The Changing Face of Medicine: A Generational View

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The Changing Face of Medicine A Generational
View

• Breda Murphy Bova, Ph.D.
• University of New Mexico

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Work underlies the very concept of who we
arechanges in society, technology and life
expectancy have influenced how, where and why we
work. The workplace is now our most diverse
national institutionand its diversity will only
grow.A Nation at Work, 2003
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Pigeonholing

• If this information is used to
• pigeonhole people,
• it will become a dangerous weapon.
• When we use it to ask ourselves,
• How can I be more effective? or
• How can I better understand behavior?
• it can be a valuable tool.

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Key Demographics

• In 1900 there were 13 million people in the U.S.
  over the age of 45today, there are nearly 100
  million.
• Fastcompany, 2004

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Key Demographics

• 11 of the active workforce is over 56.
• Between 2002 and 2012, almost 50 of the current
  workforce will be eligible for retirement.

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Key Demographics

• Over the past decade, the 50- to 54-year-old age
  cohort expanded by 55 percent, making it the
  fastest growing age group.
• The second fastest growing age group was between
  the ages of 45 and 49, which swelled by 45
  percent.

• Source American Demographics, January 2002

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Key Demographics

• One in three American workers are chronically
  overworked, with job-related stress varying
  significantly by age, employment situation, and
  demands at home.
• 70 percent of employees say that family is their
  most important priority. (Ranstad North America
  survey, 2002). This compares to 54 in 2000.
• In 70 percent of American families, all parents
  are already workingthe reverse of 1960 when 70
  percent of all families had at least one parent
  at home full-time.
• More than 1/3 of employees (36) do not plan to
  use their full vacations.

• Source Families and Work Institute, 2005

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Key Demographics

• More than 20 of households indicate they are
  responsible for some or all of the care of
  elderly relatives.
• The number of professional women working part
  timeby choicehas risen 17 percent from 1994, to
  2.9 million according to the U.S. Bureau of Labor
  Statistics.

Bailyn, 2001
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Educational Trends

• Half of what students learn in their freshman
  year about the cutting edge of science and
  technology is obsolete, revised or taken for
  granted by their senior year.
• All signs indicate that corporate involvement in
  public schools will continue to increase over the
  next decade.
• In 2003 there were more women enrolled in Higher
  Education than men.
• Todays college grads have spent less than 5,000
  hours of their lives reading but over 10,000
  hours playing video games and over 20,000 hours
  watching TV.
• Grade inflation.

From The Futurist, 2003
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THERE ARE THREE DEGREES OF INTERNET ACCESS
Digital Demographics

• COLD
• TEPID
• HOT

Source Pew Internet American Life Project,
2005
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Digital Demographics

• 26 of Americans age 65 and older go online,
  compared with 67 of those age 50-64, 80 of
  those age 30-49, and 84 of those age 18-29.
• 57 of African-Americans go online, compared with
  70 of whites.
• 29 of those who have not graduated from high
  school have access, compared with 61 of high
  school graduates and 89 of college graduates.
• 60 of American Adults who do not have a child
  living at home go online, compared with 83 of
  parents of minor children.

Source Pew Internet American Life Project,
2005
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Key Medical Demographics

• Physician practice styles have changed
• Physicians want
• Set hours
• Vacation
• Quality of life
• 64 of physicians 50-65 say younger doctors not
  as hard working
• May take 2 young physicians to replace seasoned
  veteran
• Source MHA 2004 Survey of Physicians

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Key Medical Demographics

• Physicians are aging
• 30 of physicians are 55 years old or older
• Predictions are that 23,000 physician
  deaths/retirements by 2020 versus 16,000-17,000
  new entrants
• In the next 3 years, 51 of doctors 50-65 plan to
  stop seeing patients or significantly decrease
  the number of patients they see
• Source MHA Survey of Physicians 2004

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Key Medical Demographics
More Physicians are Women Percentage of Female
Residents/2000

• Obstetrics/Gynecology
• Pediatrics
• Dermatology
• Psychiatry
• Family Practice

• 67.7
• 64.6
• 54.0
• 49.0
• 47.0

Source Association of American Medical Colleges
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Key Medical Demographics

• Two-thirds of the nurse force is over the age of
  40 average age is 45.2 years.
• The proportion of the RN workforce who are men
  has been growing at an appreciable and steady
  rate during the past two decades. The data
  indicates that this growth was somewhat bimodal
  47 percent were in their 30s, particularly ages
  35-39, and 39 percent were older than age 50.
• Employment among foreign born RNs increased 6
  annually.

• Source Health Affairs The Policy Journal of the
  Health Sphere,
• November 17, 2004.

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A Generation Defined

• Generation is defined as a group of people who
  share the same formative experiences. These
  experiences bind people that are born in
  continuous years into cohorts--a group of
  individuals that have a demographic statistic in
  common.

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Birth Year

• Most frequently, demographers use birth year as
  that common statistic.

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Generational Traits, Characteristics and Values
Are Not Universally Shared

• Not every member of a particular generation will
  share everything in common with other members of
  that generation.

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The Generation Gap
The Generation Gap is most apparent in the
workplace. Other than the family, it is the
place where we interact with our generations.
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The Challenge May Come from Interactions with

• Your supervisor
• An employee
• Co-worker
• Client or even a vendor
• As with other diversity issues such as
• age, gender, ethnicity and race,
• examining and understanding generations has
  become an increasingly important part
• of maximizing organizational effectiveness.

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A Few Specific Differences Between Generations
Include

• Communication styles and expectations
• Work styles
• Attitudes about work/life balance
• Comfort with technology
• Views regarding loyalty and authority
• Acceptance of change

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The Four Generations
The Four Generations that remain in the workplace
today are

• The Silent Generation (1925-1942) Approximately
  63 million
• The Boom Generation (1943-1961) Approximately 77
  million
• Generation X (1962-1981) Approximately 44
  million
• Generation Y (1982-1998) Approximately 70
  million

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Generations
Work/Life Balance
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Generations

• Silent Baby Boomer Gen X Gen Y

Practical Dedicated Respectful Hierarchy Self-
sacrifice Dont get it
Optimistic Driven Challenge Pay your
dues Personal gratification Responsible
balancing for everyone else
Cautious ? ? ? Inclusive Flexibility and
options
Skeptical Free Agent Unimpressed Competence Re
luctance to commit Want it now
Outlook
Work Ethic
View of Authority
View of Leadership
Relationships Work/Life Balance
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Approach to Change

• Silents
• Ready-Ready-Ready-Aim-Fire!

Boomers Ready-Aim-Fire!
Xers Ready-Fire-Aim! (Learn Experiment Adapt)
Ys Fire-Fire-Fire-Aim-Fire!
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Silent Generation
I think Ive acquired some wisdom over the
years, but there doesnt seem to be much demand
for it. (Elderly man to younger man at the
club.) Published in the New Yorker 6/14/99.
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Silent Generationaka

• Veteran Generation
• WWII Generation
• Seniors
• Geezers

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Seminal Events

• World War II
• The Great Depression
• The New Deal
• Korean War
• Rise of Labor Unions

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Characteristics of Silents

• Postpone Gratification
• Risk Aversive
• Loyal
• Family
• Country
• Job
• Respectful Communication
• Adherence to Rules
• Detail Oriented

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Paying Your Dues

• They were prepared to endure situations or master
  a body of knowledge.
• They were willing to demonstrate respect for
  those who came before them.
• Age and experience counted.

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Career and Family

• For all the years that I was working, I was
  trying to achieve a particular goal. So I wasnt
  interested in balance. I didnt sail very much. I
  didnt play any golf. I didnt take much time
  off. I ran American Airlines and it pretty much
  took up my whole life. Which suited me fine. I
  was having a great time.Now you read a lot about
  balance. In todays world people say, I have to
  have a more balanced life. I have to have time
  for my kids and my job and my hobbies. Thats
  all well and good. But people who worry about
  balance have no overriding passion to achieve
  leadership.
• Robert Crandall, retired chairman of the board
• of American Airlines
• Source Geeks Geezers How Era, Values, and
  Defining Moments Shape Leaders by Bennis and
  Thomas

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The Baby Boomersaka Digital Immigrants
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Baby Boomer Update

• 30 of the Baby Boomer generation are
  grandparents.
• 28 who are grandparents have divorced, remarried
  and have second or third sets of children. In
  some cases our children are playing with our
  grandchildren.
• Baby boomers are on the brink of retiring in
  droves leaving behind the largest labor shortage
  in history.
• 80 indicate they plan to work past age 65.

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Baby Boomer Characteristics

• Largest Generation 77 Million
• Optimistic
• Redefined Roles
• Management by Buzz Word
• Skewed Work/Life Balance
• Brought Up in a Competitive Environment
• Will Revolutionize Retirement
• Work Ethic and Worth Ethic Are Synonymous

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The Baby Boomers

• Seminal Events
• McCarthy HCUAA hearings begin
• Salk Vaccine tested on the public and Rosa Parks
  refuses to move to the back of the bus in
  Montgomery, AL
• First nuclear Power Plant and Congress passes the
  Civil Rights Act
• National Defense Education Act
• Birth control pills introduced and John Kennedy
  elected

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The Baby Boomers (continued)

• Kennedy establishes Peace Corps
• Cuban Missile Crisis and John Glenn circles the
  earth
• Martin Luther King leads march on Washington,
  D.C. and President John Kennedy assassinated
• United States sends ground combat troops to
  Vietnam
• 1965 Higher Education Act
• National Organization for Women founded

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The Baby Boomers (continued)

• Cultural Revolution in China
• American Indian Movement founded
• Martin Luther King and Robert F. Kennedy
  Assassinated
• First Lunar landing and Woodstock
• Kent State University shootings

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What the Other Generations Think About the Baby
Boomers

• Silents say
• They talk about things they ought to keep
  private like the intimate details of their
  personal lives.
• They are self-absorbed.

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What the Other Generations Think About the Baby
Boomers

• Gen Xers say
• Theyre clueless about the future.
• Theyre workaholics.
• Theyre too political, always trying to figure
  out just what to sayto whomand when.
• Get outta my face.

• They do a great job of talking the talk. But
  they dont walk the walk.
• Lighten up its only a job.
• Whats the management fad this week?
• Cant make a decision without forming a
  committee.

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What the Other Generations Think About the Baby
Boomers

• Gen Y say
• Theyre cool. Theyre up to date on the music
  we like.
• They work too much.

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Managing Baby Boomers

• Recognize their experience as a valuable asset
• Use them as mentors
• Recognize role overload and conflicting demands
• Assist with time demands
• Offer part-time opportunities

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Generation X
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GENERATION X

• Twentysomethings
• Baby Busters
• The Thirteenth Generation

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Gen X Update

• Generation X is moving into its peak family
  raising years.
• Census data shows an increase in stay-at-home Gen
  X moms. The increase is most pronounced among
  college graduates. Many indicate they are looking
  for a less frazzled lifestyle.
• Census data shows percentage of moms with
  children under 1 in the workplace fell for the
  first time in 25 years.
• Thirty percent have college degrees.

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Gen X Seminal Events

• 1971 Intels first chip developed
• 1972 First e-mail management program
• 1975 Personal computer introduced on the consumer
  market
• 1981 Centers for Disease Controls first
  published report on AIDS
• 1981 Reagan assassination attempt
• 1984 Extensive corporate downsizing begins
• 1986 Challenger explosion

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Generation X Characteristics

• Dedicated to people, projects, ideas and tasks,
  not to longevity and lifetime employment
• They are parallel thinkers
• They are independent and resourceful
• They are accepting of change
• They Want it now!
• They are comfortable with diversity
• They have expectations of balanced lifestyles
• They view mentoring as a right not a privilege
• They have a free agent approach to careers

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Generation X Physician Characteristics

• They are more likely to be female.
• Lifestyle is their core concern.
• They seek immediate stability.
• They do not seek hierarchical dominance.
• They are technically savvy.
• They have a skills-based mindset.
• They are loyal to principles, not organizations.
• They seek conflict resolution.

