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Presentation on generational differences and the impact upon medicine.
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Generational Differences
Texas Medical AssociationOctober 4, 2008
Bill M. Wooten, Ph.D.Executive Director, Organization Development
The University of Texas M.D. Anderson Cancer Center
AMA News
Philadelphia Enquirer 7/16/2005
USA Today - November 7, 2005
The Physician Workforce is Aging:250,000 Active Physicians are Over 55
Source: AMA PCD for 1985 data; AMA Masterfile for 2005 data. Active physicians include residents/fellows
94
73
44
224 231
153
99
146133
139
0
50
100
150
200
250
Under 35 35-44 45-54 55-64 65 and Over
Nu
mb
er
of
Ph
ysic
ian
s
(In
th
ou
sa
nd
s) 1985 2005
Time for Family/Personal Life Most Important Factor in Desirable Position For Physicians Under 50
% Very Important
Time for family/personal 69%
Adequate support staff and services 41%
Long term income potential 39%
Practice income 37%
Health insurance coverage 34%
Flexible scheduling 33%
No or very limited on-call 28%
Adequate patient volume 28%
Opportunity to advance professionally 27%Source: 2006 AAMC Survey of Physicians Under 50 (preliminary data)
2006 Survey of Physicians 50-65 year old
• Consider the dedication and work ethic of physicians coming out of training today, are physicians being trained today compared to when you trained(?):
Less dedicated 64% More dedicated 0%The Same 29%Other 7%
Merrett, Hawkins & Associates
Are Medical Students of Today Different?
Trends in Student Career Choices
• Life style factors– Study by Dorsey, Jarjoura & Rutecki, JAMA, 2003 - 290(9):1173-
1178 - “Women Physicians and Lifestyle: What Are All Those Doctors Doing?”
– Analyzed match preferences for 1996-2002
• Classified specialties into:– Lifestyle Controllable – Uncontrollable– Income High – Low– Hour worked Above – Below average– Years of training
Results:
Explanation of Variability in Career Choices
55% - Lifestyle
9% - Income
2% - Hours worked
4% - Years of GME training
Woman in Medical School
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
0.5
1900 1920 1940 1960 1980 2000 2020
Medical School Applicants by Gender
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1970 1975 1980 1985 1990 1995 2000
White Black
Hispanic Asian
Ethnicity of Medical Students
Medical School Applicants by Ethnicity, 2004
• 67 percent of GenX men and women would like a compressed workweek• 36 percent want a reduced work schedule.• 43 percent would like leaves and sabbaticals • And a finding that may be shocking to most traditionalists is that 72 percent of GenXers say their jobs interfere with their personal lives either "moderately" or "very severely."
Catalyst Research Group. The Next Generation: Today's Professionals Tomorrows Leaders. February 2002.
Gen X Physicians
Generation X Values Health Care ImageService orientation to high value causes Service delivered through large organizations
that are often pitted against individuals
Anti-institutional Work in large, cold, unresponsive institutions
Flexible, creative, welcome change Work is highly structured and carried out through rigid guilds that do not incorporate creativity
Technology Tied to a professional career, not open to change
Diversity Lacks the high-tech access associated with other areas of economy
Nonhierarchic; seek work for social benefits Essentially a white-dominated sector, beset with traditional middle-class values
Community work Work is carried out in a rigid, highly structured manner that is not conducive to social interaction
New skills and development
Work tied more to the system of health
Values and Health Care Employment*
What about Generational Issues?
