Are you ready for millennials at work? Apparently they're already here

How Millennial physicians will impact disease management

Jaan Sidorov, MD a deceivingly bullish post on millennial physicians over at

The Millennial non-attitude about status or rank has implications for the hierarchical command and control that, up until now, has has been overseeing health system. No longer will a VP for Medical Affairs be able to assume young physicians will readily agree to taking “call” in evening outpatient clinics to off-load unnecessary emergency room visits. If a Grand Rounds speaker lacks sufficient eye-candied edutainment in PowerPoint, all the more reason for those young docs to skip out, grab some tofu and surf some YouTube. White coats will be optional and these docs will default to a first-name relationship with their patients.

Why deceivingly bullish? Reading the above passage you might think Sidorov's position is staunchly boomer, deeply rooted in the old myth that whatever generation comes next can't possibly be as hard working, determined, focused as those that came before.

To be sure, there's some of that in his post. So much of the flow of practice in a hospital depends on all parties buying in to the historic framework of how things have always been. Shake that up with med students that don't buy that line on some level and the status quo breaks down, falls apart, disintegrates. When patient care hinges on a status quo student and staffing process that is so fragile, it's no wonder the old school medical community is a touch on edge.

All that said, the millennial transformation at work offers several key benefits for organizations always at the ready for change.

They are technical, and they don't even know it. Millennial employees have an understanding of technology and communication tools which they didn't have to learn, they simply absorbed. They understand email, twitter, social networking and collaboration online at the genetic level, and have experience first hand how these tools make them more efficient communicators. No, they don't communicate the way we do, but don't mistake that for a lack of insight on their part

They are expert collaborators. Fueled by their technical experience, millennials have an innate understanding of what it takes to work together to achieve their objectives. While they might be stymied by an empty cubicle, give them a integration problem and a conference room, and their natural team dynamic takes hold with great positive results.

They have much to teach. If it were 1995, I would be able to make a joke about an 8-year-old setting the clock on the VCR right here. I haven't seen a VCR in years, but the millennials have the same experience to offer today as that 8-year-old of the 90's. They're quick studies, they love to play in the most constructive fashion, they are quick to the point and, most important of all, they really do work to live. There are reminders in the millennial work ethic that can make work better for all of us, if we're willing to listen.

The Key To Getting Through This Economic Crisis

The economic crisis has jump-started a long-standing conversation among senior leaders in Higher Education. How can we best deliver services to our core stakeholders while finding ways to positively impact our financial condition? Since the economy tumbled in September 2008, actions taken by universities run the spectrum of “wait and see” to rethinking how to deliver services and programs, all while keeping the academic and administrative trains running. Like its corporate partners, colleges and universities are now publicly embracing the “bottom-line” as the core enabler of its mission. For institutions that have embarked on broad organizational change, one thing’s for sure. Staff and faculty are anxious. While the most prevalent anxiety spoken is “Will I still have a job on the other side of this crisis?”, it's not always about losing one’s job. The underlying fear is uncertainty.

It's not so much that we're afraid of change or so in love with the old ways, but it's that place in between… It's like being between trapezes. It's Linus when his blanket is in the dryer. There's nothing to hold on to. Marilyn Feguson Author and Public Speaker

In this period of change, institution leaders have two primary concerns: What if our planned restructuring to address the financial crisis evoke a sufficient negative reaction that cause it to fail? Even worse, what if the changes put in place are not enough?

On the other hand, if you ask staff doing the work what they fear, it's the uncertainty of how they're jobs may change or worse, go away.  The power of uncertainty can have great control over our lives.

The Power Of Uncertainty

Take this example from a study conducted at Emory University:

A team at Emory University examined what happened when people waited for an impending electric shock. Some people dreaded the shock so deeply that they chose to receive a more powerful shock earlier rather than waiting for a lesser shock to arrive at a later, random time. David Eagleman NY times Op-Ed, December 3, 2009

Why would someone choose this counter-intuitive behavior?  Simple.  It's more stressful to wait for something negative to happen than get it over with now.  Knowing what's coming has tremendous influence over our ability to focus.  When changes like possible layoffs or organizational restructuring are anticipated, people's anxiety levels are raised and strong emotions  are evoked - from anger and fear for some to enthusiasm and excitement for the lucky few.  The majority react to anticipated change assuming it will be bad for them.  This, in itself is an irrational reaction.

Shifting One's Focus

If we’re serious about transforming Higher Education, we need leaders to make tough decisions that position our institutions in a fiscally sound direction. These changes will not come all at once and require thoughtful analysis before implementing. There is no getting around that in this period of analysis, anxiety will be heightened because not all the answers will be clear.  Institutional leaders need to help their most important assets, people, get through this period of accelerating change.

