Managing Office Staff Across the Generation Gap


SAN DIEGO — A good office staff is essential for a thriving medical practice, and understanding generational differences is key to finding and keeping good employees, Dr. Larry Anderson said at the American Academy of Dermatology's Academy 2006 conference.

Patient surveys show that roughly 70% of patients who change physicians do so because they feel in some way put off by office staff attitudes. “Unfortunately, the doctors seldom know this,” said Dr. Anderson, who is in private practice in Tyler, Tex.

He stressed that two major demographic trends are converging in a way that will amplify the importance of finding good staffers at the same time as it will become ever more difficult to do so.

The U.S. labor force showed nearly flat growth in the late 1990s, and this hasn't changed much in recent years. During this period the population of younger working people shrank by about 14%.

That's bad news for the 80 million Baby Boomers who will require increasing levels of services, medical or otherwise. Retirees are the fastest-growing segment of the population, but the 20-something workforce is the slowest-growing segment.

“In the next decade, we're expecting to see a 30% shortfall in younger workers, and this will persist for about 40 years,” Dr. Anderson explained.

“During this time our services will be needed more and more, and it will be harder for us to get and keep good employees.” The bottom line, said Dr. Anderson, is that physicians need to see their employees as an asset, not a liability, and they need to develop the sort of office culture and work environment that attracts and nurtures the best and the brightest.

In terms of employer-employee relations, many physicians are now facing what amounts to a significant generation gap. While attitudinal differences between the Boomers, born between 1943 and 1964, and the so-called Generation X, born from the mid-1960s to the mid-1980s, may not be as great as the cultural divide between the Boomers and their Depression- and World War II-era parents, it can be much greater than many people realize, especially when it comes to matters of career and identity, Dr. Anderson noted.

Gen-Xers tend to be more skeptical than are the idealistic Boomers, and they demand to know why something is the way it is. They have fewer expectations about finding their fulfillment at work, and they place a high premium on their lives outside their jobs.

Dr. Anderson said many Boomers hold the misconceptions that Gen-Xers have a “you owe me” attitude and that they do not want to work hard. Both of these are untrue. In his experience, Gen-Xers are willing to work hard, but they are staunchly unwilling to be exploited, and they are more interested in personal autonomy and their pursuits outside their jobs than they are in building their careers and amassing status symbols.

In terms of work styles, the Gen-Xers tend to be highly independent. “Remember, these are the latchkey kids all grown up. When they were younger, their mothers gave them a list of things they needed to get done, and they learned how to do them on their own, in their own way.” They carry this general approach into their professional lives. They want to know what has to be done, why it must be done, and when they must deliver. Beyond that, they want to be left alone.

When managing Gen-X staffers, be aware that they are definitely not impressed by authority unless it is earned and backed by unquestionable competence. This generation has the “question authority” attitude in spades. Do not assume that just because you're the doctor, your Gen-X staff will automatically submit to your vision of things.

“With this generation, rules don't count unless they have input and understand the rationale,” Dr. Anderson said. In managing Gen-Xers, it is best to give them guidelines, while at the same time letting them into the planning process and allowing them to figure out the implementation.

“Fear-based management doesn't work with them. They respond to that with an attitude of, 'Fine, fire me!'” Remember that Gen-Xers grew up in a time of unprecedented job mobility and career flexibility. They don't expect to work at any one company or office for their entire adult lives.

Gen-Xers are nearly allergic to office politics, and they resent favoritism and nepotism. They react badly to micromanagement, and they dislike it when their ideas, opinions, and suggestions are categorically ignored. They prefer direct communication to indirect messages and layers of bureaucracy. Gen-Xers despise being treated like children, so at all costs, avoid resorting to a “because I said so!” stance. They simply will not buy it.


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