From Boomers to Gen Z: Navigating Generational Differences on Health Care Teams

We’ve all heard the stereotypes—passed on through jokes or gritted teeth—about the different generations. “Baby boomers are stuck in their ways and reinforce hierarchy.” “Gen Xers are off on their own playing a video game.” “Millennials think they should have it all but don’t want to work for it.” “Gen Z thinks the world exists on a smartphone screen.”

Are these stereotypes helpful? Of course not. And the year we’re born is only one of countless factors that shape who we are. Yet our age and everything that comes with it—world events, cultural trends, and technologies, to name a few—influence how we’re raised and see the world. And we bring all of that to our work.

We chose to write about the topic of intergenerational teams because we think about it and talk about it a lot. The CAPC team, like many health care teams, ranges in age from colleagues in their twenties to those in their seventies. To be effective, we need to leverage that age diversity for its strength while creating an environment that can accommodate the different styles and expectations of the group.

We’ll start by sharing our own experiences with generational differences in the workplace.

"I’m on the cusp—I am an “elder Millennial.” But I was raised in a Midwestern farming family where you were judged using a traditional yardstick: how hard you worked, how respectful you were to your elders, and whether you delivered on practical tasks. As an adult professional, I found this set me up to identify more with my older colleagues and managers than with many of my fellow Millennials. Over time, I’ve seen younger Millennials and now Gen Zers enter the workforce with different expectations than I did—where I had been taught to put my head down, produce, and not ask questions, my younger colleagues seemed to feel more empowered. If they were bringing their time and talents to an organization, they wanted the culture and benefits to meet their needs. Some days, I feel admiration and am envious about this, and some days, I’m exasperated. And often I feel like a generational buffer—translating between the generation before me and the generation behind me—and trying to bridge the gap."

"I’m definitely in that baby boomer, 1960s, save-the-world generation. We believed in our agency and our ability to accomplish things through hard work, persistence, and determination. I personally experienced the power of taking action—protesting and ending the Vietnam War in the 60s and 70s, marching for civil rights, and, miraculously (at the time) being part of the first generation that allowed women to pursue expertise, become professionals, and lead. Coming from that context, for me, the roles and responsibilities of being a clinical health professional always felt like a calling.

I know that the U.S. health system younger clinicians are entering is not the one I entered—it is less personal and more like a machine—and I can see the impact of that evolution on the psyches and in the work-life expectations of my trainees. When the focus shifts from our patients and their needs to ourselves and our needs, a tension emerges between our professional commitment to patients and our own well-being. The pendulum has swung from a culture of self-sacrifice to one of self-preservation. I worry about what it means for the future of health care—both for patients and for us as health professionals."

The boomer and millennial jokes may be stereotypes, but we’ve all observed differences in work styles across age cohorts. They may pop up in a number of ways in the workplace:

This could include anything from your preferred communication method (whether you like to pick up the phone, send an email, or just write a text or a direct message) to expectations around acceptable tone/formality in professional communications. “That email was cold. She must not like me!” vs. “That email was efficient. She knows I’m busy.”

‘Digital natives’ are people who were brought up during the age of digital technology and were familiar with computers and the internet from an early age. Whether you’re a digital native can have a lot to do with how comfortable you are learning new technologies at work.

Whatever the generation, health professionals who have been in the workforce for decades have weathered organizational ups and downs and have seen culture and policy change (albeit slowly). For people who are newer to the workforce, it can be harder to think along timelines of years or decades—and to believe that change eventually happens!

The fodder for many stereotypes about millennials, this is an issue that crops up in teams from all industries but can be felt particularly acutely in health care settings. Patients’ needs don’t follow a 9-to-5 schedule—and at the same time, U.S. health care is the setting for widespread clinician burnout. Just how much of yourself should you give to your profession? Which boundaries are healthy and which are unrealistic? Whatever you feel personally to be the answer, the reality is that the concept of ‘self-care’ has grown more central in recent decades, and health professionals from different generations may find themselves at odds in their feelings about appropriate work-life balance.

