by Kay B. Stanley, FACMPE*
Diversity in age and culture—medical practices and healthcare entities mirror the business world in the diversity of culture and age groups among their employees and patients. Differences create challenges, but with understanding and skillful communication, distinctions become opportunities for growth and excellence. The concept we are exploring is that as a generation we are who we are because of what was going on in our world during our formative years. We find that just naming ourselves as part of a group is a good starting point. The objective of this article is to identify characteristics of various age groups and to present ways to promote harmony and to maximize performance through practical management techniques. The goal is to better understand ourselves and each other so that our work is more productive and rewarding.
Definitions
- Generation—a group of people living contemporaneously
- Historical era—a period in history, especially a long period or one associated with or named for a distinctive characteristic, achievement, or influential person (e.g., the space age)
- Stage of life—one of the stages or phases in the lifetime of somebody or something
- Traditionalists, Silents, Matures, or Veterans generation—born prior to 1943
- Baby Boomers generation—born 1943 to 1960
- Generation X, Baby Busters generation—born 1960 to 1980
- Nexters, Generation Y, Millennials, Media generation—born after 1980
Many factors affect our world view. Personality styles; family life and upbringing; birth order; and whether birth occurred at the end, beginning, or middle of the defined period influence our perspectives. The generational characteristics are the aspects that we will explore in this article.
TRADITIONALISTS
Born before 1943 and coined “The Greatest Generation,” the defining moment occurred at 7:49 a.m. on Sunday, December 7, 1941, when the Japanese attacked the U.S. Pacific Fleet at Pearl Harbor, Hawaii. This generation grew up during the war, when all worked together for a common cause. The applicable motto of the generation would be “An honest day’s work for an honest day’s pay.”
As a whole, Traditionalists have a practical view of the world. They are dedicated workers, respectful of authority, accustomed to hierarchical leadership, willing to sacrifice personally in relationships, and turned off by vulgarity. Typical Traditionalists’ personality traits may be described as follows: like consistency and uniformity; like things on a grand scale; conformers; disciplined; past-oriented and history-absorbed; proponents of law and order; and conservative spenders.
Traditionalists don’t take their jobs for granted and are grateful for them.
Characteristically, the Traditionalist work ethic and style is loyal, dependable, and determined. They don’t take their jobs for granted and are grateful for them; they view work as noble and something to be revered; they are confident in their own abilities; they were taught to respect leaders and their institutions; and they rarely speak out against authority.
Traditionalists are known for having a directive leadership style, with command-and-control leadership and executive decision making. They prefer simple and clear leadership that gets things done. The Baby Boomer and Generation X generations appreciate the Traditionalists’ take-charge management style, and Nexters seem attracted to this style of leadership and sometimes emulate it.
Growing up working as team members and with a civic mindset, traditionalists perform best when part of a team that works by consistently enforced rules, policies, and mutual agreements. They are well suited for the hierarchical method of running a business suited to armies and manufacturing, with brains at the top in the executive ranks and brawn at the bottom on the front lines.
Most medical practices are hierarchical with physicians (the brains) at the top. Although practicing physicians from this generation are waning in number, many younger physicians have a hard time turning over decision making to their administrators; likewise, administrators may find it difficult to turn over information to underlings. Command-and-control leadership is likely to endure in the medical practice setting. Traditionalists expect their own orders to be followed, and they will always clash with those who question their authority and disrupt the chain of command.
What Traditionalists Bring to the Workplace
Medical practices struggle to find qualified workers. Characteristics like dependability, loyalty, and confidence in their abilities are valuable qualities highly regarded by managers. Respect for authority and comfort in working on teams are suitable for the medical practice. This generation is a valuable resource and has a great deal to contribute to the productiveness and the stability of medical office staffs. Their wisdom, maturity, and consistent behavior will enhance the work environment.
How to Work with Older Workers
For best results and maximum productivity in working with older workers, treat them with respect and appreciate their wisdom. Appreciate that they can be far less prone to stress than other employees. Consider using them for part-time or project assignments. Let them know what to expect and when things will happen. Training on technology works best in a stress-free environment. Provide a personal touch in work relationships with the Traditionalist and coach tactfully and respectfully. Demonstrate your appreciation continually for the best results.
