Generation gaps: Managing a multigenerational staff

A staff made up from a range of age groups with different priorities and styles can lead to conflict. Understanding generational tendencies can ease that.

By — Posted June 14, 2010

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Recognizing diversity of race, gender, ethnicity or religion in the workplace has grown in importance, but business experts are increasingly recognizing one more facet of a diverse working population -- age.

There are four distinct generations in the workplace, all of whom have wildly different expectations of how they will work and how they will be managed. Experts say a more rapidly changing society means that generational zeitgeist may be formed by vastly different experiences. The issue goes beyond the long-standing tradition of older generations thinking those who are younger are not working as hard as they once did.

"People are discovering that a generational personality sticks with you your whole life," said Debra Fiterman, a millennial generation associate at the consulting group Bridgeworks in Minneapolis. "It's not just about life stages. This is actually a form of diversity that can affect managing, motivation, and retaining a successful work force."

There are the "matures," or "silent generation," born 1925 to 1944, who are still in the work force either because they want to be or do not have the funds to retire. The "baby boomers," born 1945 to 1964, are well into mid-life or approaching the end of their careers. "Generation X" captures the mid-20s to mid-40s age group, those born between 1965 and 1984. The "millennials," or members of "Generation Y," are the newest entries to the work force, and were born from 1985 to 2004.

Only the baby boomer generation is officially defined by the Census Bureau. The other generational labels are those commonly used by researchers.

"Not many of the [millennials] are doctors yet, but they certainly have entered the work force and have escalated these problems," said Cam Marston, president of Generational Insights in Mobile, Ala.

Linguistic differences -- as well as other distinctions in the ways those in the various generations work, relate to one another, want to be rewarded or see their role in a team -- can be sources of conflict that interfere with the running of a medical practice as well as recruitment and retention.

"Businesses that say, 'This is what way it's always been done, and this is the way we have to work,' are not going to be able to recruit new talent," Fiterman said.


Getting multiple generations to work well together has been the subject of several presentations at medical meetings. The American Medical Association hosted an educational session on "Generational Change" at its 2009 Annual Meeting. Marston presented a presentation "Four Generations in the Workplace" at the Medical Group Management Assn. meeting in Denver last year.

Experts say the secret is to understand the different aspects of the generations but not to label them as good or bad. "It's important for us to understand why the differences occur, without putting value judgments on them," said Richard Corlin, MD, a gastroenterologist in Santa Monica, Calif., who gave the presentation at the AMA meeting. Dr. Corlin is a past president of the AMA, but was speaking personally.

Understanding how various generations work differently also may be key to finding ways to motivate employees, maintain respect in the workplace and encourage greater productivity.

"We have all got our own set of standards and values and how things should be done" said Larry Johnson, a consultant in Scottsdale, Ariz., and co-author of Generations Inc., from Boomers to Linksters, Managing the Frictions Between Generations at Work. "But it makes sense to create an environment where everyone can perform their best."

Experts say one of the key areas where the generations differ is in levels of formality and respect for hierarchy. For instance, Bradley Fox, MD, a family physician in Erie, Pa., said he has had to spend some time convincing his younger workers to refer to him as "Dr. Fox" and not "Brad" during work time. He doesn't have that problem with older staffers.

"Younger people call everyone by their first names," Dr. Fox said. "How they show respect is very different." He has about eight employees, ranging in age from 20s to 60s. Dr. Fox himself is a Gen Xer.

Millennials, many of whom have grown up being asked for input about family decisions, have a greater expectation that they will be able to voice their opinion in all situations, including in the workplace. Prior generations expect this less.

"Millennials have more of an expectation that things will be discussed, and their opinion will be considered," said Meagan Johnson, a consultant in Scottsdale, Ariz., and co-author of Generations Inc., from Boomer to Linksters.

Researchers say team participation also is viewed differently. Those of the silent generation, who grew up in the Great Depression and World War II, tend to put greater value on teamwork, preferring that any recognition be for the team rather than the individual. On the other end of the spectrum, millennials are more interested in individual recognition. And baby boomers, whose formative years were in the 1960s, want the spotlight on both the team and the individual.

There are also differences in what kind of work should merit special recognition. Members of the silent generation, or matures, tend not to expect attention to be paid for doing the job as required, but millennials, who often were given trophies just for participating in a school event, tend to want public recognition even for parts of the job that are considered routine.

"[Millennials] are used to getting recognized for just showing up," said Terrence Cahill, EdD, an associate professor of health sciences at Seton Hall University in South Orange, N.J.

Communication styles also can be vastly different, and word choice can vary. For example, when Dr. Fox thinks something is funny he says so. But one of his millennial staffers would be more apt to say "LOL," the shorthand for "laughing out loud" commonly used in text messages and Internet chat.