But it's ultimately up to the individual to decide whether the coming changes are something to avoid or an opportunity to take advantage of.

Those who maintain a positive attitude through these challenging times are not free of fear or anxiety; they just choose to put their energy elsewhere.  How can I improve my value or get more involved?  What opportunities may come out of these changes that I can take advantage of?  Are there things I can be learning that will help me get through this better?  These questions are at the heart of shifting one's point of view from "Why is this happening to me?" to "How can I best get through this?"

The key to getting through this economic crisis is to build a business culture that helps people learn to make positive choices in the face of uncertainty.  It's a partnership between management needing to focus on the big picture and the individual choosing to be part of the solution.  This is true change management, transforming fear that breeds inaction to optimism that promotes opportunity and personal growth.

Raising the Bar on Buy-In!

Asking for "buy-in" to your latest initiative will get you passive indifference at best.  Maybe indifference is what you're looking for - light years improvement from outward dissatisfaction or hostility.  But if what you really want is to motivate stakeholders (senior management, administrators, researchers, faculty or staff) to your idea, buy-in often only produces a willingness to not go against the initiative.  Most likely you're looking for champions or enthusiastic support.  Saying to a group "we're looking for your buy-in" communicates you want to inform, not involve. The way to get enthusiastic support is if you bring them into the circle by asking for help, feedback, ideas and participation.  Yes, some stakeholders may ask difficult questions.  But don't fool yourself into thinking that by keeping them at arm's length with periodic updates that you've got their support. 

Too often the bar is set too low around what we can ask or expect of others. For a group to be jazzed about an idea, you've got to get them involved in the change, not just inform them what's coming.

To learn more about how to do this, feel free to contact me.  I'll be happy to share some of our strategies.
Howard Teibel
617 448-3634 mobile

If It's Not Broke...

There is a certain relief in change, even though it be from bad to worse! As I have often found traveling in a stagecoach, that it is often a comfort to shift one's position, and be bruised in a new place. ~Washington Irving As part of a larger strategic effort to improve operational performance across your organization, centralizing business functions can be a very useful change. The rationale behind these projects is that by reducing redundancy, the quality of the work can be improved, processes can be made more efficient and cost savings can be realized.

If only it be this easy. Like many initiatives that include structural and people change, solving one problem creates another. Imagine an army of people sitting in their metaphorical chairs for years at a time, comfortable with what they know and their position in the organization. Centralizing work changes all the rules.

Three guiding principles will help when embarking on centralizing work projects:

1. Getting management on the same page

The best way to create positive momentum on these projects is to have leadership speaking with one voice. Once new roles are defined and the model is tested (ex: a Business Center becomes operational) it is critical for staff to know that management will hold people accountable to their new roles. Without a consistent voice from management and regular reminders of people's roles, staff will push on the boundaries of their shifting responsibilities, making it much more difficult for everyone to adjust to the new model.

2. Building trust by being inclusive

The process your staff will go through getting accustomed to new roles and responsibilities takes time and requires patience from everyone involved. Management should set up check points where people can weigh in how the new process is working. Asking for feedback and genuinely listening to their ideas and concerns will go a long way to helping build trust. The more people feel they have a voice, the more they will take ownership in the change.

3. Attitude is everything

Two primary groups are affected by this change - those who will be inheriting the work of others and those giving up pieces of their job. Although this can be stressful, at some point people need to make a choice - they're either part of the solution or part of the problem. This doesn't mean accepting an unworkable process, rather for all players to ask themselves what they can do to help the new process succeed.

By applying these three principles - Leadership speaking with one voice, management listening to staff ideas and concerns and most importantly everyone asking themselves how they can be part of the solution - this is how you get through initiatives that involve changing roles, responsibilities and reporting lines.

A Clash of Cultures

As we speak, technology is reinventing relationship. Instant messaging continues to find its way into the workplace, slowly replacing that outdated technology called “email”. It should be of no surprise why this is catching on, given IM is that perfect balance of achieving dialogue without having to deal with eye contact and other interpersonal annoyances that come with having to influence people sitting across a conference table. Discussion boards, blogs, social networks – the way we connect is changing faster than our ability to embrace any of these tools. And with a generation of up-and-coming leaders who grew up embracing electronic media, our views on how work gets done and the meaning of “relationship” is under attack.

