Mark Laney: Bridging the Generation Gap — the Art of Managing Multiple Generations

One of the greatest challenges facing healthcare executives today is managing physicians and employees from different generations. When I was president of Cook Children's Physician Network in Fort Worth, Texas, a position I held until I came to Heartland Health last year, this issue took more of my time than any other.


I managed 270 doctors at Cook Children's with varying behaviors and values, which frustrated me very much. Then one day a young accountant noticed my turmoil, pulled me aside and said that she would like to make a presentation for our administrative group about managing different generations in the workforce.

It was a beautiful presentation. She brought home the point to me that it wasn't appropriate to judge others. I came to realize that people of different generations have varying motivations. To help people work together with less friction, I needed to gain a fuller understanding their values. This was truly a breakthrough for me and I started thinking in a different way. The experience reminded me of one of the most fundamental leadership goals — to seek first to understand.

I began reading about the different generations and their attitudes. I am a baby-boomer, born between the years 1946 to 1964. This generation tends to be extremely hard-working. Boomers define themselves by their career and a lot of their self-esteem comes from their work. That puts our lives out of balance sometimes. Physicians in my generation think nothing of working 60-80 hours a week. We baby-boomers tend to have very traditional values. We respect hierarchy and authority and seek recognition and promotion as our reward.

After the boomers comes Generation X, people born 1965-1981. Many of them were latchkey kids, coming home to an empty house because their parents were at work. This makes them generally very independent. They don't value hierarchy, titles or experience. Their parents were divorced in many cases, making them very family-focused. They want a balance in their life. They don't want to work 80 hours a week and miss their children's birthday party. They take all their vacation time. They don't define who they are through their work. GenXers value freedom, flexible work schedules and time off to spend with family.

On the horizon is the millennial generation, born after 1980. If they are going into medicine, they are just starting residency training. Millennials are completely different from the two previous generations. They are idealistic and team-oriented. They value work that has meaning above all other rewards. They demand the absolute newest technology at the workplace. They may be the ideal generation for healthcare because we are going to need to be team-based and their idealism is a good fit for medicine, where incomes may not be as high they were. I have tremendous hope for the millennials. They will be a fascinating group.

Making a team out of different generations
If you put a boomer physician next to a GenXer and don't understand the differences in their basic philosophies, they can come into conflict very quickly. The millennials will enter the workforce in five to 10 years and come into contact with the other two generations. Because each group has different motivations, you can't just treat them all the same. It's like making a quilt: You take differently shaped pieces of cloth, sew them together and make something beautiful, but it takes a lot of work, leadership and understanding. One of the big leadership challenges of the future will be taking individuals that look at life differently and creating a cohesive team that shares the same medical values.

How can this be done? The first step is learning to understand and overcome the conception that there is just one right or wrong. It's a breakthrough moment to realize that just because I look at life in a certain way, it doesn't mean it's the only way. Managing multiple generations definitely takes more administrative time, but it is entirely worth it. It is very gratifying to turn anger and frustration into mutual respect by working through conflict and educating yourself about the differences. Setting expectations in orientation, recruitment and compensation plans allows organizations to put all of the pieces together. Knowing what your expectations are and articulating them before a person joins the organization can help both parties decide whether the relationship can be a good fit.

When you look back over time, generational differences aren't something new. They have been cycling through history. It's not a new phenomenon, but I think it's better understood today. I definitely think managing multiple generations is a skill-set any hospital executive, or anyone who manages a physician group, must be aware of because it's not going to change.

It was that one young accountant that changed my mind about this issue, when she had the courage to step forward and give that presentation about the values of her generation. She really opened my eyes and helped me learn a great lesson.

Mark Laney, MD, became president and CEO of Heartland Health in St. Joseph, Mo., in 2009. He was previously president of Cook Children's Physician Network in Fort Worth, Texas. He is a pediatric neurologist who received his fellowship training at Mayo Clinic. He received his MD degree from University of Texas Medical Branch and graduated from the pediatrics residency program at the University of Arkansas. Learn more about Heartland Health.

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