BABY BOOMERS
The generation born between 1943 and 1960 marked the end of a 200-year population decline due to hardships, wars, pandemic illnesses, and economic depression. This generation’s defining moment was in 1946, nine months after VJ (Victory over Japan) Day, when a tidal wave of babies broke across the fruited plain and changed its physical and psychological geography forever. One baby was born every 17 minutes for 19 years; most survived. The motto that is fitting to the generation known as Baby Boomers is “Life is work, and work is life.”
Boomers tend to have an optimistic view of the world, are driven to high levels of achievement in the workplace, have a love/hate relationship with authority, prefer leadership by consensus to be sure they get “their way,” seek personal gratification through relationships, and are concerned with political correctness.
Boomers are characterized by a desire for growth and expansion, celebrity roles, optimism, teamwork, and the pursuit of self gratification.
Boomers are characterized by a desire for growth and expansion, celebrity roles, optimism, teamwork, and the pursuit of self gratification. They demonstrate habitual soul searching and trendsetting. Boomers are segmented by work ethic and style into one of three groups: those who are economic achievers, those who are laid-back and cynical, or those who march to a different drummer. While these segments differ, they are also alike. All are the offspring of the optimistic post-World War II era that prayed in school and were the first to have TV, to eat commercially prepared food, and to watch world events. This generation has seen the fall of communism, the Civil Rights movement, and the first steps taken on the moon, and they experienced Vietnam. Boomers have enjoyed prosperity, advances in healthcare, and a dynamic educational system.
What Boomers Bring to the Workplace
The group classified as economic achievers are typically older Boomers, born in the late 1940s and early 1950s. They are goal- and result-oriented, looking for opportunities to get ahead, ways to increase their status and prestige, and chances to gain control and power. They are prone to work hard to advance their careers, even to the extent of sacrificing their personal lives. They tend to look down on those less invested in their work. They can be smooth and personable, but ruthless to those who get in the way. They feel immune to criticism for their hard-nosed ambition, which they regard as a virtue.
The laid back and cynical segment of the Boomer generation, born in the late 1950s, is the largest single Boomer segment. This group has less regard for materialism and is often critical of older Boomers. Not as driven as their older cohorts, these Boomers tend to make decisions based on family—not attaining wealth. In this group, both parents are active in parenting.
For the third group of Boomers, those that march to a different drummer, their concerns center on balancing a career with their desired lifestyle. They are willing to work hard, but not at the expense of their family. They struggle constantly with keeping everything in their lives balanced and together.
Boomers grew up wanting and needing to prove themselves to their parents who sacrificed for their freedom. Work holds a singular importance in their lives as proof of worthiness. This generation tends to define themselves through their jobs. They achieve identity by the work they perform. In the mind of the typical Boomer, “work ethic” and “worth ethic” are synonymous. Looking for opportunity and security, Boomers work in all types and sizes of industries and organizations. They love glitz and glamour as part of the work package. Boomers enjoy work and find it fulfilling. They love training and education at work and in their free time.
Having experienced teamwork all of their lives, Boomers advocate teams and team building, consensus, quality circles, and participative management.
Half of the Boomer workforce is in technical and production jobs. One-quarter occupies management roles. Boomers comprise the majority of workers in high-paying categories, such as doctors, lawyers, and accountants. Members of this generation prefer work environments that are democratic, humane, and casual.
As leaders, Boomers profess concern for a participative spirit and fair treatment for all, but they have a hard time practicing this management style. With few having the skills required to achieve participative management (i.e., understanding, listening, communicating, motivating, and delegating), attempts at participative management are often limited to lip service. Many Boomers in leadership are not aware of their ineffectiveness.
Having experienced teamwork all of their lives, Boomers advocate teams and team building, consensus, quality circles, and participative management. They are not good at sharing—especially the spotlight. Because they want to be liked, Boomers do well at delivering service. They will do what makes the customer happy, as long as it reflects well on them. They perform best when treated as equals and when they feel in charge or empowered.
