"Nobody wants to work:" A generational guide for practice staffing

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Practices nationwide are feeling the pressures of a changing workforce, as the new Physicians Practice Staffing & Salary Survey reveals that hiring and retaining quality staff continues to be a challenge years after the COVID-19 pandemic.

Generational attitudes toward work have undergone a marked evolution over the past several decades. From Baby Boomers—who generally entered structured, hierarchical workplaces—to Generation Z—whose earliest career experiences have been profoundly shaped by the COVID-19 pandemic—employers across industries, including health care, must adapt to shifting expectations to recruit and retain staff effectively.

A legacy of loyalty
Baby Boomers (1946-1964) came of age in an environment that championed traditional career paths and a strong sense of employer loyalty. In many cases, these individuals spent much of their working lives at a single institution. In health care, specifically, this often translated into decades with the same hospital or physician practice, forming deep institutional knowledge and long-standing professional networks. As Boomers now retire in large numbers—a trend noted in recent data from the Bureau of Labor Statistics—some practices are left grappling with how to replace both clinical expertise and the mentorship these veterans have long provided. Several national health care staffing agencies have emphasized the need for succession planning and leadership development to mitigate potential knowledge gaps.

The independent pragmatists
Gen X (1965-1980) frequently labels itself as the “middle child” of the workforce, sandwiched between two massive cohorts. Known for prioritizing work-life balance—even before that phrase was in vogue—Gen X was the first generation to experience widespread dual-income households and the simultaneous responsibilities of caring for both children and aging parents. Their adaptability carries into health care, where many Gen X professionals merge the hierarchical leadership style favored by Boomers with a willingness to embrace new technology and protocols. Physician practice managers who want to retain Gen Xers often offer flexible scheduling, autonomy, and career development perks such as continuing medical education opportunities or specialized certifications.

Millennials and mission-driven work
Millennials (1981-1996) became the largest cohort in the U.S. labor force in the mid-2010s, according to the Pew Research Center. Shaped by the economic turbulence of the 2008 recession, millennials place a premium on finding meaningful, mission-driven roles and have been more willing than previous generations to switch jobs for better alignment with personal values. In health care, many millennials champion the use of electronic health records, telemedicine, and other digital tools to streamline patient care. Work-life balance remains a priority, but so do transparent leadership, consistent feedback, and clear pathways to advancement. According to Gallup, professional development opportunities are a decisive factor for millennials when choosing new roles.

Gen Z steps in

Gen Z (roughly 1997-2012) comprises the first fully “digital native” generation, having grown up with the internet, smartphones, and social media. Unlike many millennials—who recall at least part of their childhood without pervasive digital technology—Gen Z is accustomed to immediate communication and rapid feedback loops. In health care, this translates to a high comfort level with telehealth, remote patient monitoring, and other digital platforms.

A 2022 survey by Deloitte found that Gen Z respondents ranked flexible working arrangements, corporate social responsibility, and robust mental health resources among the top factors influencing their choice of employer. This preference for flexibility is evident in physician practices that allow administrative tasks to be carried out remotely, even though direct patient care often requires on-site staffing.

Emphasis on mental health and well-being
Across the board, employees are increasingly citing mental health as a crucial concern. However, Gen Z is uniquely vocal about advocating for workplace initiatives that address stress, burnout, and overall well-being. The American Psychological Association’s “Stress in America” survey found that 70 percent of Gen Z adults reported stress levels during the pandemic that significantly impacted their work or academic performance. Many in Gen Z view mental health support—such as access to counseling, wellness stipends, or a culture that normalizes discussions about stress—as essential rather than optional. By contrast, Boomers and some Gen Xers have historically viewed mental health as a private matter, not the purview of an employer.

COVID-19 and the Great Resignation
The pandemic underscored workplace vulnerabilities and accelerated existing changes in employment attitudes. In health care especially, employees were under enormous strain: elevated patient volumes, supply shortages, and chronically thin staffing structures. These conditions contributed to what has been called the “Great Resignation,” when unprecedented numbers of workers voluntarily left their jobs in search of better compensation, safer conditions, or more flexible arrangements. Data from the Bureau of Labor Statistics shows a notable increase in resignations in health care and social assistance, especially during the peak of the pandemic. Employers offering retention bonuses, hazard pay, or flexible scheduling typically reported better staff retention, reflecting the urgency of adapting to new workforce expectations.

Adapting to remote and hybrid work
While remote or hybrid work is more common in some industries, health care organizations have found ways to offer partial work-from-home arrangements for administrative roles. Tasks such as billing, scheduling, insurance pre-authorizations, and telehealth triage increasingly lend themselves to remote or hybrid setups. Gen X employees often appreciate the flexibility for family responsibilities, while millennials and Gen Z treat such models as a given rather than a perk. A Gallup poll indicated that many younger workers now make job choices based on whether or not remote or hybrid work is available.

Quick to Speak Out, Quick to Move On
Gen Z’s digital fluency also informs its readiness to call out policies or practices perceived as outdated or misaligned with personal values. Younger workers are more likely to leave a role if an employer does not meet their expectations for inclusivity, values alignment, or work-life balance. This stands in contrast to many Boomers, Gen Xers, and even some millennials, who historically stayed in roles longer due to economic concerns or cultural norms around job tenure.

Looking ahead
For physician practices aiming to navigate generational differences, strategies often include:

• Transparent communication: Provide frequent updates on staffing, protocols, and leadership decisions.
• Flexible scheduling where possible: Enable remote or hybrid models for administrative tasks; consider part-time or job-sharing roles.
• Targeted professional development: Offer mentoring programs, continuing education stipends, and clear leadership pathways.
• Technology investments: Enhance telehealth services and user-friendly electronic health record systems to align with Gen Z’s digital expectations.
• Mental health support: Normalize wellness discussions, provide access to counseling, and incorporate stress-management resources into daily workflows.

By recognizing and accommodating these varying work styles—from Baby Boomers nearing retirement to Gen Z entering the profession—health care organizations can strengthen their teams, respond more effectively to patient needs, and better position themselves to thrive in an era of rapid transformation.