The Generations in the Work Force
Veterans (silent) Born 1922 – 1945 55 Million
Baby Boomers Born 1946– 1964 78 Million
Generation Xers Born 1965 – 1980 47 Million
Millennial (Gen Y) Born 1980 – 2000 80 Million
Generational ProfilesVeterans 1922-1945
Baby Boomers
1946-1964Generation X
1965-1980Millennium
1981-2000
Style TraditionalPersonal
SatisfactionSelf-Reliant Modern Traditional
Size Rapidly Declining Dominant Small Group Large
Ethic Respect, Loyalty Ambitous, PoliticalProgressive,
CynicalLoyal,
Conservative
Gender RoleClassic Gender
RolesMixed Gender
RolesUnclear Gone
WorkRespect the
SystemRespect
ExperienceRespect Expertise Work to Live
Heroes Strong Heros Some Heros No Heros Anti-Heros
Seminal Events Depression, WWII Viet Nam, BCP Weak USA 9/11
Upbringing Traditional Family Trational FamilyAbsenteeism
ParentsProtective Parents
Reward A Job Well DoneMoney, Title, Recognition
Freedom and Time Work
New Doctors of the Future Will Be:
• Older than 20 years ago• Women• Dual professional couples• Balancing family and work• Work to live• Ethnically diverse• Technologically sophisticated• Professional if allowed to be
Essential Attributes of the “Physician”
• Embrace being a physician• Caring and altruistic• Honest, integrity• Team player• Strive for excellence• Accept the duty for serving patients and society• Courage, heroism
Attributes of the “Future Environment”
• Patient Focused• Flexible Hours• Prioritize physician well-bring and live balance• Reward excellence, not endurance• Promote seamless team care• Expect excellence and total commitment doing
work• Foster joy of being a doctor
Teaching Gen X will need to:
• Respond to a generation not willing to “pay their dues.”
• Demand “just in time-just enough” learning• Only give earned respect• Are informal• Have children/outside life and will need
predictable hours• If forced – will choose life style over specialty or
income
Teaching Gen X will need to:
• Deal with “non-joiners”
• Include good computerized self learners
• Multi-taskers who learn in sound bites
• Allow learner centered learning
• Satisfy the need for relevance
Medical Practices will need:
• Flexible hours, flexible call schedules
• Child care• Culture of quality, not
quantity of work• Reward excellence, not
endurance
• Insist on working hard when you work
• Prevent burn-out• Focus on the patient• Work in teams• Use IT to make practice
work well• Prioritize physician quality
of life
New Doctors will need to :
• Define themselves as Physicians• Take on the responsibilities of the role• Have integrity in the workplace• Offer proactive solutions for the practice community• Be answerable to the patient’s needs• Never compromise on quality of care
Being a Physician is:
• Who you are, all of the time• How you relate to people• Your role and identity in society• How you see the world• How you are judged• Not ‘just a job’, maybe a “calling”
New Doctors will need to be . . .
• “Unafraid of falling totally in love with being a doctor.”• Team Players who expect nothing less than
excellence in the workplace and accept – not shirk – the responsibility to serve patients and society.
• Future physicians will need to continue to be couragious healers and perhaps even heros.
Link Between Generational Identities and Workplace Behavior
Generational identities translate into distinct workplace behaviors as they relate to:
Relationship with authority Relationship with organization Relationship with colleagues Work styles Management styles Learning styles
Summary Points
• Important generational differences exist in expectations and values for health care professionals
• These differences occur with attitudes about institutions, diversity, service, education, and commitment
• Institutional leaders should be mindful of these differences when designing new systems
Questions?
Appendix – Reference Materials
A Guide to the New Intergenerational Workplace
VeteransRespect their authority, experience and loyalty; Use a directive management style; and Spell things out concisely, and check progress often. Baby boomersRecognize they are ambitious, materialistic and value personal growth; Give them a job they view as important and challenging; and Monitor them and provide constructive feedback. Generation XRealize they are self-reliant, informal and value work-life balance; Clearly state the goals and objectives of their jobs; Provide the tools and authority for success (don’t micromanage); and When providing feedback, explain why a behavior needs to be changed. Generation YRecognize they are confident, resourceful and obedient; Listen to their opinions and ideas; Explain business decisions that affect them; and Use teamwork when possible.
Relationship with Authority
Traditionalist Boomers Gen Xers Gen Ys Respect for
authority and hierarchical system
Seniority and job titles are respected
Challenge authority
Desire flat organizations that are democratic
Unimpressed by authority
Competence and skills are respected over seniority
Respect for authority who demonstrate competence
Flip traditional roles by teaching superiors how to use technology
Work Styles
Traditionalist Boomers Gen Xers Gen Ys
Linear work style
Change = Something’s wrong
Structured work style
Change = caution
Informal work style
Change = potential opportunity
Fluid work style
Change = Improvement
But how shall we educate men of goodness, to a sense of one another, to a love of truth? And more urgently, how shall we do this in a bad time?
Daniel Berrigan
Thank You!
Bill M. Wooten, Ph.D.bwooten@mdanderson.org 713.745.6448
The University of Texas M.D. Anderson Cancer Center
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