New England Journal of Medicine, May 2005
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What Xers Want in the Workplace

• They want flexibility
• They want to be developed
• They want to be engaged
• They want affiliation
• They want us to lighten up
• They want to be appreciated
• They want balance

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Managing Gen Xers

• Frequent Feedback
• Limit the Bureaucracy
• Give them plenty of elbow room
• Understand your overall employee motivation
  package
• Give them work they can juggle

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Generation Y
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Generation Y
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GENERATION Y
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GENERATION Y

• Also known as
• Net Generation
• Echo Boomers
• Digital Generation
• Generation Next
• .com Generation
• Point and Click Generation
• Generation Why
• Digital Natives

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Gen Y Update

• 72 million, second in size to the Baby Boom
  Generation
• 90 say they are close to their parents
• Most ethnically diverse group in U.S. history
• 78 believe religion is important
• Many have been raised by Helicopter parents

U.S. News and World Report, November 2003
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GENERATION Y CORE VALUES INCLUDE

• Optimism
• Volunteerism i.e., 700 chapters of Habitat for
  Humanity in high schools
• Inclusiveness
• Collective Action
• Speed

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The oldest Millennials were born in 1980, the
year

• John Lennon is assassinated by Mark David
  Chapman.
• The U.S. Supreme Court allows patents on living
  organisms.
• Mount Saint Helens erupts, killing 60 people.
• CNN is launched as the first all news network.
• Japan passes the U.S. as the largest automaker.
• Bill Gates licenses MS-DOS to IBM, makes next to
  nothing on the deal.

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Mindlist to assist managers in thinking about
what their new employees have experienced and
what they have never experienced

• The Kennedy tragedy was a plane crash, not an
  assassination.
• A 45 is a gun, not a record with a large hole
  in the center.
• They have no clue what the Beach Boys were
  talking about when they sang about a 409, and the
  Little Deuce Coupe.
• They have probably never lost anything in shag
  carpeting.
• MASH and The Muppet Show have always been in
  reruns.
• There have always been automated teller machines.
• Bottle caps have always been screw off.
• The only host of the Tonight Show they have known
  is Jay Leno.

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Mindlist to assist managers in thinking about
what their new employees have experienced and
what they have never experienced (continued)

• There has always been a national holiday honoring
  Martin Luther King, Jr.
• Bear Bryant has never coached at Alabama.
• Elton John has only been heard on easy-listening
  stations.
• Most have never seen a black and white T.V.
• They have never used a bottle of White Out.

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Generation Y Characteristics

• Using computers since Pre-Kindergarten
• E-Learners
• In a state of continuous partial attention
• Used to instant communication
• Accustom to giving feedback
• Many are into Extreme Sports
• Expect frequent and/or constant feedback
• Optimistic
• Speed is valued more than attention to nagging
  detail
• Oriented toward collective action

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Career Development Trends

• Legitimize less than full-time appointments.
• More people will be free agents.
• A hop-scotch approach will replace linear career
  pathing.
• In the future, employees will look to work for
  8-10 years, then take time off, like a sabbatical.

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Career Development Trends

• Flexible Employment Will Gain Popularity
• As more people work flexible hours, work from
  home and use technology to work for employers in
  distant locations, the traditional workday and
  workweek will further erode.
• Part of this movement will be driven by parents
  who want to spend more time with their children.

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Career Development Trends

• We see the apparent downtrend in
• career ambition as the real revolution,
• where very sizeable numbers of
• women and men are working hard,
• but not wanting the trade-offs
• they would have to make
• by advancing into jobs
• with more responsibility.

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MAJOR ISSUES FOR MANAGERS

• Loyalty
• Training/Professional Development
• Work Life Balance (86 indicate its their Number
  One priority)
• Career Pathing
• Talent Management

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Where do we go next?
Consider

• Building Communities
• Developing Relationships
• Organization Structure/Culture
• Reverse Mentoring
• Leverage Connections in the Workplace
• Professional Development of Managers
• Conduct a Demographic Audit of the Workplace
• Identify Potential Leaders
• Source Seminars for Nurse Managers, September
  2002 Nancy Wells, et al.

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QUESTIONS