Sometimes Boomers need to prove themselves to get the attention they desire, which may override the needs of the team. Boomers can be self-serving and vocal if they do not get their way. They can be very political when threatened and use their skills for self-protection, territorial improvement, or self-betterment masked as concern, the best interest of the common good, or helping someone. This results in confusion and misunderstanding. Although Boomers tend to read each other well, they seldom know how to respond to each other. Meanwhile, they know how to “play nice” and that aggressiveness is unacceptable while assertiveness is preferred. Many Boomers suffer from ulcers, high blood pressure, and tension headaches because they do not know how to respond to stressful situations.
How to Work with Boomers
Boomers respond well then their experience is valued. The Boomer will think it is important to stay on the leading edge as a medical practice. Get to know them individually, and let them know they can make a difference. Provide development and education opportunities and experiences where skills are weak, so that they may grow in their position. Take time for conversations and become personally acquainted with employees from this generation.
When coaching, be tactful and nice, giving plenty of positive feedback. Ask questions to get to the issues. Think of yourself as a friendly equal. When Boomers disagree that their work is substandard, assure them they are doing well, but that you think they could be achieving more. Respect them for their experience. Ask them; don’t tell them what to do.
Boomers will dominate the workplace until 2015 and beyond. Medical practices will be full of Boomers for the next 10 years and after. Today’s medical practices are dominated by physicians from this generation.
GENERATION X
GenerationXers, born in the years from 1960 to 1980, grew up in the shadow of the Boomers and came of age in an era of fallen heroes, a struggling economy, soaring divorce rates, and the phenomenon of the “latchkey child.” GenXers reject most everything Boomers hold dear. As their defining moment, this is a generation that grew up in the wake of Vietnam, the only unsuccessful war in U.S. history. Generation X’s motto is “It’s a job, just a job.”
Generation Xers view the world with skepticism; seek balance in work and personal time; are unimpressed by authority; and achieve leadership through competency and flexibility.
GenXers view the world with skepticism; seek balance in work and personal time; are unimpressed by authority; and achieve leadership through competency and flexibility. Due to a high sense of independence and individuality, they are reluctant to commit to relationships and are turned off by clichés and insincere promises.
GenXers are self reliant (with a survival mentality); seek a sense of family; seek balance; view time and space nontraditionally; like informality; and approach authority casually. They are naturally cynical; like adventure; and are technologically savvy.
The survival mentality that characterizes Generation X is a result of growing up in the wake of Vietnam. During this time, a wave of negative political and economic events was embedded in the hearts of these children as a once-proud nation seemed to lose power and prestige in the world’s perspective. Many from this group entered a job market that was overshadowed by Japanese ingenuity, especially in the field of technology. It seemed like America was falling short. This is a generation that learned to survive in a world where everything was not going to be all right and where the American Dream looked like a memory. During their early years, economic wars of the 1970s and 1980s were fought on the battlefields of the industrial and manufacturing arena. They saw their parents laid off by mega-corporations, causing wounds and casualties in the hearts and minds of GenXers.
Children born during these years were born when being a child was unpopular. Birth control pills were used to prevent pregnancy. Their parents engaged in developing themselves—at the health club, in self-help groups, at weekend retreats. They grew up in parent-free childhood, a time to figure it out for themselves.
What GenXers Bring to the Workforce
Thrust into the world of work at a dismal economic time, this group had to settle for low-paying jobs in the shadows of Boomers who held the top-paying jobs. They have seen and experienced corporate cuts and downsizing and, therefore, have no trust for corporate America. Members of this generation often feels invisible. They despise being labeled and would prefer to be out of the spotlight. Boomers view them as less than stellar, at least in number, if not in achievement. Those born in this generation are sometimes called Baby Busters, as they were a part of the birthing recession that followed the boom.
GenXers tend to tend to ask, “What does this have to do with my survival?” Boomers are prone to view GenXers as slackers and self-centered, yet this is far from true.
