Sorry, you're going to have to endure me twice in a row. So now we're going to shift gears a little bit, but oops, no, this is still the same one. The next one, yep, there you go, perfect. Now we're going to shift gears and we're going to talk about generational differences in practice. This is obviously a fascinating topic for everybody, right, and the greatest, the biggest news for me this year is that I'm going to become a grandfather. So I'm going to, in a couple of months, I will have, I guess it would be a generation alpha in my family. So that would be another generation that I'll have to figure out, I guess, but clearly we've seen in the workplace very different generations, and you've always heard somebody comment about the next generation, so we'll talk about that in practice. No financial disclosures again, and what we'll do is we'll start with an introduction about a little bit about some basic concepts about generations, and I will point out some generational differences, but at the end I'll talk about the bottom line, and the bottom line I'll give you the preview, the spoiler alert, is that we always focus on the differences where we talk about where people come from or the generations, but what really matters at the end is always the same. So the bottom line is that recognizing these differences is important, but at the end what people really want is very similar. So as a matter of introduction, this is fascinating to me that generational tension is not new. It is absolutely one of those things that has been around forever. This is a 3,000-year-old tablet that says, today's youth is rotten, evil, godless, and lacy. It will never be that youth, it will never be what youth used to be, and it will never be able to preserve our culture. Talk about becoming your parents, right? But basically people have been saying this forever, right? So there's nothing new about generational differences. It's just that we now have all these fancy names for it, and we talk about it a lot more probably in the workspace, because the knowledge work economy is so diverse and so dynamic. But what defines a generation is usually a time period, and these are sort of arbitrary. You can look at 10 different places and they'll say that the boomers are from different years, but it's the same time period, right? It's not like an exact science, like this year to this year, but what really defines how we think about that generation is the major world events that they went through. What is very interesting is that when you look at generational differences, for a long part of history, they were very local, because what people lived was very local. As we've become a much more global society, what people experience now is more global. So the impacts of COVID were worldwide, but that's going to define Generation Z, right? The impacts of the 2008 recession were worldwide, and that might impact the millennials, right? So I think that we're seeing that events that are shaping generations are much more global than they were in the past. In terms of the generations in the workforce, and there might be some extremes here, but in general, healthcare right now, you have the traditionalists, who are usually 78 and above, baby boomers, high 50s to mid-70s, Generation X, 40s to mid-50s, millennials, mid-20s to 40s, and now we have Generation Z coming up front, which a lot of us might have kids that are in that generation, but also there might be some students or some early people who are starting their careers who are working in that generation. I think that the next generation is alpha, but unless you're very, very gifted, I guess you're not working these days in healthcare in that generation. Now if you look at what's going to happen next year, 2025, it's going to be the distribution of generations in the workforce, and by far, millennials are going to be the predominant generation in the workforce. That is just the way things are moving, and just to recognize that, I think, is important. Ten years ago, or five years ago, there was a lot of talk about millennials this, millennials that. Well, now they're going to dominate the workforce, and I'm sure they'll start talking about Generation Z and how bad they are, and how they don't do this, and they don't do that, but that is really just the way it goes, but on the other hand, I think that we need to also acknowledge that there are tremendous benefits of diversity in generations at your ICU, right, or at the workplace. I don't know if you guys saw, I think this is a Robert De Niro movie, I think it's called The Intern or something like that, but it has some interesting things, right? When you have different generations in the same team, you bring different skill diversity. It opens the mind to different ways of thinking. There can be mutual mentorship. Mutual mentorship, a lot of times, I think, is felt to be unidirectional. I'm the person with the expertise and experience, I'll mentor you. Well, it can go both ways, right? I mean, younger generations can teach you maybe on technology or other things, so I think that mutual mentorship is probably a much more beneficial relationship. Improved decision making, there is no question that cognitive diversity improves decision making. Cognitive diversity can be based on age, gender, race, ethnicity, background, right, but that's what we're looking for to make better decisions, and then as a practice, as an ICU, as an organization, I think the more diverse you are, it definitely gives you a competitive advantage in attracting people who are diverse and who might be interested in working in a place like yours. So let's talk a little bit about generational differences. There are some, and I think a lot of it has to do with how they grew up, right? So here you can see traditionalists experienced World War II, right? There was rationing, the explosion of rock and roll, and the signature product was the car. Their attitude to technology was