Generational Divide, Management Strategies and Ways to Unify a Workforce with Varying Priorities

Allison M. Janda, MD

How can we bridge the generational divide and exactly how big is this divide? Experts on the topic, Jeffrey Berger, MD, MBA, Mary Njoku, MD, Maya Hastie, MD, EdD, Mada Helou, MD, and Elizabeth Duggan, MD, MA, answered this question from their specific generational perspectives in the session, “Climbing the Leadership Ladder: How to Navigate Generational Divide and Build Lasting Teams!” held on Saturday, March 19 at the IARS 2022 Annual Meeting. The speakers outlined differences and similarities between generations and shared strategies for employing positive generational qualities to develop a cohesive team.

Jeffrey Berger, MD, MBA, Professor and Chair, The George Washington University School of Medicine and Health Sciences, welcomed the audience to the session and introduced the need for a discussion on the unique concerns of each generation within the workplace. He recommended the attendees contemplate how to navigate these differences, similarities and leverage generational knowledge to best lead in this multigenerational workforce.

Mary J. Njoku, MD, Associate Professor, Matjasko Professorship for Education in Anesthesiology, University of Maryland School of Medicine, was the first panelist and discussed, “Managing Up: The Revered Baby Boomers” to provide a foundational understanding of the baby boomer generation and how to leverage their motivations within the workplace. She shared many historical events that shaped this generation and contributed to the key features and hallmarks of the generation. Dr. Njoku described the sensibilities of the baby boomer generation and highlighted sticking points related to communication, loyalty, meeting style and work ethic. Regarding communication, baby boomers prefer formal emails and written communication, and for meeting preferences, prioritize in-person meetings over a phone call or email. Regarding loyalty, the employees of this generation view employment transitions as appropriate if leaving for a promotion, but otherwise, it is better to stay and advance along their set career path. Baby boomer meeting preferences focus on creating equal opportunities for everyone to access information, and they expect full attention from the group, team cohesion and directed efforts to complete critical work. They find that work provides excitement and achievement, and it is all right to take portions of their work home.

Maya Hastie, MD, EdD, Associate Professor, Vice Chair for Education and Program Director of Adult Cardiothoracic Anesthesia, Columbia University Irving Medical Center, then spoke about Generation X, or those with their formative years occurring in the 1980’s. Dr. Hastie emphasized that not all GenXers will have the same lived experience, but they have witnessed changes, technological advances and lived through events that transcend generations and cultures. This leads them to believe that change is possible, and that nothing is permanent. Therefore, GenXers want efficiency, flexibility, and purpose for their work. Additionally, Dr. Hastie outlined that GenXers prefer electronic communications with timely acknowledgments in less than 2-3 days with a personal but professional tone, and favor email over in-person meetings. For any in-person meetings, they prefer to see an agenda for the meetings and expect that the time allotted is respected. Regarding work-life balance, GenXers try to protect their personal time and leave work at work. Loyalty of GenXers is not to the institution but to the values and mission supported by any given institution and therefore, community and the people they work with are both incredibly important. Dr. Hastie advised that we should avoid stereotyping and ageism and instead, promote and encourage diversity and inclusivity. She closed by emphasizing that not all conflict is due to generational gaps, and therefore conflict must be approached with curiosity and a constructive attitude, not with a divisive approach.

Mada F. Helou, MD, Associate Professor and Program Director for Anesthesiology at University Hospitals at Case Medical Center, discussed the millennial generation and generational awareness in the context of her leadership journey. Generational conflict can contribute to a lack of faculty and resident engagement. To create a more cohesive team and inspire engagement, a vision which takes all generations’ priorities into account and reflects the values of each group is key. Dr. Helou discussed a survey, which asked each generation about their opinions on what makes their generation unique. The millennials surveyed cited technology use, tolerance, liberal culture and being civic-minded, and at work, they were sociable, creative, and open to new ideas. Millennials prefer a flat corporate structure, a close relationship with their supervisor, management transparency, immediate feedback, a team-oriented approach, work-life balance, and meaningful work. Regarding communication preferences, millennials prefer text message or instant message, and their loyalties can change until the right career for that individual is found. Meetings are most effective with this group when they’re interactive. Regarding work ethic, they live in a 24/7 world and are willing to log in from home and multitask during other meetings or activities yet prefer flexibility during the workday. In the work environment, Dr. Helou discussed how GenXers and baby boomers were more similar to each other than to millennials and emphasized that a growth mindset is needed to facilitate interactions and focus on unifying opportunities, or examining the sticking points to see how these can be improved upon to work together. Dr. Helou then described how this insight was applied to the residency program at her institution, specifically involving the creation of multigenerational teams including a senior attending, a junior attending, a senior resident, and a junior resident, with self-selection for involvement in various projects. This allowed for overlap of generations working together towards a common goal and has facilitated engagement between the residents and faculty.

Elizabeth Duggan, MD, MA, Associate Professor of Anesthesiology and Director of Professional Development and Faculty Engagement at University of Alabama Birmingham, was the last panelist and synthesized the generational summaries presented by the other panelists with a talk entitled, “Bridging the Sticking Points: Unifying Strategies.” She emphasized the importance of generational research to bridge the generational gap and promote engagement. Opportunity, motivation, organizational commitment, job satisfaction and healthcare performance metrics were also important. The workplace today contains more birth cohorts or generations than it has ever before, and generational research focuses on whether generational personality differences predict work attitudes or outcomes, whether there are significant differences in work attitudes across generations, and identification of different motivational factors across generations in the workplace.

Regarding differences in personality traits across generations, the evidence supports that the generational effects are present in smaller studies. However, larger studies have found that personality changes over time, and depends on societal context and geography, and generational differences are not scientifically supported. Regarding work attitudes, all attitudinal differences are small and generally inconsistent across the literature, and motivational factors may also reflect career stage. The unifying factor for work attitudes across generations is that all generations seek meaningful work. Dr. Duggan summarized that any of the generational differences that do exist, have small effect sizes and that while the concept of generational differences can be useful, continued use of categorical stereotypes of generations can lead to bias and prejudice in the workplace. To reconcile workplace differences, Dr. Duggan recommended the “4+1 A model” which includes acknowledgement, appreciation, accommodation, and acceptance, and all create the ability to aspire to create more cohesive teams, better work environments, and improved outcomes.

A robust Q&A discussion followed the talks. Topics focused on the role of technology and tackling the “us versus them” mentality. Dr. Njoku highlighted how all the generations embraced technology during the COVID-19 pandemic. Dr. Duggan and Dr. Helou emphasized that the “us versus them” mentalities can be divisive and instead, we should focus on our similarities and work on systematic ways to solve these issues. The panelists also discussed institutional loyalty, and how to foster engagement, meaningful work and consistent values reflected by the institution. They highlighted the importance of discussing generational teamwork to educate all generations on this topic and how to handle various groups in the workplace in a unified instead of divisive manner. Dr. Hastie emphasized how the generations can learn from one another and recognize the strengths and insights each person brings to the team. The panel closed by focusing on the shared values across generations and the need for collaborations across generations to create well-functioning teams.