Roles will change during the next 30 years, as Boomers and GenXers will work together in growing numbers. With information technology (IT) acuity and growing business savvy, a disproportionate number of GenXers are reaching senior positions, particularly in high-tech companies. In many organizations, Boomers now report to GenXers, which is often a source of friction.
Work is neither survival nor self-fulfillment for this generation. Motivation comes through flexible hours, informal work environments, and just the right amount of supervision. Typically, GenXers can handle trivial information while focusing on more complex tasks. When given a lot to do and some freedom for how the work gets done, the amount they can accomplish is surprising. They can work in all areas, but they are most visible in IT functions, helping Boomers and Traditionalists figure out why, for example, their computers are frozen. This group is well suited to self-employment due to their level of self-reliance and their skeptical view of working for others. They grew up being independent, and they can function independently.
Physicians from Generation X look at both practice style and pay when considering employment. Their desire to balance medicine and family figures heavily in their decision-making. They seek at least a minimal level of autonomy and flexibility. If they open their own practices, their practice environments are likely to be less driven and more casual.
As leaders, GenXers are responsive, capable people who can change directions or projects quickly. They tend to be fair, competent, and straightforward as managers. They prefer to create and work in circles of people whose assignments and responsibilities overlap. They regard recreation as part of their work culture. They tend to be honest, sometimes to the extreme, and they are not at all interested in political positioning.
Their quest for a sense of family suits them for teamwork, although they prefer to choose their own teammates. Even in teams, their individuality comes through. They get together to check on progress and work out problems, but most of their time is spent working alone, with minor supervision. Much of their communication is done through e-mail, chat rooms, or instant messaging. Meetings occur occasionally for the purpose of review.
How to Work with GenXers
Successful work with Generation Xers comes when you value their regard for work and respect their viewpoint of an ideal work environment. Treat them as individuals and give them personal attention. Provide them with lots of resources to do their job, and give these resources to them through a variety of channels. Give them lots of simultaneous tasks and projects.
This generation resents it when others attain visible, lucrative recognition and they are left out, so treat everyone on a level playing field.
When coaching, give constructive feedback. Offer some freedom to pursue other interests and encourage them to have fun at work. Provide leading-edge technology for your GenXers to use. Review your employee-motivation package to ensure fair administration.
This generation resents it when others attain visible, lucrative recognition and they are left out, so treat everyone on a level playing field.
Make them feel like insiders; care about them and support them; allow them to take responsibility for their own issues. If you pull rank on GenXers, you will lose.
Generation X is finally coming of age in the workforce and attaining a livable wage. They are concerned about healthcare and have higher regard for companies that provide health benefits. They value convenience-oriented benefits—things that make their work easier—like flexibility.
Labor shortages could drive up GenXer wages, but it could also cause a recession. Regardless of what happens to the economy, this generation will be able to survive. They have a resilience that makes them confident. Some predict that Generation X will design a new form of virtual management, managing teams through e-mail and groupware. This is a generation that has hope for a future where someday they will be in charge of their economic lives.
NEXTERS
Born after 1980 and appearing in the workplace and in many medical practices, members of this generation are the first to know more than their parents, at least in the area of technology.
Nexters are exposed to many cultures, languages, and ideas through the Internet, computer technology, television, and newspapers. From this exposure, they know the world is a dangerous place. The defining moment of this generation occurred on September 11, 2001, when the United States was attacked by terrorists, and thousands of innocent Americans lost their lives. The motto or mantra for Nexters is “It can be done . . . let’s do it . . . this will be exciting!”
Nexters, over all, have a hopeful view of the world and a determined work ethic, and are polite to authority figures. They believe in leadership by pulling together, and they are inclusive in their relationships. Many were born into and have grown up in affluent homes, where they were wanted and planned. They have always felt love and support from their parents. They are sought after in the job market and highly valued in the marketplace. Most are hopeful, determined, and respectful, but not all...
Nexters, over all, have a hopeful view of the world and a determined work ethic, and are polite to authority figures.