We are living in a clash of cultures, those of us who have spent a lifetime developing face-to-face interpersonal skills, and the generation that is weaving emoticons (:-o zz) and instant messaging phrases (PCM or LOL) into our professional dialogue. How do we develop new definitions of relationship and trust that draws from our rich history of oral communication while taking into account the changing nature of written communication and how work gets done? Is this cultural dichotomy something we as seasoned leaders continue to resist or dismiss (“when I was young, we walked 12 miles to school and we liked it!”) or do we collectively learn how to be efficient and effective, while maintaining that personal connection with each other? If this isn’t a perfect storm for the quote by Alvin Toffler, I don’t know what is:

“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn.”

At a deeper level, how does building trust fit into our 21st century organizations? Does it mean the same thing to future leaders of our institutions as it does to the generation who “walked the floors” and connected one-on-one with those doing the work?

These questions are at the heart of what we need to engage our current and future leaders in discussion around.

Successfully Merging Organizations - Uncovering the Knowledge Gaps

Mergers and acquisitions take place for various reasons. Corporate entities merge companies to increase their competitiveness in the market. Internal mergers, i.e., departments being consolidated into one organizational unit, are a different kind of consolidation. The cultural change may not be as great as bringing two companies together, but the need for uncovering knowledge gaps is just as important.

Internal audits often drive these efforts, uncovering inefficiencies and opportunities for cost savings. The real challenge, however, is not in identifying efficiency gaps, but getting disparate groups working together so real benefits are realized.

The big picture

A consolidation reveals the need for "big picture" understanding of roles and processes across groups. Departments that perform related tasks often know very little about what the other group is doing. For example, a purchasing department that oversees the rules around acquisition of goods and services has a strong connection to Accounts Payable, responsible for dispersing funds. Ask either group about the day- to-day operation of the other and you'll probably get a few blank stares. This goes for many functional departments expected to work together; IT, Finance, HR, and other centralized groups.

The cause for this lack of understanding starts with the definition of doing a job effectively. Being successful in a role often does not demand knowing "why" work is performed, as long as the task being performed is done correctly. We call this "work by rote", i.e., doing a series of steps by memory (often aided by yellow stickies plastered all over ones monitor).

Knowing why one performs a task starts to become important when the steps need to change. With business as usual, the objective is to get work off ones desk as quickly as possible and make it someone else's problem.

Wake up call

When a department consolidation is announced, people begin to wake up. With business processes and system changes looming, newly formed project teams make their way around both departments asking questions like "Why do you do this?" and "Can we do it this way instead?" Owners of the "to-be" changes quickly begin to recognize the need to understand more of the logic behind their work, something that is rarely explained or even necessary in the day-to-day performance of one's job.

The cause for this lack of knowledge doesn't just rest with the individual, but also the organization. Although employees need to take greater responsibility for what they don't know, organizations need to be more systematic around helping people learn and develop new skills.

What are three key things an organization can do to better facilitate departmental consolidation?

Plug the leadership gap

Inherent in these efforts is a need to identify someone who will lead both groups to a better place. Sometimes this is the manager of one of the existing departments, while other times it should come from outside either group. The key is to not postpone any longer than necessary making this decision, primarily because the direction of the new organization will be driven by new leadership. Leaving this gap in place too long creates tension among both groups, with people spending more time vying for power than focusing on how to collaborate.

Conduct facilitated dialogue sessions

Once a new leader is identified, the next step is to alleviate confusion and set proper expectations. Not everything will be changed overnight. A matter a fact, much will evolve over the next year. People need to be reassured that some of the changes will be gradual, while others need to be in place on day one.

Bringing both parties together through facilitated dialogue sessions can help alleviate tension, frustration and anxiety about the change. Most importantly, you want to get both groups working together in as positive a framework as possible. These sessions should be both an opportunity for people to get to know each other, along with discussing new business practices and vision for the new organization.

Designing learning maps

One final technique to demystify upcoming changes in work processes is to develop learning maps of the organization, combining visual flows of roles, processes, and handoffs across groups. For example, the steps to pay a vendor cut across roles and departments. Having a visual understanding in one place of who does what and why they do it is an important step to build competence for the consolidated environment.

To see an example of learning map, go to

A smooth transition

With strong leadership setting the right context and expectation for the change, facilitated sessions where people can come together and voice concerns as well as get to know each other, and finally, visual representations of the "as-is" and "to- be" processes, you will be well along your way in creating a smoother transition for the new organization.

Facilitation Tip

When facilitating a discussion, a key skill is how you handle questions. Keep in mind two things: Listen carefully to the question. Secondly, answer as if the group asked the question. This has three benefits.

  1. When questions get asked, you won't get tunnel vision by focusing on individuals, ignoring the rest of the group.
  2. By answering for the group, you'll more likely remember to repeat or paraphrase the question, an important technique to keep everyone engaged in the dialogue.
  3. You'll minimize getting sucked into the void of "one-on-one" confrontations by directing your response to the group.