For the Affordable Care Act to have been successful there needed to be a complete buy – in by millennials, those born within the year 1980 to 1996. In layman’s terms, millennials would largely make up the healthy pool of health insured that could financially prop up the sick and poor population. For whatever reasons, and there are many, this did not happen.

What the ACA did teach us is millennials are a major force in the $3 trillion a year healthcare market. Early in 2016, ghg | greyhealth group partnered with its sister company Kantar Health to survey more than 2,000 millennials. The survey’s goal was to discover how millennials manage their own healthcare.

Surprisingly, the study found that this much-discussed generation is less likely to trust doctors and far more inclined to consult online experts and other informal sources, such as friends and colleagues, for advice. Millennials believe the number one problem with modern healthcare is today’s healthcare management continues to cling to the old model, where a primary care doctor serves as a trusted advisor for patients. Millennials take issue with this relationship since they also see the physician as a trusted intermediary for drug companies and insurers. Millennials have clearly rejected the 20^th Century healthcare model. In this pivotal time in the industry, it is clear the country’s healthcare leaders need to pay attention to the millennial voices, or the ACA will not be the only thing lost.

The survey’s study provided some clues for success for not only physicians but to all players in the healthcare market. The ghg | greyhealth group came up with five rules for the healthcare industry in dealing with millennials, as written by Lynn O’Connor Vos and published in Fortune Magazine:

1. Get on the same page. Today’s young adults do not define health as simply the absence of disease, the way other generations do. For this generation, health goes way beyond [t]he Merck Manual to include mental health, fitness, longevity, healthy lifestyles, and more. To millennials, exercise and nutrition are as essential to healthcare as antibiotics are to curing infection.

2. Gain their trust. Millennials have lived through the financial crisis, 9-11, skyrocketing academic debt and one of the most divisive and controversial elections in history. It’s no wonder, then, that they tend to mistrust authority. In our survey, just 58 percent of millennials said they trust their physicians compared with 73 percent of all others. Millennials have opinions. We need to listen to them, build on their knowledge, and treat them with respect.

3. Be a team member. Taught to feel empowered, millennials view themselves as a part of the solution and not merely recipients of care. Only a minority (41 percent, vs 68 percent of non-millennials) view doctors as the single best source of information, and they are unlikely to rely on a doctor as their sole advisor. Professionals need to realize that when millennials arm themselves with reams of information from a variety of sources, they shouldn’t get defensive. Instead, ask them what they know and take it from there.

4. Bolster their confidence. Self-assured as they may seem, our qualitative research showed that millennials often struggle to make decisions. Paralysis of analysis is a widespread side effect of life in an information age. So open minded that they tend to question their own judgment, even after they appear to have settled a question, millennials need large doses of reassurance to go along with any prescription. “They have access to all the information in the world, but they’re incredibly insecure,” says Natasha Burgert, MD, a pediatrician from Kansas City. Millennials need partners to advise and support them, to refer them to reliable online sites and provide shortcuts through the maze of health information and bureaucracy.

5. Join the fold. As young people move away from religion and civic engagement, they still need ways to connect. Millennials crave contact with like-minded people who can reinforce and advance their interests, so much so that they think about health and fitness as something akin to a religion. In fact, many view their gyms and yoga studios as a kind of church, where they go for connection, comradery, spiritual fulfillment, and even fun. This hunger for association represents an opportunity for the healthcare industry to build different types of communities around healthy living.

Make no mistake about it. The millennials’ influence in healthcare will continue to grow as the generation ages, with nearly one-third already being parents. A millennial’s interest in healthcare takes on new meaning when it no longer is just about them.