Generations at Work:
Generational Diversity in the
Practice and Teaching of Medicine
Terri M. Manning, Ed.D.
Center for Applied Research
Central Piedmont Community College
Two Generational Issues Impact You
• The generation of doctors currently
coming out of medical
school and practicing
(who you work with)
• And the generation (plus
the parents) of children
you are treating
• As these change,
their expectations
change
First, some information about
generations……
Each Generation
• Consists of approximately a 20-year span (not
all demographers and generation researchers
agree on the exact start/stop dates)
• Has a unique set of values
• Reacts to the generation before them
• Looks at their generation as the standard of
comparison
• Looks at the next generation skeptically “these
kids today…”
• Those born on the “cusp” may have a blended
set of characteristics
• They are either idealistic, reactive, civic or
adaptive
The Veterans (also known as the Silent
Generation or the Greatest Generation)
1925–1942 - adaptive
• Raised by the GI Generation (civic)
• Large families (3-5 children)
• Strong sense of extended family
(same town or home)
• Grandparents in the home
• Average 10-year-old spent 4-6
hours daily with a significant adult
role model
• Rural society
• Apprenticeship businesses and
farming
• Perception of the world as “safe”
Core Values
Dedication
Hard Work
Conformity
Law and Order
Patience
Delayed Reward
Duty before
Pleasure
Adherence to Rules
Honor
The Veterans
• Children of the Great
Depression and WWII
• Lost their childhood
• The overall goal was not
to change the system,
but to work within it.
• While economically very
successful, they were
also the inventors of "the
midlife crises”.
• As philanthropists, they
are the largest
generation of donors.
Important Events
•Lindbergh Completes
First Transatlantic Flight
•Stock Market Crash
•Depression
•The New Deal
•Social Security
•Pearl Harbor
•The End of WWII
•FDR Dies
•Korean War
The Baby Boomers 1943–1964 - the largest
generation – 84 million - idealistic
• Divorce reached a low in 1960 of 9%
• Families moved due to GI Bill, GI housing
and industrialization
• First generation to live miles from
extended family
• Family size smaller (2-3 children)
Core Values
• Few grandparents in the home
Optimism
• Moms stayed home, dads carpooled
Team Orientation
• Children spent significant time with
Personal Gratification
Health and Wellness
adult role models
Personal Growth
• Perception of the world as “safe”
Youth
Work
Involvement
The Boomers
• Are about "visions and values."
• Value individualism but are “teamoriented.”.
• Generation gap occurred between
them and their parents.
• Learned to mistrust authority
figures.
• Did not get along with their
parents and swore they would not
raise their kids like they were
raised.
• Work an average of 55 hours
per week as adults.
• Philanthropically, you should
respect their individualism and
focus on civic participation.
Important Events
•Rosa Parks
•First Nuclear Power Plant
•The Civil Rights Act
•Cuban Missile Crisis
•John Glen Orbits the Earth
•Martin Luther King Leads
March on Washington, D.C.
•President John F. Kennedy
Assassination
•National Organization for
Women Founded
•Martin Luther King
Assassination
•Robert F. Kennedy
Assassination
•Watergate
•Kent State Massacre
•Vietnam War
The Gen Xers 1965–1981 - A Lost Generation… A
Nomadic Generation….. Half the Size of the Baby Boom
– 41 million - reactive
• Divorce reached an all-time high
• Single-parent families became the
norm
• Latch-key kids were a major issue of
the time
• Children not as valued – looked at Core Values
Dedication
as a hardship
Hard Work
• Families spread out (miles apart)
Conformity
Law and Order
• Family size = 1.7 children (many
Patience
only-children)
Delayed reward
Duty before pleasure
• Perception of the world as “unsafe”
Adherence to rules
• Average 10 year old spent 14 ½
Honor
minutes a day with a significant
adult role model
Generation X
• This is the conscientious,
extremely pragmatic, selfsufficient generation that has
a ruthless focus on the
bottom-line.
• Learned that they could only
count on one thing themselves. As a result, they
are very "me" oriented.
• They are not active voters,
nor are they deeply involved
in politics in general.
• Philanthropically, they focus
on practicality and locality.
Important Events
•Women’s Liberation Protests
•Watergate Scandal
•Energy Crisis begins
•Tandy and Apple Market PCs
•Mass Suicide in Jonestown
•Three Mile Island
•US Corporations begin
Massive Layoffs
•Iran Hostage Crisis
•John Lennon Shot and Killed
•Ronald Reagan Inaugurated
•Challenger Disaster
•Exxon Valdez Oil Tanker Spill
The Echo Boom/Millennials…
 The Millennials are almost as large as the baby boomsome say larger - depending on how you measure them
(approx. 81M).
