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Journal of ASPR - Winter 2013 - A physician’s perspective: Why are Generation X and Generation Y phy
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A physician’s perspective: Why are Generation X and Generation Y physicians so non-committal?

By Ashok K. Tyagi, DO, MBA, Co-Medical Director, Critical Care department at McLaren - Greater Lansing, Founder,

Ashok K. TyagiA lot has been written about the physician shortages expected in the coming years, especially in the face of healthcare reform. Several new medical schools have opened throughout the United States, medical class sizes are increasing, and furthermore, physician assistants and nurses are developing new skills for the predicted healthcare shortages. As 10,000 baby boomers retire each day for the next 19 years, healthcare needs are predicted to rise. Healthcare organizations are preparing to meet the needs of this populace, and physicians are at the forefront of delivering these needs. The challenge for many healthcare organizations has been the lagging supply of physicians to meet their demands. Subsequently, healthcare organizations are vying for physicians to meet the needs of their community, resulting in ample opportunities for physicians. However, an unintended outcome has resulted from the addition of healthcare jobs: physicians with a lack of loyalty to the healthcare organization. Several pundits have weighed in on this issue and have shared their views:

  • “GenXers watched their parents or their friends’ parents lose jobs after long commitments to organizations.”
  • “Younger physicians are seeking a more balanced lifestyle, and they are not willing to trade money for it.”
  • “Xers’ idea of loyalty toward the employer is giving the employer two-week notice.”1

The pundits must be right! After all, statistics do not lie — an average physician leaves his or her first job approximately 2.4 years after joining. This must be due to the lack of commitment attributed to Generation X and Generation Y physicians…, right? I beg to differ. So then, why are Generation X and Generation Y physicians so non-committal? Is there any credence to this claim?

According to research1 Generation Xers and Generation Yers reported wanting to stay with their current organization for the rest of their life at a mere 40% and 20%, respectively; however, this was only part of the equation. The same article cites that Xers and Yers were not found to change jobs more frequently than their older counterparts did at the same age. Furthermore, the frequency at which individuals change jobs may be related to the economy, as people are more likely to change jobs if the economy is good and opportunities are numerous. Finally, younger workers typically hold several jobs while still studying, but tend to stabilize with one employer as they get older.

Being a healthcare system-based Generation X physician, I can speak to the complexity of employee-employer loyalty in the current climate. Multiple factors contribute to increasing employees’ loyalty, including:

  • Opportunities for advancement and promotions;
  • Opportunities to learn new skills;
  • Higher salaries or benefits;
  • Company values matching their own;
  • Ability to respect the wisdom of the old/respecting the young for their talents.

I would contend that the physician workforce is similar to the general public. Younger and older physicians are looking for a place to be valued for their talents and experiences. Loyalty has less to do with the generation in which the physician was born than with the trust and support provided by the healthcare organization. Generation Xers and Generation Yers are no different from previous generations in looking for a safe place to practice. As good will develops between the physician and the organization, retention rates, job satisfaction, and common vision will fall into place.

How then, do organizations begin to develop good will with Generation Xers and Generation Yers? Organizations can start by creating an onboarding program. This helps new physicians integrate into the community quicker and results in an earlier financial benefit for the organization. Onboarding programs begin at the first contact with the interested physician candidate. An organization can share its culture, mission, expectations, and responsibilities of a position and determine mutual interest. Clear, direct communications regarding practice specifics establish a trusting working relationship. Furthermore, assigning a physician mentor early on, as part of the onboarding program, will improve workplace satisfaction and successful integration into a new work setting.

Carefully plan the assimilation of new physicians into the community at large and the medical community. Attention to detail, such as information to the physician’s spouse and family regarding job opportunities and schools, are a must. Ensure that any promises made have been kept or plans discussed have been implemented. Seek the new physician’s input regarding the process of integration. Encourage open dialog at any time and meet with your new physician at 30, 60, and 90 day intervals and again at 180 days. Listen to them and take the opportunity to improve best practices based on feedback received.

Finally, celebrate your mutual milestones — first year, second year, and everything else in between!


  1. Deal, J.J. (2007). Retiring the generation gap: How employees young and old can find common ground. San Francisco: Jossey-Bass

Related Reading

  • Tolbize, Anick. Generational differences in the workplace. August 16, 2008.
  • Jenkins, J. (2007). Leading the four generations at work.
Journal of ASPR - Winter 2013

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