Healthcare across the Generations

Our healthcare system serves five generations of Americans concurrently and they are all very different. To deliver patient centered care, an understanding of the values and characteristics of each generation becomes essential. This is a daunting task that is further complicated by the fact that each of us looks at life through the lens of our own generation. This is a case in which “one size” does not fit all. What do we need to know to deliver healthcare across the generations?

Traditionals (born 1900-1945) are loyal to their providers. They are also thrifty and value personal responsibility as a result of experiencing the effects of the great depression and WWII. Many have avoided the technology explosion and they are not likely to be found on social networks. Some will utilize e-mail and smart phones in their daily lives, many will not.

Boomers (born 1946-1964) are optimistic, competitive, and reluctant to accept the concept of aging. This is the largest generation (80 million) and the one that will drive a great deal of healthcare cost in the next 10-15 years. Many have embraced technology as a way to make their lives easier and more convenient.

Gen X (born 1965-1980) at just over 46 million, is the smallest of the generations living today. They do not trust large institutions and tend to change jobs and locations on a regular basis. This is a talented group of people that only have half of the number of peers to compete with as the boomer generation. They will demand balance and refuse to be micromanaged.

Millennials (born 1981 and 2001) are finishing college while others have recently entered the workforce. These young people were born into a global world. They have many interests in life that they consider equal or more important than work. They prefer to shop for all of their needs by tablet or laptop. They expect immediate, 24-hour access to information and services. For them, healthcare is no exception. Millennial patients want to be deeply involved in their healthcare decisions and will make the commitment to be informed about their diseases or conditions. “Shared decision-making” for them will be the norm. Providers will be expected to answer questions about cost and outcomes candidly so that these patients can make informed choices. Millennial patients will not tolerate a wait at the front desk while your assistant calls to check eligibility. They will expect you to know what their co-pays or deductibles are and how much their portion will. They will expect pricing information available prior to, not after, the visit thus creating an expectation of service far above that currently provided by many healthcare providers.

The youngest generation is Generation Z (born after 2001). They have not yet reached adulthood nor entered the workforce. