Mending the Generation Gap: How to Manage Diverse Perspectives in a Five-Generation HIM Department

By Lisa A. Eramo, MA

When Carolyn Rubin, CPC, CPC-I, became the director of revenue cycle management at Dallas Nephrology Associates, she had an important task on her to-do list: Relieve the workplace tension that had plagued health information management (HIM) staffers for years. Communication and collaboration needed a boost so the team could function more cohesively. Rubin, a Baby Boomer who currently manages 45 employees, says understanding generational differences was critical to bringing everyone together.

“You have to learn how to communicate with each generation and what drives each generation—and how to pull all generations together for one commonality,” Rubin says. “In our case, that one commonality is patient care. Sometimes it means a little extra work on my part, but that’s ok because the team is responding.”

Seth Jeremy Katz, MPH, RHIA, associate administrator of information management at Truman Medical Centers in Kansas City, MO, agrees that HIM managers need to be sensitive to generational differences. “You can’t have a successful team if people don’t get along and aren’t on the same page,” says Katz, a borderline Generation Xer/Millennial who oversees members of multiple generations and serves as an adjunct HIM faculty member at a local college. “If you think you can take a one-size-fits-all approach, you’re going to have problems.”

Rebecca Teleszky, RHIA, supervisor of operations in HIMS at UCLA Health, agrees. “It is necessary to have an understanding of where people are coming from and how to best approach them in order to have success when it comes to their ability to comprehend and to take on new projects and tasks,” says Teleszky, a Millennial.

By 2020, HIM managers could conceivably find themselves managing five different generations within a single department—Traditionalists, Baby Boomers, Generation X, Millennials, and Generation Z. Why is this daunting? Each generation tends to have its own values, mindset, communication styles, and motivations. Friction occurs when members of each generation work together side-by-side without having a mutual respect for and understanding of each other.

“It’s extremely important for managers and leadership to be sensitive to the generational differences that exist in the workplace,” says Stacey L. Murphy, MPA, RHIA, CPC, chief of HIM at VA New Jersey Health Care System. Murphy, a Generation Xer who currently oversees five generations of employees, says keeping everyone engaged and motivated is probably the biggest challenge.

As generational gaps widen, HIM directors must work hard to maintain a united department. The cost of failing to do so could be significant—employee turnover and dissatisfaction, ongoing tension, failed projects, and underproductive teams are just a few of the many negative ramifications.

“If you don’t understand what makes each group tick and how to get them to relate, then you’re going to have friction in the workplace, a very toxic environment, and staff who are unengaged,” Katz says. “You’re not going to be able to drive the organization forward. It will be a tense department with a lot of cliques that will lead to a lot of problems.”

Five Quick Tips to Manage Multiple Generations Effectively

Today’s HIM managers are faced with many challenges, one of which is to bridge the gap between a diverse group of employees from multiple generations. Consider these tips to help create a collaborative and respectful environment:

  • Recognize your own generational biases as a manager. Do your own generational traits prohibit you from truly understanding others’ perspectives?
  • Be mindful of generational differences. Take these differences into account when developing training sessions, setting expectations, rolling out new processes or technology, and communicating with staff.
  • Provide generational sensitivity training for your staff. All staff members—especially newer managers—can benefit from this training.
  • Don’t make assumptions about each generation. It’s easy to assume all generations fit into a stereotype—for example, the idea that Millennials aren’t interested in job longevity or Baby Boomers will never embrace technology. Take the time to get to know each staff member individually to gain greater insights.
  • Set realistic expectations. Don’t expect employees of a different generation to adapt to your management style. For example, it may be more appropriate to text or e-mail a Millennial, but you may need to follow up with a Baby Boomer in person. Be prepared to adapt to your employees and their preferences.

Get Familiar with the New Multi-Generational Workforce

Managing multiple generations is not a new concept. What is new is the diversity of the group. Traditionalists and Baby Boomers came of age long before the technology boom, while Generation Xers grew up with personal computers and, later, the Internet—but not cell phones. Generation Zers never knew life without mobile devices, laptops, social media, and apps, while for Millennials life without these things is a distant memory.

Technological advancements are only one reason why generational differences occur. Each generation is also shaped by changes in social norms, parenting styles, and more. To ensure a successful and productive HIM department, managers must understand and embrace these generational differences that will only continue to persist as people live longer lives and remain in the workforce.

The challenge of multi-generational management is even tougher for those managers who have their own action items and tasks to complete daily while also trying to manage others, says Valerie Grubb, author of the book Clash of the Generations: Managing the New Workforce Reality. It’s a delicate balancing act that requires patience, insight, sensitivity, and a desire to understand differences, Grubb says.

Give All Employees a Voice

Managing multiple generations requires a keen awareness not only of generational differences but also personal preferences. Grubb encourages HIM managers to meet with employees individually or solicit their feedback to understand what motivates them, what feedback they need to be successful, and what they’re looking for in terms of a manager.

Rubin, for example, launched an employee questionnaire when she first joined Dallas Nephrology Associates to help her get to know her staff. In it, she asked questions such as: What drives you? How do you prefer to learn? What communication style do you prefer? What changes do you want to see in the department?

Murphy meets monthly with staff members to discuss individual achievements and processes that affect workflow. This engagement effort is part of each manager’s performance appraisal. “It requires managers to work effortlessly to ensure that employees of all generations feel like they are an integral member of the department, but more importantly, to ensure that their voices are heard and concerns are addressed,” Murphy says.