largely disengaged, and they aspired to own a home. That was their dream, right? Baby boomers, Cold War, the 60s, right, big event, I mean Woodstock, the product or signature product was the TV, right? They were early maybe IT adapters, but ultimately what they thrived for was job security, and a lot of baby boomers have had one job for their whole life, right? That is, I mean, kind of how they were brought up. Gen X, end of the Cold War, the Berlin Wall falls, the first PCs show up, right? Early mobile technology, from a music perspective, Live Aid, I guess, and the signature product was the personal computer, right, which started with very rudimentary computers that could do nothing to what we have today. So they were digital immigrants. They were the ones who played with the first Ataris, right, then I mean started with computers, and they also saw their parents probably work a lot and say, well, I want to do more work life balance maybe. Millennials impacted by 9-11 or post-9-11 war, social media exploded during that era. Reality TV, which didn't exist before, what is their signature product? It's the handheld, the phone, the smartphone, right? They're digital natives. They had an iPad or something from an early age, and they look for freedom and flexibility. Now we have Gen Z, which is being shaped, not a lot of them in the workforce, but a lot of us might have relatives or kids who are in that generation. They are worried about the economic crisis, global warming, cloud computing, COVID-19 impacted them at a very formative time of their life, right? I have a son who finished high school and went to college during COVID, and it was a disaster for him, right? I mean, so I think that clearly they have an impact that we didn't have, and they're technoholics. They basically live with technology from the moment they remember, and they're looking for security and stability. So as you can see, there's differences, right, in how these generations are formed, but also how the world around them is functioning, right? And it's important to recognize that because of all that exposure, they might learn different. And this is important also for patients. How do you convey information to your patients? How do you convey information to your trainees? How do you teach old dogs new tricks, right? And these are just some of the differences. You can look at the different generations, baby boomers, Gen X, millennials, and they might have preferred learning styles a little bit different. Some people prefer verbal instruction and face-to-face communication. Some people prefer active engagement and interacting in a social learning situation. Generation Y now is moving towards, or millennials, to technology-based learning. They'd rather do it at home. It's the same thing with the Gen Zs. And then also their ability to consume information. Some people like to read a book, or people just give me a TikTok, give me a tweet, give me a short video, right? And just recognizing that is important because when you're trying to disseminate information, we talk about this in the lead committee, you want to do it through different vehicles because different people will gravitate toward different things. Some people might like a short video, some people might like just a short infographic. Other people want to read something or want references. And just recognizing that there might be differences that are mostly probably created because of how you grew up and how you grew up learning, right? When I went to school, we eventually had PCs, but nobody had an iPad, right? I mean, that was not something that was around. But now, I mean, kids from kindergarten, I mean, are learning or playing on iPads. And this has also led to some work-related differences. And your life-shaping experiences might influence your attitude towards your career. So traditionalists and baby boomers were really jobs are for life, and the organization defined your trajectory, as opposed to Gen X, which is much more loyal to the profession but not the employer. Millennials are much more entrepreneurial, they don't really care about moving so much. And Gen Zs are basically multitaskers and side hustles, right? They are probably getting educated for jobs that don't exist yet, right? And they will end up doing things that are not even on their radar right now. Very, very different. And this also probably influences what are the values that are most important to them, right? I mean, if somebody has different values, it doesn't mean that they're worse or better, just have different values, right? And traditionals are very loyal, baby boomers are very goal-oriented, Gen X is very efficient and productive. Trying to find that work-life balance, but when kind of like the, I work hard and play hard, right? But you find that balance. Millennials are more about meaning and using their creative skills. And Gen Z is really about authenticity and connectivity, they're much more concerned with social justice. So as you can see, these have influenced the type of worker they become, they influence the preferred work environment that they want, and we're seeing such a change right now. Even I think about, I was just talking with Steven, five years ago, pre-COVID, if you did a Grand Rounds somewhere, you would go there and give Grand Rounds. Now like doing it through Zoom is like very acceptable and the new generation doesn't even blink if it's on Zoom, right? That's what they expect. So I think that even when you think about the future of Congresses like this, as things evolve, where are we going? And I think it has to do with the shaping experiences of the newer generations. So this is, I think, something that's very important. It's communication preference and understanding how to communicate important things to colleagues and understanding that not everybody's going to receive or respond in the same way to a communication vehicle. So traditionalists are really, they want it