear or see from the internet or strangers, regardless of the position he or she holds. As a result, what may be seen as entitlement, lack of respect for authority, and non-compliance may actually have more to do with expectations of instant gratification, lack of trust and skepticism.  
Certainly, this is a much more complex topic and of course each generation is tailored by the current beliefs, attitudes, subjective norms, cultural context, social supports and emotional health challenges present at the time. So who’s to blame? Helicopter parents? The Kardashians?Social Media? I say lack of experiential learning opportunities. Bottom line is that we can’t just blame helicopter parents anymore. Kids know so much more than they’ve ever known before however they don’t necessarily know how to use their knowledge and they don’t always trust authority. This makes the “Because I said so” line obsolete. This young generation may need a little guidance in terms of relating to others and understanding the entire process of rehab based on evidence they can see for themselves. That’s where we, the athletic trainers, stepin.
I can’t tell you how many times I have had to sit down with a kid and explain something that I felt was complete common sense only to watch a dusty light bulb come on for the first time. Common sense is something people get from experiences. We often forget that many kids aren’t getting physical experiences in life, just lots of time on an iPad. That said, it’s our job, like it or not, to show them the importance and relevance of the rehab process. I don’t disagree that at some point a kid will have to take responsibility for his or herself in life because there won’t always be someone there to catch them when they fall. But I do believe that we can only take that stance after we have done our best to build the knowledge base.
So what can we do? The secondary school setting is one place where every aspect of our skill set is put to the test daily and this is no exception. At any given moment, the secondary school AT must play many different roles in an athlete’s life such as parent, counselor, coach, administrator, teacher and advocate, and then one can turn the focus to therapy. The advantage in the secondary school is that often times we know these kids and their families so we can better tailor a home exercise program to meet their needs and abilities. We just have to include them in the process and make them a partner in it. When athletes better understand the goals of rehab, as well as what it will take to reach them, and are given a stake on the outcome, they are often more inclined to follow through. We already know that barriers to rehab are misunderstanding instructions, poor form, forgetfulness and plain old ignorance of medical advice. We can’t fix all the factors but we can easily combat 3 of the 4! 

Here are a few Tips that might help you maintain your sanity and keep them on the road to recovery.
·         Build the Relationship on knowledge-It’s no secret that rapport plays a huge role in the rehabilitation process. They may like you just fine but that doesn’t mean they trust you. Focus on being a trusted source.
·         Don’t be afraid to speak their language- Certainly, each state and district has its own policies on social media interaction with students but consider a professional Twitter account, or maybe a Remind101. Remind 101 lets you send a group reminder daily to do their prescribed plan. Make it general. It’s just a reminder to do what they need to do.
·         Be willing to compromise-meet them where they are. For example, understand they have other things going on in their lives and are still learning how to juggle, so time management is a learned skill. Also know that the home lives of some bring about very specific challenges that they may not know how to navigate. As a result, therapy is the furthest thing from their minds.
·         Be patient(I know, easier said than done sometimes). The “your way or the highway” option is not effective. This group needs to know why so take a few minutes and explain the goals for the day.
·         They require positive feedback and lots of it. The rehabilitation process may go against every fiber of their being because they crave instant gratification. Remember, they have had highly involved parents constantly giving them feedback on performance their entire lives, instant access online to grades and thousands of texts with their friends available at the push of a button, all of which condition them to expect more instant feedback from the world around them. Not getting instant feedback may feel as if they have done something wrong.
·         Give them ownership over their success-when appropriate, allow them to help in the planning process. Certainly they can’t design the program but they can give input on what works for them and what doesn’t.
·         Find out what motivates them-Sure, most athletes tend to be motivated but some need incentive. Depending on the maturity level, consider allowing athletes to keep track of their own progress using a chart that can be kept for them in a file. Each day they can fill in their activities and update their rehab goals weekly.
·         There’s an App for that-Well, maybe not yet but consider working with your technology department to create an app that might allow students to “sign in” for therapy when doing their HEP and track their progress, giving them points for completion and milestone achievement. It won’t work for everyone but it might help the troubled few struggling to stay on top of their rehab. Maybe even offer some sort of added incentive for the athlete that earns the most points in a week.

Though there are many challenges that the millennials bring to the ATR, this doesn’t need to impede the healing process.  Just remember to remain patient, meet them halfway and treat each episode with an athlete as a opportunity to hone your technology skills while improving their communication skills. This makes for a win-win situation.