Five Generations in the Workforce

By 2020, these five generations will work side-by-side in the workforce. The below lists some general characteristics about each generation along with some defining events in their lifetimes.

1. Traditionalists (aka, the Silent Generation)

Born: 1928-1945
Shaped by: Great Depression and World War II
Characteristics: Disciplined, believe in conformity, dislike conflict, and prefer hierarchical organizational structure

2. Baby Boomers

Born: 1946-1964
Shaped by: Vietnam War, hippie culture, rise of Rock n’ Roll, civil and women’s rights movements
Characteristics: Hard working, strong work ethic, innovative, loyal, goal-oriented, high level of professionalism, may fear that Millennials and Generation Zers will take their jobs

3. Generation X

Born: 1965-1980
Shaped by: Challenger explosion, Fall of the Berlin Wall, Gulf War, Cable TV and MTV culture, AIDS, early Internet, and advancing technology
Characteristics: Independent, free agents, seek ongoing training and growth opportunities

4. Millennials (aka, Generation Y)

Born: 1981-1996
Shaped by: 9/11 attacks, the Internet, the Great Recession and housing market collapse, mobile phones, social media, and Google
Characteristics: Confident, value diversity and community service, team players, tech savvy, want to be coached and mentored

5. Generation Z

Born: 1997 to present
Shaped by: Tablet devices, smartphones, personalization/fracture of media and entertainment, mobile apps, and social media
Characteristics: Optimistic, prefer mission-driven work, able to multi-task, extremely tech savvy, highly dependent on technology

Understand Workplace Priorities, Motivations

In a workplace environment, each generation is looking for something slightly different, and a savvy HIM manager takes the time to explore these preferences, Grubb says.

All employees want to be included in workplace decisions, but this is especially important to Baby Boomers and Generation Xers, as it demonstrates a manager’s respect for their input and experience, Grubb says. “Ask them for their opinion,” she adds.

Millennials and Generation Zers, on the other hand, often seek more coaching and mentoring opportunities than coworkers in other generations. They also want constant learning opportunities. “They demand that managers care about their long-term career growth,” Grubb says. “As a manager, you’re going to have to be ‘on your game’ thinking about how you’ll keep the employee engaged.” Onsite training, job shadowing, and online courses are just a few solutions to consider, she adds.

Millennials and Generation Zers also like to multi-task. “Be prepared to give them multiple creative projects to work on because they are always ready and willing to add more to their plates,” Teleszky says.

In addition, Millennials and Generation Zers like to connect their work with a larger purpose. For example, remind them that accurate coding and documentation enables clinical research and could even save lives, Grubb says.

Likewise, what motivates each generation may also differ. For example, Millennials and Generation Zers value time off, frequent praise, and a work-life balance, while Generation Xers and Baby Boomers often prefer public recognition.

Accommodate Different Learning Styles

In HIM, change is the only constant. New technology, new privacy and security threats, new codes, and new processes are common. Successful managers are those who remain cognizant of how each generation prefers to learn and adapt to change.

For example, Baby Boomers on the verge of retirement may not want to delve into all the bells and whistles of new technology, while Millennials may be interested in learning about more advanced functionality. Ask staff members about their expectations for training so everyone feels included and as though they’re getting what they need, Rubin says.

Katz agrees, noting Millennials may only require a quick demo while Baby Boomers may prefer a demo plus hands-on training. Neither method is wrong, and neither generation should be shamed, he says. “People talk about how to motivate a staff person or they don’t understand why technology is so challenging for the older staff,” Katz says. “I just want to shake my head and say ‘Did you talk to the staff and try to work with them to understand where they’re coming from?’”

For example, Truman Medical Centers recently implemented e-signatures for patient consents, a new process that was daunting for many Baby Boomer registration staff. Katz says he took staff members step-by-step through the e-signature process and gave them ample time to practice the new process before rolling it out in a live environment. “That empowers them to learn the technology and be successful,” he says.

Rubin recalls a similar experience when rolling out front-end claims scrubbers. She says it’s important for all managers—particularly younger ones—to remember that although they might grasp new technology quickly, Baby Boomers might need more time to process the information.

Capitalize on Each Generation’s Strengths

Each generation has its own unique strengths on which HIM managers can and should capitalize, Grubb says.

For example, let Baby Boomers serve as mentors for Millennials and Generation Zers. “The Boomers have a lot to offer to the younger generation. They’ve been in the workforce a lot longer and can tell them what it takes to succeed and move up in the organization,” Katz says.

Likewise, train Millennials and Generation Zers to become super users of new technology who can help Baby Boomers when questions arise, Rubin says.

Helping staff members realize each other’s strengths is also important. Rubin implemented a reward system that encourages peers to recognize one another for going above and beyond the job to help a coworker. Every time someone is acknowledged by a peer for their hard work, they receive a silver coin. Staff can redeem five silver coins for one gold coin, and two gold coins for a half-day off.

“That has been one of the most successful things that we’ve put in place for the team,” Rubin says, adding that the reward system has helped bridge generational gaps.

Lisa Eramo ( is a freelance writer and editor in Cranston, RI, who specializes in healthcare regulatory topics, health information management, and medical coding.

Article citation:
Eramo, Lisa A. "Mending the Generation Gap: How to Manage Diverse Perspectives in a Five-Generation HIM Department" Journal of AHIMA 88, no.9 (September 2017): 26-29.