Workers' favored communication medium can vary as well. Matures and baby boomers tend to want written memos or directives, or in-person meetings. Gen Xers tend to favor e-mail, and millennials are more involved in text messaging and social media, experts say.

The different generations also vary in how they want to be managed. Gen Xers, for example, prefer to be assigned something and left alone. They are likely to be satisfied with once- or twice-a-year performance reviews.

"[Millennials] need more feedback," Cahill said. "If they don't get [it], they interpret that as bad."

Work-life balance also is an important issue. The concept of lifetime employment with one company really doesn't exist for younger age groups.

"The millennials in many cases define their job as just that -- a job," Marston said. "Many of the baby boomers who entered medicine saw it as a calling."

If conflicts do emerge because a millennial doesn't feel listened to, or a mature finds using "LOL" and "OMG" in common speech disrespectful, experts suggest educating staff on generational differences. View it as a form of diversity training.

"If another person's outcome is as good as yours, you can acknowledge that there may be a different process that can work," Marston said.

It also may help to recognize that a feeling of unease among those who are older because those who are younger do things differently is common and not a new phenomenon.

"Human nature tends to get complacent and comfortable with the way that we are," said Barbara R. Reed, MD, a dermatologist with the Denver Skin Clinic. "We don't like change."

Experts acknowledge, though, that no matter a staffer's age or generational affiliation, some things do have to be done in certain ways.

For Dr. Fox, that meant paying employees from the time they are "ready to work," rather than the time they get to the office. He found that his older workers tended to arrive at the office 15 minutes early so they were ready to begin working when their shift started. Younger employees cut their arrival time much closer and often weren't "ready to work" at their start time.

"There is a difference in how people see what is included in the work day," Dr. Fox said. "But [the latecomers] very quickly start showing up ready to work on time."

Experts say, however, that unless it's a matter of safety, doctors should be open to the idea that things can be done differently.

"You can really miss a lot of opportunities if you don't pay attention to these differences. There's always room for improvement," said Mona Sedrak, PhD, acting director of the physician assistant program at Seton Hall University. She, with Cahill, led a session on addressing generational tensions at a recent American College of Healthcare Executives meeting. "But providing quality, compassionate care will never change."

Those who work on the issue also cautioned about using labels as stereotypes. The identified generational differences are generalizations and may not apply uniformly to everyone. Birth order, class, race and a range of other variables can also affect a person.

"When you are dealing with people on a one-to-one basis, that's a real person sitting across from you at the table, not a statistic, not a trend," said David Novis, MD, a pathologist and consultant in Dover, N.H., who has presented at past MGMA meetings on this topic. "They may or may not fit with what people have said. You cannot assume they fall into that mold. You have to find out what is important to them and what their goals are."

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What works for one generation may not work for another

Here are some tips from management experts on how to get the maximum out of the various generations of your staff. Experts note that these are generalizations and may not apply to all individuals, but they might supply some explanation for why your staff acts how it does.

Matures/Silent generation/Traditionalists (born 1925 to 1944)

  • Want recognition for outstanding achievement rather than doing the job expected.
  • Expect that, if work was carried out as part of a team, the team will be recognized rather than the individual.
  • Value teamwork. Generally do well in teams, recognizing that the group is more powerful and important than the individual.
  • Value a handshake and a "thank you" from the boss.
  • Listen to tenured higher-ups who spell out clearly what is expected. Shortened text-messaging terms such as "LOL" may be viewed as rude and indecipherable.

Baby boomers (born 1945 to 1964)

  • Need recognition that celebrates the individual and the team. Awards that can be publicly displayed, such as trophies, plaques and lapel pins, are valued.
  • Use text messaging and email occasionally but prefer face-to-face communication.
  • Want communication to highlight team goals, accomplishments and celebrations.
  • Favor collaborative meetings where everyone can provide input.
  • Want face time with supervisors and do not want to be managed from a distance.

Generation X (born 1965 to 1984)

  • Want recognition of achievements inside and outside of work.
  • Need talk from those who run medical practices to always be supported by action.
  • Respond to individualized communication rather than mass communiqués. E-mail is the first choice, followed by face-to-face interaction.
  • Want to be allowed to do work with minimal interference or interruptions.
  • React positively to being able to choose from a list of recognition options.

Generation Y/Millennials (born 1985 to 2004)

  • Want to be informed about how working at a particular medical practice or in a particular way will help them achieve their personal goals as well as those of the company.
  • Respond to positive feedback. Any criticism should be given with several compliments.
  • Value life outside of work.
  • Need frequent feedback at various milestones toward achieving a goal.
  • Prefer an egalitarian organizational set up rather than a strict hierarchy.

Note: The baby boom generation is the only one officially defined by the Census Bureau. The other categories are those widely accepted by generational researchers.

Source: Generational Insights

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