If health care leaders are to build a resilient system and leave a legacy, mentorship of millennials should be a top priority. Mentorship also provides a benefit to older physicians.
ABSTRACT: Millennials will comprise the majority of the U.S. workforce by 2025. If current health care leaders are to build a resilient system and leave a legacy, mentorship of millennials should be a top priority. Organizations offering mentorship for their youthful physicians also provide benefit to their older physicians by exposing them to insights about the evolution of the health care marketplace with millennials as consumers.
Many U.S. health care leaders are baby boomers, born between the mid-1940s and mid-1960s. However, a recent American Health Association report of leading health care institutions showed that the percentages of baby boomers and traditionalists (the preceding generation) have steadily decreased in the workplace.1 While the percentage of Generation X (the generation that followed baby boomers) health care professionals has remained flat, the percentage of millennial (born between the early 1980s and late 1990s) health care professionals is growing and is now the largest generation in the industry. Despite this growth, few millennials are in leadership positions in health care firms.
As in other industries, health care firms now find themselves competing to attract and keep millennial talent. Millennials are interested in mentorship, actively seek mentors and will look for new jobs if mentorship isn’t available for career advancement.2-8 Investment in the effective mentorship of millennials thus becomes important for health care organizations to build a robust leader pipeline.
The recent business book Your Network Is Your Net Worth proclaims that building a network is essential for success.9 This approach is well-suited for millennials, who grew up with social media and “Internet 2.0,” which emphasizes collaboration. This approach also is essential for rapid and continual integration of millennials into an organization’s social structure. Although millennials often are characterized as requiring excessive attention and praise, they can be thought of collectively as being inherently social with a natural desire to collaborate.
Preceding generations came of age in times when information was warehoused in libraries, multivolume encyclopedias and telephone books. Research and information-gathering often were solitary tasks pursued through print. By comparison, millennials are apt to ask a friend or use a search engine for a rough-estimate answer to an inquiry. Millennials recognize that as a network broadens, so does access to expertise.
More than previous generations, millennials were enrolled in multiple extracurricular activities as children, and structured activities often replaced free play, with de-emphasis on winning and losing. Senior business leaders can thus help millennials in the workplace to think beyond rigid confines and realize that many solutions require thinking outside of the apparent ground rules.
Millennials engaged in this manner will be encouraged to challenge the norms in the same way that baby boomers once challenged social norms of race, gender and sexuality. Such thinking, combined with the vigor and innovation of millennials, equate to the development of leaders optimally equipped to lead competitive firms, particularly in health care, where the landscape is evolving with uncertainty.
The T-Shaped Model
In a traditional health care paradigm, physicians are asked to be the best caregivers they can be while administrators take care of financial and operational logistics. In the current, rapidly evolving health care system, physician leaders are tasked to both deliver care and build efficient and sustainable systems. However, the skills necessary to build and improve systems are not generally included with the subject matter expertise physicians acquired throughout their medical education and during residency and fellowship training.
In 1991, Guest10 first described the expertise required for effective leadership as “T-shaped skills.” The descriptions later were disseminated by Brown and other experts.11,12 The vertical bar of the “T” represents the deep subject-matter expertise that everyone needs to succeed in a field or practice. Physicians and scientists obtain these skills in medical school and residency. The horizontal bar of the “T” represents “the ability to collaborate across disciplines with experts in other areas and to apply knowledge in areas of expertise other than one’s own.”13
The T-shaped model has been used as a metaphor to explain the full set of skills that leaders need to be successful. Physicians and scientists in leadership positions must have in-depth and widely respected subject matter expertise (see table). However, today’s collaborative and interconnected delivery systems require all successful leaders to develop the horizontal part of the T-shaped model by practicing skills from what traditionally has been considered the business side of health care.
That said, the most valuable physician leaders possess a comprehensive understanding of business concepts, such as operations, strategy, finance, marketing and organizational structure. Seasoned leaders who have leveraged these domains and can help others learn to do the same are connectors. Connectors are invaluable as mentors and can teach millennial physicians how to develop and nurture these business-related skills.
Given the evolving nature of health care, the need for physician leaders to develop a T-shaped skill set, and the social and collaborative characteristics of millennials, health care organizations need to consider nontraditional means of mentorship.
Many companies are adopting “reverse mentorship” strategies to better incorporate millennial ideals and practices into their firms while simultaneously developing future leaders.
First popularized in 1999 by former General Electric CEO and chairman Jack Welch, reverse mentorship involves pairing senior executives with junior associates to bridge generational knowledge and cultural gaps and to empower leaders.14 UnitedHealth Group recently rolled out a reverse mentorship program with an average age gap of 25 years between eight senior executives and eight emerging leaders.15 In addition to leadership training and exposure obtained by the younger half of this cohort, the program is intended to improve innovation and to influence the workforce to adapt to the growing presence of millennials in the health care landscape.