Many Nexters live in poverty. One in four is officially impoverished, living in a family of four with an annual income of less than $15,000. There is a significant division between the “have” and “have nots.” The impoverished and the affluent differ in their values and world view. Those who live in poverty have a clouded perspective that negatively influences their ideals.
Nexters that grew up or live in affluence are generally optimistic and confident, resilient, respectful to authority, believers in collaboration, welcoming to outsiders, and moral and ethical.
What Nexters Bring to the Workforce
As workers, Nexters are optimistic about their ability to get a job, entering the workforce right after college. They are idealistic in their expectations of future career plans. Although they have not had much real-world experience, they realize they need to work hard to achieve good things.
Nexters are usually adept typists due to their life-long exposure to technology. They can be restless in meetings, and they tend to avoid face-to-face interaction, preferring e-mail and instant messaging. Their work ethic resembles the Traditionalists in that they believe in collective action, are optimistic about the future, trust in centralized authority, have a will to get things done, and exhibit a heroic spirit in the face of overwhelming odds.
How to Work with Nexters
Nexters benefit from maximum orientation to your work environment. For example, let them know the pros and cons, expectations, and long-term goals, etc. With this generation you can disregard preconceived gender roles. If you have teams predominated by GenXers, expand the size and appoint a strong leader.
Watch for conflict between GenXers and Nexters, as they have significant differences.
Watch for conflict between GenXers and Nexters, as they have significant differences. Nexters want to continually develop their skills, so offer ongoing training. Match young workers with seasoned people who can mentor them. Nexters may not be naturally good at customer service, so specific training will be required for most.
It is too soon to tell what kind of world Nexters will create and what kind of workers they will be. We know that technology will be easy for them, and the medical practice may benefit. If you welcome, orient, train, and mentor this generation, you may have a wealth of resources.
WORKING TOGETHER
All generations have much in common, and in many areas they are alike. Every human being deserves respect for his or her historical place. Employees are eager to please and will go the distance for respect. The savvy manager of multiple generations will discover what is important to employees by listening and responding. To manage successfully will require you to avoid judging others through your own generational viewpoint. Just because others do not share your work ethic, it does not mean they are lazy or indifferent. If GenXers seem like slackers when compared with Boomers and Traditionalists, it may be because of the way workaholism affected their own upbringing. They’ve seen its damaging affects on their families, and they are not apt to fall victim to it themselves. On the other hand, GenXers can usually accomplish a great deal in a short time when left on their own to complete assignments. Likewise, GenXers should learn to appreciate hard work, recognizing contributions Boomers have made to the economy and the good qualities they possess.
SUMMARY
You have now identified the four generations that are typically represented in a medical practice staff, and you have a general understanding about their varying personality traits and work styles. You also have a generational perspective about yourself as a leader, manager, or employee, and you can apply your knowledge to your own organization. What all employees want most is trust and respect. Offer acceptance and respect and engender a spirit of open communication that is incoming and outgoing, positive and negative. Avoid stereotyping individuals, as generalities do not always apply. Capitalize on strengths and minimize shortcomings of each generation, for no generation or individual is perfect.
As the lyricists write in the song “Not Enough Love in the World,”
I’m not easy to live with
I know that it’s true
You’re no picnic either, baby
That’s one of the things
I love about you.1
You will get the most from your employees and your practice will be a viable, productive, enjoyable workplace when you understand, appreciate, and respect the qualities that each individual offers.
Additional articles from The Journal of Medical Practice Management:
1. Benmont Tench, Don Henley, Daniel Kortchman. Not Enough Love in the World. Audio Album “Building the Perfect Beast.”November 1984; www.secondhandsongs.com/song/24514.
Reprinted with permission from The Journal of Medical Practice Management, Copyright Greenbranch Publishing, (800) 933-3711, www.mpmnetwork.com.
*Associate Partner, The Coker Group, 1000 Mansell Exchange West, Suite 310, Alpharetta, GA 30022; phone: 800-345-5829; fax: 678-832-2016. Copyright © 2007 by Greenbranch Publishing LLC.