Across industries, the historical mindset was that new employees needed to pay their dues: “Do what you’re told, and hope to advance over time.” Today’s new entrants to the workforce don’t always share this perspective. As one leader shared, “I used to be able to give an order to a young employee and expect it to be carried out at once. Now I have to spend 20 minutes explaining why it’s important.” For a generation that has grown up with technologies that allow for virtually unlimited access to information and communication, this makes sense—but it can feel presumptuous to older colleagues who had to advance through a more rigid hierarchy.

While most health systems and even smaller community-based organizations now have DEI offices or roles, this was not the case even ten years ago. For younger professionals, conversations about the importance of DEI principles—and taking action based on those principles—has been part of workplace culture since they entered the workforce. More seasoned health professionals may have had much less exposure to DEI conversations early in their careers, and some may fear that the implication is they’ve been “doing it wrong” all along.

Of course, all of these examples are generalizations—but our guess is that you’ve witnessed many of them play out in your team.

It’s time for a reality check: every new generation scandalizes or annoys the previous generation. Socrates is attributed as saying, “The young people today think of nothing but themselves. They have no reverence for parents or old age. They are impatient of all restraint. They talk as if they alone knew everything, and what passes for wisdom with us is foolishness with them.” At the same time, each new generation amazes us. You can do what?!

Intergenerational tension is not new. But here are several reasons why age diversity can be a strength for health care teams:

A multigenerational team means having team members who are comfortable connecting with patients across age ranges and can help one another learn about cultural norms among patients much older or younger than oneself.

While younger team members may feel more comfortable integrating new technologies into team workflows, more seasoned team members may feel more confident in a crisis. These are just two examples of the many ways that health professionals from different generations can make a multigenerational team stronger.

Each generation of the health care workforce has been more racially diverse than the last. A plethora of literature demonstrates that racially concordant care (when a patient and clinician share the same race or ethnicity) leads to better patient experiences and outcomes. Diverse teams are also known to be more effective. Net/net: a multigenerational team is more likely to be diverse in other ways, and that’s good for patients and teams.

While the advantages of multigenerational teams are compelling, the challenges are also real. Team leaders need to take into account the different needs, styles, and expectations of team members that span a broad age range. The following principles will help leaders and managers navigate the adventures of managing an intergenerational team:

If age dynamics are coming into play on a team, ignoring the issue won’t help.

As Dr. Megan Gerhardt, co-author of the book “Gentelligence” says, “Just as we wouldn’t expect our actions to be accurately understood or universally agreed with when we travel to other places, we shouldn’t expect our reasons for approaching our work in particular ways to be clear to people who have grown up and started their professional lives at different points in time.”

Managers of intergenerational teams can facilitate discussions that help team members understand where each other is coming from and short-circuit some of the stereotypes that lead to misunderstanding or resentment among colleagues.

We work in the real world, where current events and social movements are happening. How we feel about the world evolves over time and is heavily influenced by our personal exposure to ideas, people, and events—and also often our age. For many health care teams, COVID was a flashpoint that surfaced acute differences in opinions and perspectives across teams.

Teams that are explicit about their shared values—such as safety, respect, and quality patient care—are better able to build the psychological safety needed to acknowledge differences while continuing to work side by side.

Some younger employees may be hesitant to contribute to a discussion for fear of sounding arrogant or impertinent in front of more experienced colleagues. Others may feel more comfortable jumping in than team members from an older generation who “grew up” professionally in a culture that was less welcoming of feedback. As a manager, it is important to observe these patterns in your team and actively work to elicit and balance the voices in meetings.

Communication styles and use of technology are two areas where generational differences are often most apparent. And let’s face it—sometimes, as managers, we need to pick a solution and stick with it, even if not everyone loves it.

For example, consistent use of one communication technology, whether that’s chat, text, or email, means your team won’t miss anything). But in other cases, flexibility for age-related (or just personality-related!) preferences may be just fine and highly appreciated by your team. Does everyone have to represent the team on social media, or wear an ugly sweater to the holiday party? Nope.

There is a growing and helpful body of thought on successful intergenerational teams for interested leaders to explore:

• Harvard Business Review: How to Manage a Multi-Generational Team
• The Center for Leadership Studies: 5 Tips for Leading Multigenerational Teams
• Nurse Leader: Generational Differences in the Nursing Workforce: Strategies for Nurse Leaders