 The Millennials are the children born between 1982 and 2002
(peaked in 1990), a cohort called by various names:
Echo Boom
Generation Y
Millennials
Net Generation
Things Began to Change for This Generation
• Abortion rates peaked in 1980 and began a slow
decline.
• Poverty rate for children peaked in 1983 and began
a slow decline (Medicaid began).
• US divorce rate peaked in 1981 and began a decline.
• Homicide rate against children peaked in 1982 and
began a decline.
• They were born into a better world, a more
optimistic world than the generation before them.
What We Know
• 35% are non-White
• 1 in 5 has at least one
parent who is an immigrant
• Have the best educated mothers in history
• Have better educated parents
• Came out of the infertility era – were very
wanted as children
• Grew up during a monumental financial boom
• Safest generation we have seen
What We Know
• Born to older parents and raised in smaller families
(lots of only children) – many have never shared a
room
• Been plugged in since they
were babies
• Expect technology to be free
• Think it is cool to be smart
• Have had cell phones since they were children
• Expect to have 4 or more jobs in their lifetime
• Are as interested in where they live as what they
do – so cities are working to attract them
Major Influencing Factors
1.
2.
3.
4.
5.
Their parents
The self-esteem movement
The customer service movement
Gaming and technology
Casual communication
Parenting Millennials
• This generation is being parented by welleducated, over-involved adults who
participate in “deliberate
parenting.”
• They have explained
outcomes to their children
and have created a “what’s
in it for me” generation.
• Boomers were the first
generation to be thrown out in to an unsafe
world as adolescents (60s and 70’s were very
scary and many were not prepared.)
Baby Boomers as Parents
• Boomers rebelled against the strict discipline
of their parents.
• Decided not to say “because I
told you so” or “because I’m the
parent and you’re the child.”
• Boomers wanted open and
friendly relationships with their
children. They wanted to have
open lines of communication
with them (what they did not have.)
Baby Boomers as Parents
• They read up on everything.
• They explain things to their children, (actions, consequences,
options, etc.) – they want them to learn to make informed
decisions.
• They allow their children to have input into family
decisions.
• They tell them “just because it is on
television doesn’t mean it’s true”
or “you can’t believe everything
you read.” Questioning authority is good.
• Millennials have become “masters of
negotiation.” They are capable of
rational thought and decision-making
skills at young ages.
Helicopter Parents
• Helicopter Parent (n) A
parent who hovers over his
or her children.
• Or Snowplow parent: Parents who clear the way for
their children
• ……these (echo) boomers are confident,
achievement-oriented and used to hovering
"helicopter" parents keeping tabs on their every
move. (Anthony DeBarros, "New baby boom
swamps colleges," USA Today, January 2, 2003)
Perceptions of Parents
• This generation loves their
parents
• Thinks they were great parents
• Share their values, like their music
• Have no desire to “get away” from
their parents when they go to college
like other generations.
• When they need something – they
ask the parents first – go to them for
help
• Parents want to help them and protect them
Millennials - Not Very Hardy
• Our parents told us “when the going gets
tough, the tough get going” and “if at first
you don’t succeed, try, try again.”
• Their philosophy “when the going gets
tough, it means you should try another
route” and “if at first you don’t succeed,
maybe you shouldn’t be here.”
• They have trouble staying in
classes with rigid teachers,
working for strict bosses and
living in situations where they
have no flexibility or encouragement.
Millennials - Not Very Hardy
• Seems like the tougher you are, the quicker
they quit
• Have no preconceived ideas about expectations
• See a lack of consistency among bosses
• Have to tell them more common sense things
than the generation before them and we resent
it
Focus on Self-esteem
• This generation was the center
of
the “self-esteem” movement.
• 9,068 books were written about
self-esteem and children during
the 80s and 90s (there were 485 in the 70s).
• The state of California spent millions studying the
construct and published a document entitled
“Toward a State of Self-esteem.”
• Yet they can’t escape the angst of adolescence –
they still feel disconnected, question their
existence, purpose and the meaning of life. They
want to feel valued and cared about.
Focus on Customer Service
• Expect access (24/7)
• Expect things to work like
they are supposed to
• If they don’t “that is your
problem”
• They want what they have paid for
• Everything comes with a toll-free number or
web address
• Want a “system restore”
option in life
Add the Impact of Gaming
• Gaming has impacted children
– The game endings changed based
on the decisions children made
(Role Playing Games [Legend of
Zelda, Final Fantasy, Chronotrigger])
impacting locus of control.
– Involves a complex set of decisionmaking skills.
– Teaches them to take multiple
pieces of data and make decisions
quickly.
– Learning more closely resembles
Nintendo, a trial and error approach to
solving problems.
We navigated our way through…..
They navigated their way through…..
