Transition from Resident to Attending

OK Boomer, MD: 4 steps to better communication across generations

Brendan Murphy , Senior News Writer

Communicating across generations in any setting can be challenging, as the emergence of the divisive “OK Boomer” meme goes to show. Medicine is no exception.

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For a study published in the journal Cogent Social Sciences, researchers examined how physicians from different generations can effectively communicate. They interviewed a small number of Swiss physicians across the spectrum of age and experience and also looked at literature on multigenerational workplace settings and leadership communication.

For the study, researchers looked at dynamics between baby boomers (those born before 1965), generation X (born between 1965–1980) and generation Y, also commonly referred to as millennials (born between 1981–2000). The youngest generation in the physician pipeline, generation Z, was excluded because many are still in training.

While the study’s sample was small and there are structural differences between systems of care across countries, some of the takeaways may be applied to help create more cohesion across the spectrum of physician practice in the U.S. Researchers outlined four key themes that can create better cross-generational communication: increased transparency; a flattening of the physician hierarchy; a need for feedback; and more effective leadership communication.

As a millennial practicing with physicians from older generations, Ricardo Correa, MD, offered his thoughts on how these communication patterns play out on the wards.

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The study’s authors highlighted that physicians from the millennial generation grew up with open, almost instantaneous access to information. Because of that, they want access to all key data points and also want to be made a stakeholder. By contrast, the study labels physicians from older generations as digital immigrants who gained much of their knowledge by working under more senior physicians.

“I have seen situations where physicians from a different generation practice based on expertise,” said Dr. Correa, program director for the endocrinology fellowship at the University of Arizona. “And sometimes these physicians have been practicing for 30 years. But that doesn’t mean they are correct or that they are practicing medicine with the best available evidence. If you are offering a different idea, and you are correct, you still have to tell people in a professional way.”

Physician training is naturally hierarchical. Millennials don’t simply want to learn via observation, the study’s authors contend. They want hands-on coaching. A flattening of the hierarchy also manifests itself through an increased willingness to ask why. “When I started my career, it was difficult for me to ask multiple questions to my senior colleagues,” Dr. Correa said. “I was afraid that the perception would be that I didn't study or I don't know. To me that perception has changed. If you don’t understand things or see a different way to do it, it’s perfectly fine to ask a question.”

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According to the study, 42% of workers from the millennial generation would like weekly feedback. That desire is in contrast with the way baby boomers and physicians from generation X were treated early in their careers. For them, feedback was largely punitive.

“Feedback is something we had to ask for early in our careers,” Dr. Correa said. “If you were getting feedback it was like you were doing something bad and that’s why. That has changed a lot. Feedback is being given because everybody wants to improve.”

Millennial physicians have an interest in hearing from leaders, and they are best served, the study’s authors wrote, by improved communication skills from physicians in leading positions.

From Dr. Correa’s experience, barriers in communicating with key decisions-makers at the specialty level are usually created by time, not attitude. His advice if you do want to speak to a leader: Don’t hesitate.  

“There are still many physicians, when they start their careers, they are afraid to talk to people in leadership positions at the hospital,” he said. “I come from a setting where I really don't care if you're the CEO. If I have to tell you something, I will send you an email and I will make an appointment with you. It will probably take me three months because you're busy, but I will make the appointment and I will talk to you.”

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