For several years, the corporate world has been in a bit of a tizzy trying to define, recognize, analyze, and find a way to attract and retain what they refer to as “the Millennials.” The term refers to the newest generation entering the workforce, also known as “Generation Y,” which is forcing companies to spend billions of dollars in turnover costs because they can't seem to keep them.
Books have been written on the topic, webinars are all over the Internet, and just in time for the most frantic job market in emergency medicine, along come the millennial physicians who make it doubly difficult to hire and retain staff in the ED. This generation was born between 1980 and 1999, primarily children of the Baby Boomer generation. Millennial emergency physicians began graduating from residency last year, during the onset of the most wide-open job market the specialty has ever seen. With as many as five positions for every residency trained emergency physician in large areas of the country, graduating residents are a hot commodity.
And that's the problem. The bulk of employers don't know what the new generation wants, and they are applying old hiring techniques with a high failure rate. Even more unsettling is that those who hired a 2010 graduate will have a difficult time keeping him on board, as will employers who hire graduates over the next 10 years.
“The Millennials are coming! They're well educated, skilled in technology, and very self-confident. They bring to the workplace high accomplishments and even higher expectations. Millennials move fast, and want to be challenged. What's more, they're not loyal to employers like their Baby Boomer parents were,” according to the 2009 book, Keeping the Millennials, by Joanne G. Sujansky, PhD, and Jan Ferri-Reed, PhD. And that's just in the first few pages. They go on to say this new generation puts a strong emphasis on work-life balance, in some cases even more than money. And make no mistake about it, money is a very big issue with this crew.
I've worked with graduates since 1991, and the changes over the past 20 years are vast. Emergency medicine residents used to have career goals set on shreddable paper. My usual experience with a graduate in the '90s went something like this:
September: “I simply have to have a job in Colorado because skiing is my life.”
October: “My friend just interviewed for a job in Texas, and they are paying really high dollars. Can you get me that in Colorado? No? Well, what do you have in Texas?”
November: “That job in Texas sounded great, but my wife wants to go to Vermont near her parents. What have you got there?”
December: “Oh, you got me an interview in Vermont? Gee, I just signed on a job in Michigan.”
Nowadays, it's a bit different. They say, “I will look at only partner-potential positions in the states of Illinois and Wisconsin where our families live. I require a fully computerized ED, proximity to a major airport, high-level schools for the children, a fully funded maximum retirement plan, and a minimum of $300,000 the first year. Oh, and if you can arrange loan assistance, that would be a plus.” This is a sample conversation that took place in June, before the job market for the upcoming season even got started.
This year's newest physicians and those who will be graduating over the next decade or so are a lot less clueless than their predecessors. They are more aware of what will be available in the job market, and they know how much in demand they are. And they are quite prepared to take full advantage of that. Just as important as knowing what they want, they know what they don't want.
Because we are hip-deep in a candidate-driven market that appears to be set in stone for the foreseeable future, the needs, desires, and whims of this generation of emergency physicians are important to potential employers. Can anyone satisfy them all? Of course not. But they can prepare now to make changes and updates that will make the difference between having a 50/50 chance of attracting and retaining a talented graduate and little to no chance at all. We'll look at what some employers are already doing, and what others may find affordable and effective. Some of these alterations will need to be in the way physicians communicate with each other and with patients. Some will affect a physician's time off as much as their time working. Compensation methods will also come into question.
Be advised, however, it's not all about employers adapting to the millennial physicians; those physicians have a new set of shortcomings that will need to be addressed and handled as well. Case in point: Interpersonal and verbal communication skills have taken a nosedive in a generation raised to communicate by device. Texting a patient or a family member is hardly as effective as looking into the eyes of a father or spouse and talking about their loved one.
In preparation for this series, I created a three-page questionnaire, and distributed it to the program directors at all the allopathic residency programs in the country asking for participation from graduating residents. I was astounded at the level of response. Of approximately 1,400 residents across the country, I received an 11 percent return rate, and more are still coming in. The survey covered their priorities, preferences, and communications. I will share the results next month. In the meantime, I have been doing interviews with a random sampling of residents that will help flesh out this whole scenario.
There is one more important factor that is going to have a resounding effect in emergency medicine and the corporate world. According to an article in the July-August issue of The Atlantic, “The End of Men,” “women became the majority of the workforce for the first time in U.S. history. Most managers are now women, too. And for every two men who get a college degree this year, three women will do the same.”
Let me amend my earlier statement: Here come the Millennial women! The days of expecting female emergency physicians to put career first or suffer the consequences are over, but more on that next month. In the meantime, I suggest all employers take a look at the opportunities they have to offer a resident, and analyze what's hot and not so hot. The key word is and will be flexibility.