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

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73

44

224 231

153

99

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139

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50

100

150

200

250

Under 35 35-44 45-54 55-64 65 and Over

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ysic

ian

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(In

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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