The New Generation of Leaders

Value systems, work ethics, and expectations can clash when younger physicians join a practice headed up by "mature" doctors. Learn what makes each group tick, and how physicians - regardless of generation - can work more effectively together.

By Teresa G. Odle | Feature Articles


Mark Slidell, MD, is midway through his general surgery residency at Georgetown University Hospital in Washington, DC. He has taken two years off to acquire a master’s degree in public health and focus on surgical outcomes research, then he’ll return for the final three years fo training. He considers the extra education “another arrow to add to my quiver, an additional strength to offer.”

At 33, Slidell is a Generation Xer; he entered medical school later than most of his fellow residents. When he completes his training, he’ll be an asset to any practice or program. And like most Gen Xers—particularly those in subspecialties—he’ll be heavily recruited.

Several years ago, medical practice and hospital leaders began taking note of the “new breed” of physicians entering the market. They also realized that predictions of a physician glut were proving untrue. Recruiting picked up and competition increased for the new Gen X physician similar to Slidell. But like the latest technological equipment that every physician “has to have,” many practices recruited Gen X physicians without thinking through how best to use them. And unlike laparoscopes, humans don’t come with training manuals on CD-ROM. Many older physicians weren’t sure how to manage these young physicians, so they avoided issues and made assumptions. Often, conflicts arose. The young physician felt misunderstood; many simply moved on.

“One of the biggest hurdles to overcome for the generations is a lack of understanding of each others’ value systems,” says Cam Marston of Charlotte, North Carolina, a workplace generations specialist and the author of the book, Motivating the “What’s in it for Me?” Workforce (Marston Communications, 2005). And neither the older nor the younger group communicates readily about the issues. “It’s unspoken; they just walk away, scratching their heads.”

National practice management consultant Judy Capko of Thousand Oaks, California, confirms this is how physicians handle generational, as well as other conflicts. “I have experienced where the troublesome physicians just stick their heads in the sand to avoid confrontation,” she says.

Distinctions uncovered

Marston offers the “beeper at the hip” as a classic example of generational differences. Doug Lundy, MD, a young Boomer orthopaedic surgeon with Orthopaedic Center of the Rockies in Fort Collins, Colorado, agrees. “It’s well known that younger physicians don’t want to take call as much,” says Lundy. He specializes in trauma, and taking call goes with the territory. (See “The Generation Beat.”)

Brigitta Robinson, MD, a Gen X general surgeon with Associated Surgeons MD, PC in Denver, says younger physicians today often “ask for fewer hours but expect more money.” This is largely due to a core commitment to lifestyle vs. profession. Health-care consultant Rebecca Anwar, PhD, agrees. “Younger physicians want a life outside medicine,” says the co-founder of The Sage Group in Philadelphia. Yet they also have financial obligations. They may be married—even to another physician with debts.

Gen X physicians enter practice with technical savvy typically unmatched by their older colleagues and though loyal to principles, they are less loyal to organizations. This puts even more burden on physician leaders to understand and embrace their differences and values.


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