Technology
• This generation has been plugged in since they
were babies.
• They grew up with educational software and
computer games.
• They think technology should be free.
• They want and expect services
24/7.
• They do not live in an 8–5
world.
• They function in an international
world.
The “Information Age” Mindset
• Students have never known life without the
computer. It is an assumed part of life.
• The Internet is a source of research,
interactivity, and socializing (they
prefer it over TV).
• Doing is more important than
knowing.
• There is zero tolerance for
delays.
• The infrastructure of most
business environments may not meet
the expectations of students
raised on the Internet and interactive games.
The Information Age
• This generation has been raised at a time
when all possible content is on the Internet.
• Their parents educate them through the
internet – about health, safety, consumer
issues, etc.
• Their parents have access to everything and
are rather well informed.
• How does this impact the way patients
interact with their physicians?
Cell Phone Technology
• They all have cell phones and expect
to be in contact 24/7. They are on 24/7.
• Not a phone – a lifestyle management tool
• Staying “connected” is essential.
• Communication is a safety issue for parents.
• Communication has become casual
for children (IM, text messaging,
email, MySpace, Facebook and
cell phones.
• How has this changed how they
interact with their family, teachers,
bosses, and patients?
But Things are Different for 1st
Generation or Low-income Families
• Not all parents and children are proficient; first-generation
children and those from working class families may have
less experience.
• Their experience with technology has been in arcades and
minimally in school (poorer districts.) Technology equates
to entertainment to some children.
• They have not had the exposure to educational uses of
technology. Educated parents and those in professional
jobs tend to view technology as a tool that can do work for
you. They teach this to their children.
• Huge digital divide between the “haves” and the “have
nots” based on income levels (class not race).
• Digital divide is appearing in pre-K.
Now Let’s Discuss Changes in the
Workforce and Work Environment
Who Is Working Today?
Veterans
Boomers
Gen X
Millennials
1,000 die per day
Youngest are 5 years old
14%
33%
Half the size of the generations
on either side of them
10%
43%
7,198 turned 60 every day in 2006
The Generational Births
(Millennials)
(Boomers)
(Xers)
Age Among Physicians Working Today
Percent
Under 35
35 to 44
18%
19%
45 to 54
55 to 64
31%
32%
50% are Babyboomers
Source: American Medical Association, Physician Characteristics and Distribution
in the U.S., 2001-2002 Edition.
Obvious Changes in that Workforce
100.0%
White
87.9%
African American
Other Minority
Male
85.0%
Female
73.9%
80.0%
60.0%
54.0%
40.0%
46.0%
20.0%
11.6%
5.0%
16.3%
15.0%
9.8%
0.0%
1900
2000
Business Today…
• The business world we live in today was created
by generations who are (mostly, 95%)
no longer working (or alive).
• They were influenced by the
military and created a
workplace reflecting a hierarchy
with a clear chain of command.
• Employees worked hard to receive
raises, bonuses and higher ranks.
Higher rank (with the higher salary) was valued
and envied by employees on their way up and
held in high esteem by those at the top.
Will We Have a Workforce Shortage?
• Will the Boomers retire in droves?
• Could see a 4-10 million worker shortage by 2010.
• We don’t have enough well-prepared young
workers.
• Will young workers be willing to work the way we
have always worked?
• Greatest needs in fields with advanced education
such as medicine and education.
• Also industries with mostly older workers such as
the oil and gas industry.
How Have The Various Generations
Impacted the Workforce
• How have their early experiences impacted
their perspective?
• What values did they bring to work?
• As generations change – does the workforce
keep pace?
• Let’s look at them…..
Values of Employees in this Age Group
• Loyal to employer (company man) and
expect the same in return
• Believe they should be rewarded for
tenure
• Work ethic = efficiency and hard work
• Stable, thorough and detail oriented
• Don’t buck the system but
work within it
• Uncomfortable with conflict
and disagreements
• Not change oriented
Boomer Employee Values
• Majority of teaching faculty and hospital staff
• Always share personal experience – “what has
happened to me is relevant to you”
• Value stability and respect
• Like to see their successes
• Tend to “workaholism” and have
difficulty balancing their lives,
working 40 hours is “slack.”
• Are competitive
• See themselves as the standard of comparison
• Appreciate technology because of how easy it
makes their work – still fear they might “break it”
Boomers at Work
• Ethic = long hours show
commitment
• Team oriented and relationship
builders (don’t like conflict)
• Work to become a better “me”
• Not budget minded
• Sensitive to feedback
Gen Xers as Employees
•
•
•
•
•
•
•
•
•
•
•
Significant number of teaching faculty and hospital staff
Cynical and pessimistic
Want work-life balance
Think globally and seek independence
Like technology and want an informal work environment
Don’t want the boomers’ work ethic
Communication is important and talk to adults as
friends/peers (not impressed with authority)
Believe reward should be based on productivity not hours
worked
Want control of self, time and future
Loyalty to people not an institution
Impatient with poorer people skills
What Millennials Want
• Ability to work whenever and wherever
they want.