A cynical person might alternatively describe the concept of reverse mentorship as simply listening to and obtaining feedback from employees throughout an organization, including frontline staff, new employees and staff members who do repetitive tasks that require fewer technical skills. However, learning someone’s passion, motivation and goals while simultaneously providing him or her with advice and guidance is an invaluable process that takes time and commitment. When completed in a two-way manner, both parties come away enriched and more knowledgeable.
This process in practice over time is reasonably considered two-way, or reverse mentorship. Helpful resources have been published on this topic.16
The reverse mentorship model has clear benefits for health care organizations and millennial physicians. The group that usually holds power and seniority in a medical organization likely has been waiting 20 years or more to be in a position of influence. Often, these leaders have ideas and goals that coalesced earlier in their careers and when they were at their peak energy, enthusiasm and drive. Those ideas may reflect outdated medical or financial constructs, however, and might no longer be optimal or efficient because they were conceived in what is now an obsolete reality.
Engaging millennial physicians is essential to evaluating and cross-checking long-held ideas and plans to ensure they are developed in a way that enables both current and future success in an evolving health care landscape.
Other Mentorship Methods
Reverse mentorship is not the only way firms look to engage and develop millennials’ leadership talent. Other atypical, generation-specific forms of mentorship include group mentoring and anonymous mentoring.
Done both longitudinally and in peer settings, group mentoring involves dissemination of ideas and concepts among peers and through various modes of communication. Group mentoring can reduce the costs of time and training. In anonymous mentoring, mentees have electronic access (primarily online) to an anonymous senior executive outside the mentee’s firm for six to 12 months. Such a relationship appeals to the technological, high-yield characteristics of millennial employees.2
Medical training programs and specialty professional societies often are fertile ground for both types of mentoring, which also can be thought of as distance mentoring. The highly subspecialized nature of medicine has made traditional apprentice-style mentoring difficult in health care organizations because young physicians often find themselves as unique members of a care team by the end of training, if not immediately thereafter.
This can be detrimental to the natural, de facto transmission of leadership skills and career development inherent in close relationships of the past between early career and seasoned-expert physicians. Distance mentoring remedies this challenge by eliminating geographic barriers and mentor time constraints.
Integrating Millennials into System
As health care evolves, physicians increasingly are becoming employees of large, integrated health care delivery systems.17 Similar to firms in many other industries, these systems are in markets where competition exists for both market share and the attraction and retention of talented workers. Millennials are entering health care as consumers as well as employees, and they are cost-conscious, concerned about convenience, reliant on technology, and interested in crowd-sourced opinions.18,19 Similarly, millennial physicians heavily rely on technology and digital resources and overwhelmingly favor a collaborative approach to care for patients.20
To remain competitive and profitable, health care firms must be welcoming and desirable to millennial physicians and patients. An easy way to meet this challenge is to prioritize mentorship of millennial physician leaders and to integrate their views and values with traditional health care culture.
We recommend health care organizations offer mentorship with new physician onboarding, particularly for those deemed to be potential future leaders. At Mayo Clinic, all newly hired physicians are assigned a mentor called a “buddy” to assist with the adjustment to organizational culture and practices. This mentor usually is a physician who has spent a considerable amount of time within the Mayo Clinic system.
Not surprisingly, baby boomers tend to serve in this capacity, and they are encouraged to do so by organizational leadership. In times where a young physician is identified as a potential future leader within the organization, the selected mentor can be a nonclinical administrator. This provides the mentee with further development of the horizontal line needed for a T-shaped skill set.
People are the most important investment for an organization, whether the leaders of the organization realize it or not. Regardless of whether the millennial generation has a perceived, expected or actual shorter tenure of employment in organizations, it is vital to establish and maintain a strong and varied mentorship environment.
Mentorship builds better leadership skills and can develop a deep loyalty. This investment pays off for the organization by avoiding the potential gaps in staffing when millennials otherwise could feel unconnected in their workplace and leave a job.
It also pays off by reaping the benefits of well-trained, dedicated employees who operate within an increasingly productive team, because members of the team share a common vision and a trust in leadership. This is of utmost importance in the modern health care setting, where teamwork, collaboration and evolution are all crucial to organization success and sustainability.
James S. Hernandez, MD, MS, FCAP, is medical director and laboratory medicine division chair, and associate professor of laboratory medicine and pathology, at Mayo Clinic and its College of Medicine in Arizona.
