Generational Change in the Healthcare Workforce: Perspectives from Health System Leaders

The healthcare workforce has never included so many different generations, creating both important opportunities and vexing challenges. Little is known about how health system leaders conceptualize generational differences among clinicians, respond to mismatched expectations, promote patient safety despite employee turnover, and minimize conflict.

The authors conducted semistructured interviews with 17 key informants in executive leadership roles, including chief officers for operations, medicine, nursing, human resources, and academic affairs. A qualitative analysis using a thematic content approach was performed.

All participants and their institutions were wrestling with tensions arising from a multigenerational clinical workforce, including differing perspectives on complex issues such as burnout, well-being, and clinical expectations. Some issues represented aftershocks from major events or trends, such as trainee duty hour regulation, the corporatization of medicine, and the COVID-19 pandemic. Respondents described both reactive and proactive adaptations, and expressed interest in developing organizational frameworks and solutions to minimize intergenerational conflict around work duties, manage end-of-career transitions, and address issues caused by rapid employee turnover. Human resources professionals demonstrated expertise in managing turnover and benefits but felt underutilized by clinical leaders.

Generational change in the healthcare workforce is an urgent but understudied area for clinical and safety leaders, given worsening stresses on the healthcare system. Respondents recommended strategies to enhance the value of multigenerational workforces, including tighter collaboration with human resources professionals, new retention strategies for early-career clinicians, and creative job design for senior health professionals.