Millennials are more likely than baby boomers to crowdsource their choice of physician, both online and in-person with friends, according to a new 3,000-person survey from Nuance.

“We know a huge number of patients today are looking up symptoms and health information online, so it’s just a matter of time until they shop for physicians and communicate grievances that way, too,” Dr. Tony Oliva, national medical director at Nuance, said in a statemant. “These are informed healthcare consumers who, if they feel rushed, are likely to share criticism online. Healthcare organizations need to find ways to help physicians optimize time spent with their patients and to protect their reputations.”

The survey found that 70 percent of patients aged 18 to 24 choose a primary care physician based on recommendations from family and friends, compared to just 41 percent of patients over the age of 65.

When patients are unsatisfied with their care, different age groups use that information in different ways: 51 percent of patients 65 and older tell their doctors directly, while 60 percent of patients aged 18 to 24 tell their friends instead.

Fifty-four percent of young millennials (aged 18 to 24) say they search online for health information and rely on online physician ratings before seeing a doctor. The global average for all patients was just 39 percent. Millennials are also more than twice as likely as people 55 and older to trust others personal recommendations when it comes to choosing a doctor.

Oliva warned in a recent blog post for Nuance that increasing patient reliance on online reviews could hit some doctors hard if their numbers don’t match the reality of the care they provide: for instance, doctors who specialize in working with very ill patients might come off looking like poor doctors because more of their patients die. The key, he wrote, will be making sure the review tools available accurately reflect the quality of care for each physician.