Kenneth Poole, MD, MBA, is medical director of patient experience and community internal medicine division consultant at Mayo Clinic in Arizona. He also sits on the admissions committee for Mayo Clinic School of Medicine.
Thomas E. Grys, PhD, D(ABMM) is director of microbiology in the laboratory medicine and pathology department at Mayo Clinic in Arizona.
- Fry R. “Millennials overtake baby boomers as America’s largest generation.” Pew Research Center; April 25, 2016 (accessed April 10, 2017). pewresearch.org/fact-tank/2016/04/25/millennials-overtake-baby-boomers/.
- Meister JC, Willyerd K. “Mentoring millennials.” Harv Bus Rev. 2010 May;88(5):68-72.
- Winograd M, Hais M. “How millennials could upend Wall Street and corporate America.” Governance Studies at Brookings; May 2014 (accessed April 10, 2017). brookings.edu/wp-content/uploads/2016/06/Brookings_Winogradfinal.pdf.
- American Hospital Association. Managing an Intergenerational Workforce: Strategies for Health Care transformation. January 2014 (accessed April 10, 2017). https://www.aha.org/system/files/2018-01/managing-intergenerational-workforce-strategies-health-care-transformation-2014.pdf.
- Moore K, Zampino S. “The modern mentor in a millennial workplace.” Forbes. Sept. 11, 2014 (accessed April 10, 2017). forbes.com/sites/karlmoore/2014/09/11/the-modern-mentor-in-a-millennial-workplace/#78af29d25c78.
- Diesing G. “How millennials will transform health care.” Hospitals and Health Networks; Nov. 16, 2016 (accessed April 10, 2017). hhnmag.com/articles/7697-how-millennials-will-transform-health-care.
- Aaron M, Levenberg P. “The millennials in medicine: tips for teaching the next generation of physicians.” J Acad Ophthalmol. 2014;7:e17-e20.
- Warraich H. “Can millennial physicians carry medicine?” Psychology Today; Nov. 3, 2016 (accessed April 10, 2017]. psychologytoday.com/blog/modern-medicine/201611/can-millennial-physicians-carry-medicine.
- Gale P. Your Network is Your Net Worth: Unlock the Hidden Power of Connections for Wealth, Success and Happiness in the Digital Age. New York (NY): Atria Books; 2013.
- Guest D. “The hunt is on for the Renaissance man of computing.” The Independent. Sept. 17, 1991.
- Hansen MT. “IDEO CEO Tim Brown. T-shaped stars: the backbone of IDEO’s collaborative culture.” Jan. 21, 2010 (accessed April 10, 2017). https://chiefexecutive.net/ideo-ceo-tim-brown-t-shaped-stars-the-backbone-of-ideoaes-collaborative-culture/.
- Hansen MT, von Oetinger B. “Introducing T-shaped managers: knowledge management’s next generation.” Harv Bus Rev. 2001 Mar;79(3):106-16.
- Doyle M. “Why engineers need to develop T-shaped skills.” Dec. 3, 2014 (accessed April 24, 2017). blogs.ptc.com/2014/12/03/why-engineers-need-to-develop-t-shaped-skills/.
- Quast L. “Reverse mentoring: what it is and why it is beneficial.” Forbes. Jan. 3, 2011 (accessed April 10, 2017). forbes.com/sites/work-in-progress/2011/01/03/reverse-mentoring-what-is-it-and-why-is-it-beneficial/#2e838d4621cc0.
- Crosby J. “Target, UnitedHealth and other companies turning to ‘reverse mentoring’ to tap millennials’ knowledge.” Star Tribune; July 25, 2016 (accessed April 10, 2017). startribune.com/target-unitedhealth-and-other-companies-turning-to-reverse-mentoring-to-tap-millennials-knowledge/388085972/.
- American College of Healthcare Executives. ACHE Mentor Guide. Undated (accessed April 10, 2017). https://www.ache.org/newclub/career/MentoringNetwork/mentor_guide.pdf.
- Poole KG Jr. “Hospital employment deja vu.” Physician Leadersh J. 2016 May-Jun;3(3):56-8.
- Barnet S. “Leadership and management. Millennials and healthcare: 25 things to know.” Becker’s Hospital Review; Aug. 4, 2015 (accessed April 10, 2017). beckershospitalreview.com/hospital-management-administration/millennials-and-healthcare-25-things-to-know.html.
- Seidel A. “Millennials are now America’s largest generation: Here are 4 ways they’re changing health care.” Advisory Board; April 29, 2016 (accessed April 10, 2017). advisory.com/daily-briefing/2016/04/29/millennials-changing-health-care.
- Inventive Health Public Relations Group. Millennial Mindset: The Collaborative Clinician. June 2016.