As we all know, the HM revolution has evolved at a breakneck pace. While our specialty’s growth has outpaced that of any other in the history of modern medicine, hospitalists have a narrow bell curve of age, with a relatively rare “old” hospitalist. Having been a specialty for less than 20 years, HM’s working hospitalists primarily encompass a single generation. However, we are on the brink of brining a new generations of hospitalists into the workforce: Generation Y.
Social scientists and peer-reviewed publications have spent countless hours and pages speculating and defining generational spans. The typicality of each generation is both completely fascinating and grotesquely overgeneralized.
Baby boomers (born 1946-1961) are characterized by expansive individual freedoms; they are associated with civil rights, gay rights, and the feminist movement. They are notoriously hard-working, disciplined, independent, and relied little on their parents.
Generation X (born 1962-1981) is characterized as being media-savvy and highly educated, but more materialistic and less hard-working than baby boomers. Most hospitalists fall into Generation X, currently ages 31 to 50.
And now enter Generation Y, born beginning in 1982. This generation has more nicknames than Snoop Dogg. They also are known as Millennials, Generation Next, the Net Generation (referring to a reliance and comfort with the Internet), the Trophy Generation (referring to their need for rewards based solely on participation), the Boomerang/Peter Pan Generation (referring to their delay of typical adult transitions and a longer reliance on their parents), and “echo boomers” (as children of the baby boomers).
David McCullough brilliantly summarized Generation Y in a recent commencement speech. If his name does not sound familiar, it is likely because you have never lived in Wellesley, Mass. Known as “Swellesley” to local residents, it is a charming town about 15 miles west of Boston. Wellesley has a “Lake Wobegon” mentality, where “all the children are above average.” McCullough, a Wellesley High School English teacher, delivered the high school’s commencement speech this year to a packed room of high achievers. His message?
“Contrary to what your under-9 soccer trophy suggests, your glowing seventh-grade report card, despite every assurance of a certain corpulent purple dinosaur, that nice Mister Rogers, and your batty Aunt Sylvia, no matter how often your maternal caped crusader has swooped in to save you … you’re nothing special.
“Yes, you’ve been pampered, cosseted, doted upon, helmeted, bubble-wrapped. Yes, capable adults with other things to do have held you, kissed you, fed you, wiped your mouth, wiped your bottom, trained you, taught you, tutored you, coached you, listened to you, counseled you, encouraged you, consoled you, and encouraged you again. You’ve been nudged, cajoled, wheedled, and implored. You’ve been feted and fawned over, and called sweetie pie. Yes, you have. And, certainly, we’ve been to your games, your plays, your recitals, your science fairs. Absolutely, smiles ignite when you walk into a room, and hundreds gasp with delight at your every tweet. Why, maybe you’ve even had your picture in the [local newspaper]. And now you’ve conquered high school … and, indisputably, here we all have gathered for you, the pride and joy of this fine community, the first to emerge from that magnificent new building …
“But do not get the idea you’re anything special. Because you’re not.”1
I imagine this blasphemy caused something on the order of an existential crisis in Wellesley, but it does capture the essence of what it has been like to grow up as a Generation Y’er.
Two longitudinal surveys also give a glimpse into the generational psyche separating baby boomers, Generation X, and Generation Y: the “Monitoring the Future” survey and the “American Freshman” survey, both conducted annually by the University of Michigan and UCLA, respectively. A few notable trends from these surveys comparing the last three generations include:2
- The proportion who responded that being wealthy is very important ranged from 45% of baby boomers to 70% of Generation X and 75% of Generation Y;
- Fifty percent of baby boomers, 39% of Generation X, and 35% of Generation Y said it is important to keep up to date with political affairs; and
- Seventy-three percent of baby boomers and 45% of Generation Y responded that it was important to develop a meaningful philosophy of life.
While these characteristics might not sound particularly appealing, social scientists have found highly laudable adjectives that accurately describe the psyche of Generation Y, which include confidence, tolerance, and affability. One writer describes them as “polite, pleasant, moderate, earnest, friendly … no anger, no edge, no ego.”3
So, as with every generation, Generation Y comes with its share of traits that are irresistible and those that are maddening. Eighty million strong, accounting for about one-quarter of all Americans, how can future HM groups adapt to the flood coming down the pipeline?
We can learn from other industries, as Generation Y has been in the workforce elsewhere for years. Companies like Goldman Sachs and IBM figured out how to keep them engaged in their workplaces in a meaningful way, knowing they have high expectations for workplace mentorship/coaching, salary, and advancement, and seek more feedback and decision-making involvement.
I offer a few tangible recommendations; many of these will be beneficial for any hospitalist group:
- Ensure a robust and ongoing mentoring program. Generation Y’ers are more likely to need and thrive from a functional mentor program, where they can seek and receive advice and guidance in regular intervals.
- Ensure that financial compensation, incentive programs, and pathways for advancement are clearly defined. As mentioned above, many Generation Y’ers consider wealth important, so avenues for advancement should be well defined for those willing to pursue it.
- Create non-financial reward systems, such as “Hospitalist of the Month” recognitions based on clinical or other criteria (teamwork, attitude, fortitude). This generation, more than most, has an expectation for recognition and rewards. These non-financial rewards can be easily, appropriately, and fairly built in.
- Utilize information technology to its fullest capacity, and engage them in creating ways of using technology to its advantage, including blogs, Twitter, etc. More than past generations, they are comfortable with and have an aptitude for information technology, and that should be harnessed at the point of care.
- Ensure hospitalists have a firm understanding of the appropriate use of social media at work, and outside it. They are as comfortable with social media as past generations have been with email, and helping define clear boundaries will be of benefit to everyone in the group.
And when you spend a few years getting all your Generation Y’ers settled in, along will come Generation Z.
Dr. Scheurer is a hospitalist and chief quality officer at the Medical University of South Carolina in Charleston. She is physician editor of The Hospitalist. Email her at firstname.lastname@example.org.
- Brown B. Wellesley High grads told: “You’re not special.” The Swellesley Report website. Available at: http://www.theswellesleyreport.com/2012/06/wellesley-high-grads-told-youre-not-special/. Accessed July 8, 2012.
- Healy M. Millennials might not be so special after all, study finds. USA Today website. Available at: http://www.usatoday.com/news/health/wellness/story/2012-03-15/Millennials-might-not-be-so-special-after-all-study-finds/53552744/1. Accessed July 9, 2012.
- Deresiewicz W. Generation Sell. The New York Times website. Available at: http://www.nytimes.com/2011/11/13/opinion/sunday/the-entrepreneurial-generation.html?pagewanted=1&_r=1. Accessed July 8, 2012.