• Variation on the job
• Continual feedback from supervisors
• Opportunities to learn, retool and reinvent
themselves
• Challenge, new problems to solve
• To be in charge of their lives and
future
Marston, Cam, Motivating the “What’s In It for Me” Workforce: Managing
Across the Generational Divide and Increasing Profits, 2007
What They Are Not Interested In
• Time-honored traditions
• Doing things the way they
have always been done
• Paying their dues and being abused
• How their managers got to where they
are (rank)
• A work ethic that requires a 10 hour day
• Unquestioning loyalty to a company
Marston, Cam, Motivating the “What’s In It for Me” Workforce: Managing
Across the Generational Divide and Increasing Profits, 2007
Focus on Retention
• “Ambitious yet aimless”
characterizes this generation
– They work for a while until they save enough
money to live for a while, then quite – play for
several months and then look for work again.
– They know at the age of 21 that they may have
to work until they are 70 – 75. So why hurry into
a career job now.
– They have the same attitude with school.
– They stop out regularly and see if things work
out. They appear to be in “no hurry.”
– They swirl….
They Want to Experience Life
• 25 years old, college graduate – moved to
Charleston to live at the beach (working in
whatever to live).
• Graduated in pre-med in May 08 (24 years
old) – moved to Hawaii …. surfing.
Older Generations Make Assumptions
• That younger generations will measure
success just as we have.
• Young worker must pay their dues and
follow the same paths to success as previous
generations.
• The company ladder will remain intact.
• Workers go where the jobs are.
Marston, Cam, Motivating the “What’s In It for Me” Workforce: Managing
Across the Generational Divide and Increasing Profits, 2007
Millennials Were Asked….
• What are the top five things
that make you respect a
company?
Top Five
1. Give back to their community.
2. Have fair labor practices.
3. Have products and services that do
what they promise to do.
4. Having products and services that
truly help people in need.
5. Being “green” or “eco-friendly.”
(Just Kid Inc. KID Formation Series, July 2008, “Meet the Millennial
Generation: An Explosive New Consumer Force.”)
Change in Values
Two youngest generations:
– Define success differently
– Their time is equal in value
to money
– Will pursue other rewards for their work
– The company/corporate ladder has
become irrelevant
– View their predecessor’s experience as a
warning, not a road map
– Don’t value the rules of management,
motivation and reward
Marston, Cam, Motivating the “What’s In It for Me” Workforce: Managing
Across the Generational Divide and Increasing Profits, 2007
Skepticism
The two younger generations:
– Have been given ample reason to question
authority
– Don’t believe their leaders tell the truth
– Question the motives and truthfulness of
institutions across the board
– Invest their loyalty and trust in individuals and
therefore, the right boss is critical (otherwise
they change jobs, #1 reason they quit)
Marston, Cam, Motivating the “What’s In It for Me” Workforce: Managing
Across the Generational Divide and Increasing Profits, 2007
What Will It Take for All Generations to
Work Well Together
• A new understanding of what employees want
from their jobs, bosses and workplace
experience
• A new understanding of loyalty and how to
develop it (not through pay, promotions and
benefits)
• A new definition of self – young employees
define themselves by what they do outside the
job, not what they do for a living
Marston, Cam, Motivating the “What’s In It for Me” Workforce: Managing
Across the Generational Divide and Increasing Profits, 2007
What Will It Take
• New behavior from leaders who realize younger
workers enter the workforce seeking self-fulfillment
and aren’t interested in “paying their dues” for an
unspecified amount of time for a vague reward
• Because young people are doing everything later –
staying in school, living at home, getting married,
having kids – this impacts their commitment to
work
Marston, Cam, Motivating the “What’s In It for Me” Workforce: Managing Across
the Generational Divide and Increasing Profits, 2007
How The Younger Generations Will Push
Us…
•
•
•
•
•
More independence in the workforce
Consumer-based fairness
Better technology
Enhanced professional development
Get rid of “that’s the way we’ve always done
it”
• Have more life balance
• Re-establish priorities
What We Know
• Times are changing – in business and society
• So – leadership must change
• The younger generations are working in a
different economy and business world
• They have different values and goals
THEY WILL NEVER BE LIKE US!
Copy of Presentation:
• http://www.cpcc.edu/millennial
• Click on presentations and workshops
• It is under “Keynotes for Business/Industry
Groups”
• Title: “Generations at Work: Generational
Diversity in the Practice and Teaching of
Medicine”