During a recent conversation with colleagues, a comment was made that young doctors “don’t want to work,” that they lack the strong work ethic of prior generations.  I responded with what I think they want, which is more defined work/life balance … and is that really a bad thing?  I spent a considerable amount of time studying generational differences in my prior Director of Nursing and Chief Nursing Officer roles, mostly as a means to inform my leadership of a multi-generational nursing workforce.  The principals, however, apply to the generations within any profession, including physicians, and taking generational differences into consideration in the workplace is one of the many ways leaders can create not only a positive work environment, but also a culture of flexibility, acceptance, and understanding, which will only serve to better the team overall as well.

Unlike class status, the generation one is born into is unalterable.  Singular or multiple significant life events during a generation have a profound effect in shaping the life perspective of those born during that time.  That is not to say that all members of a generation will be the same or think the same; however, certain qualities become inherent in the majority of the group since they share a somewhat collective life experience that shapes their development.

In general, the Baby Boomers, Generation X, and Millennials make up the current physician workforce.  We can’t quite exclude the Veterans as yet, as a very minute number of physicians over 80 are still practicing.  Plus, it is important to understand what shaped that generation and what the impact has been on subsequent generations.

The following list (source: Weingarten, 2009) shows a timeframe for each generation, but these are note exact.  Other sources note different years, but these are generally accepted for the range.  And while I list Gen Z and Gen A below for reference, members of these groups are of course not yet old enough to have completed medical school and residency.

  • Veterans (aka: Traditionalist or Silent Generation)
    • 1922 – 1945
  • Baby Boomers
    • 1946 – 1964
  • Generation X
    • 1965 – 1980
  • Millennials (aka: Generation Y)
    • 1980 – 2000
  • Gen Z
    • 1997 – 2012
  • Gen A (Alpha)
    • 2012 – 2025?

Even despite the flexible start/end dates for the cohorts, and a significant overlap between Millenials and Gen Z, it’s important to note that not everyone falls neatly into one of the major groups.  There are those considered to have been born on a cusp between two generations, and these individuals are called cuspers.  I am a cusper myself, born in 1961 (now giving away my age!), which per the above is sometimes considered the end of the Baby Boomers and/or the beginning of the Gen X’ers.  I identify much more with Gen X than the Baby Boomers, and that likely stems from the fact that I have lived and experienced all of the life events of the Gen X cohort, but only the very tail end of what the Baby Boomers experienced.  Typically, when a younger of the two overlapping generations feels they are not being heard, a cusper can provide the voice of representation.

So, given all this background, understanding some of what has shaped these generations can help hospital and program leaders create an environment that supports the needs of individuals, reduces conflicts, and maximizes contributions of all. Outlined below is a summary of each generation in today’s workforce.  Reading and understanding the traits of these groups and the differences between them can do much to provide insight into optimizing that person’s contribution to a team in a way that makes them feel comfortable, valued, and successful.

Veterans – Also known as Traditionalists or the Silent Generation, they grew up during very difficult times that included the Great Depression and WWII.  People of all ages were called to make sacrifices, some through rationing of goods and services at home and some through fighting and even dying to serve the country.  They grew up with strong value placed on sacrifice for the greater good, along with loyalty and hard work.  Math was done by hand, letters were typewritten, copies were mimeographed, and long-distance calls were only made in an emergency.  They had great organizational loyalty and believed seniority was important to career advancement.  They had a great respect for authority and were supportive of hierarchy.  They believed in lifetime employment with one institution.  They worked very hard and believed that hard work resulted in rewards.

Baby Boomers – Grew up in a healthy post-war economy where nuclear families were still the norm.  They were encouraged to value their individualism and express themselves creatively, and have been described as the most egocentric generation because they were told from a young age that they could change the world … and they have by rewriting the rules.  Major life events included the Vietnam War; the Cold War; the assassinations of John F Kennedy, Robert Kennedy, and Martin Luther King, Jr; the Civil Rights and Women’s Rights movements; the moon landing; and the addition of TV sets into living-room décor.