written and they want face-to-face meetings. Baby boomers want verbal, personal interaction. That's the type of people that pick up the phone and call me, right? Gen X, a lot of things by voicemail or might send an email and they think the email's okay. But for some things that you have to make critical decisions, might prefer a face-to-face. Millennials are about text and email, right? And maybe for some reasons face-to-face. And Gen C is about FaceTime. And think about it, when I asked my Gen C son, what did you do last night? Oh, I hanged out with my friends. Okay. In my world, that means that my friends came to my house and we hanged out. In his world, it means we're all connected virtually, watching a movie or playing a video game, right? And again, I mean, it's just how they see things differently, right? Like for me, it's very important that if it's somebody's birthday, pick up the phone and call them, right? For Gen C, it's like a text or a quick video and they're done, right? That was perfectly acceptable communication. So just realize also that when you're disseminating things, if you only use one vehicle, it might not be received in the same way by a team that has different generations. So very important. So what's the bottom line? What can we do actually to make a difference? At the end of the day, what do we want at the workplace? We want engagement, right? This is prescany data up to last year, and when you look at all employees and multiple business environments versus physicians, which is what I had, you can see that over the years it's gone down. We had a little bump at the beginning of COVID, right, after 2020, which is when people were recognizing our job, but that quickly fell down, but the truth is that overall, levels of engagement have moved in the wrong direction, and we want to have more people who are engaged at our workplace. So what engages all generations? Purpose, autonomy, and mastery. Making sure that they understand what the purpose is, right, for our jobs, what we're trying to accomplish, that we give them the autonomy to make decisions of how to use their skills to make a difference in the life of other people. Autonomy does not mean that you do whatever you want. Autonomy means that you're empowered to make decisions that make a difference within certain structures. So we all have structures that we have to follow, and then what I think is most important, and the reason why you're all here, is as long as you're learning, you're more likely to be engaged, right? So that pursuit of mastery, of always learning new things, I think is very, very important, and we should not only look at it for ourselves, but try to provide it to all generations, and they might want to learn different things, and that's where mutual mentorship might be great, right? You might teach a technology, and you might teach them communication skills, right, but it can go both ways. Individuals are not generations. We use generations in a very stereotypical way, and there might be some truths based on what they experience as a group and the world around them, but the truth is that if you want to engage people, you've got to engage them at the individual level, right? And this is a Gallup data that for me is just very, very, very clear, and I think it also plays very well into our next session that Kwame will do about playing to your strengths. When managers and leaders pay attention to the strengths and interests of an individual, they're 60 times more likely to be engaged. When you pay attention to them but talk a lot about what you can do better, so weaknesses, they're twice as likely to be engaged, but if you don't talk to them at all, they're 20 times more likely to be disengaged, so that I think is a very important message for us, right, that not only we should engage with our individual team members on a regular basis to try to help them grow, but we should really be playing to their strengths, right? What are the things that you like to do? What can you do better? There's obviously certain things that you have to do to be part of the team, but that's separate, right? But when we're trying to grow, really focus on what they do well, where they can contribute the most, and they're much more likely to be an engaged member of the team, and that really goes across generations. The bottom line I think is understanding what different generations have been through and what they value is important, so empathy is really, really valuable as a leader in a team that has multiple generations. I think curiosity is very important, right, to understand what people are doing, why they do it, why they find it interesting, right? I think it's important at the workplace as it would be at home to understand what do they enjoy doing, what do they like, why, what do they think the way they think, to ask more questions, and I think finally as a leader, humility is probably the most important attribute that you can have, and recognizing that no matter what generation they are, both extremes, right, because we always tend to be, I think, dismissive of the extremes, they know something that you don't know, and that you should try to learn that, and you should try to share with them what they don't know that you know, and I think it's a great way to build the team. So we talked about the fact that generational tension has been around for a long time, and it's nothing new, and it's not going to go away, right? But there are some differences from generation to generation, and a lot of it has to do with the world in which they grew up, and I think recognizing that and appreciating that has value. But finally, the bottom line is recognizing that there might be some small differences, what really engages people and makes fulfilling careers very similar throughout generations, and we should really strive towards that.

generational differences

workplace impact

communication styles

engagement strategies

fulfilling career