Generational Inversion – An Opportunity for Health Care Leaders

Gen X Takes Over, the January 13, 2018 article by Tammy Erikson on (actually a prequel of her longer case study in February’s Harvard Business Review) nominally comments on the Gen-X (Obama post-Bush and Clinton) takeover. But it’s mostly about the emerging generational inversion in the business world. And since it is about business leaders, in the world of the Health Care Leadership Blog it’s fair game to consider the ramification of this phenomenon for healthcare leaders. So check it out, as well as it’s more complete cousin, the HBR case study.

Getting from Boom to X

Ms. Erickson makes the point that most corporate leaders ascend at relatively young ages (in their 40’s) and therefore are in the curious position of managing their elders (both experientially and chronologically). More interestingly, in 2009, this means that Boomers are beginning to be replaced by Gen-Xers. Which means the competitive, productivity and investment oriented, risk-taking generation that came on the heels of the preceding depression babies is now taking a back seat to the pragmatic, techno-savvy, impatient, cynical, lifestyle aware, no-nonsense pre-millennials. As she puts it, this gives “… [Gen] X’ers a strong advantage in remaking organizations to reflect twenty-first-century realities: the need for transparency, accountability, real-time performance, lack of ideology, top-of-market effectiveness, and cash value.” Now that’s a heavy duty wish list for transformative (health care) leadership.

X-ers As Model Physician Leaders?

The emerging Gen-Xers currently represent 30-40% of the physician workforce and the oldest among them are entering their early forties this year. So the lead edge of X-ers is just entering healthcare leadership territory – which I suspect begins somewhat later than in business. Could they represent the holy grail of healthcare leadership? Will they demand the accountable, performance-based, effective, and transparent system that has eluded us Boomers? It’s certainly the direction President Obama, for example, says he wants to take us towards as a nation.

And what’s additionally provocative is that given the nature of generational inversion, the X-ers will emerge into leadership positions as the Boomers (still 60% or so of the physician workforce) remain around, presumably yielding leadership, and presumably not retiring any time soon given the economy. Will this result in a creative tension in which the pragmatism of the X-ers will harness and redirect the work ethic of the Boomers towards a common goal? Will the more ideological and competitive Boomers, who have been slow to adopt technology and pragmatism to date, resist that change and limit the X-ers potential. Will the pragmatism and life balance concerns of the X-ers be a rate limiter to the change they can/wish to achieve?

In my leadership effectiveness consulting work, I have thus far encountered only a few X-ers. But they have impressed me as highly attractive “new model” physician leaders whose pragmatism and transparency has yielded results while being refreshing and disarming to the old guard. Watch for the inversion phenomenon and factor it into your strategic leadership planning – it just might represent a hidden formula for success. Observing the effectiveness of President Obama might provide some early intelligence as to what we should expect.