Older members of the Baby Boomers were the youth hippy culture of the 60s, where their adolescent rebelliousness corresponded with an era of questioning the status quo.  They set out to change the world through love, music, and non-violent demonstration.  The younger members grew up during the tumbled economy of the 70s that included the oil embargo and the Watergate scandal.  As a result of these experiences, both sets of Baby Boomers learned to not respect authority, but rather challenge it, and question the integrity of leaders.  They still tend to believe that anyone “in charge” is not to be trusted.

As the Baby Boomers entered the workforce, they were driven and dedicated.  With their belief in their ability to change the world, they equated work with self-worth, contribution, and personal fulfillment, thus leading to them to work an excessive number of hours. In this way, this generation often sees the quantity of time spent working equates to quality of work.

Generation X – Not really the letter X but the roman numeral because this generation is the tenth identified and studied.  The structure of the American family changed during the formative years of this cohort as a result of increasing divorce rates, which meant large numbers were raised in single-parent households.  Those with two parents were likely to have two working parents, therefore were raised as ‘latchkey kids’ who came home from school to an empty house where they cooked their own snack in the microwave and entertained themselves with video games.

Their major life events included the fall of the Berlin Wall, the breakup of the Soviet Union, and the introduction of MTV and home computers. They saw Japan overtake the US in dominance of the world market, and technological prowess of the US was called into question as they watched the Challenger Space Shuttle explode on TVs in their classrooms.  Exposure to violence and adult themes on television forced teenagers to deal with adult subjects, often before they were ready.

They also watched their parents work extremely long hours and sacrifice leisure time for success at work and then witnessed massive corporate layoffs, downsizing, reorganizing, and re-engineering, which in term affected long-term employees like their parents and grandparents.  They learned that there is no guarantee of lifetime employment, but rather, if you hone your skills and expand your resume, you can be guaranteed employability.  Therefore, Gen X does not have the same organizational commitment as older members of the workforce.  They do not expect to spend a long time with any one employer and they don’t expect their retirement to be funded by the company or the government.   More Gen X’ers believe in UFOs than believe there will be funding in Social Security for their retirement.

Millennials – Also known as Gen Y, this is the second largest cohort in the general population, and will soon become the largest in the hospital workforce.  They are expected to be “the next great generation.”  They are often compared to the Veterans in their values because they are civic minded and interested in work that supports the greater good.  They were the first group of students to be required to do a public service project for graduation from high school, they accept climate change and believe in equality of all races and lifestyles.  They were, however, raised by so-called “Helicopter parents” who nurtured and structured their lives perhaps too much so.  Millennials are very used to playing in groups.

Their major life events include the September 11, 2001 Terrorist Attacks, the war on terror, the Persian Gulf War, and many natural disasters around the world that played out on the TV and internet, showing that any life can end in an instant.  They have watched celebrities being mass-marketed through social media as pop royalty.  They have only known widespread use of technology, cell phones, and the internet, most notably including social media networks.  They have been exposed to technology since birth and are therefore very adept at communication through technology (vs. telephone or face to face).

Millennials have much to offer and are a good fit for the medical profession, as they are team-oriented people who want to make a difference in the world while also being able to embrace the rapidly-changing healthcare workplace and its technological advancements.  However, their upbringing has also instilled in them the importance of family, which makes work-life balance just as important.

So to revisit my initial example… it may sometimes be challenging for Baby Boomers to see the younger generations choose to not spend excessive hours at work, but instead place equal value on “free” or family time.  Other generations should step back and realize this is not an issue of work ethic, of being lazy, or of simply not wanting to work, but rather, the younger generations desire not to miss out on the “life” side of the work/life equation, which, I believe, is NOT a bad thing after all.

As program leaders, colleagues, consultants, or healthcare professionals in general, giving some awareness and attention to generational differences in the workplace is a worthwhile exercise in empathy and team-building.  And only by seeing a situation through another’s perspective of life experience, and learning about why workers work the way they do, can lead to success in shared goals and valued contributions from every member of a team, regardless of any generation gaps.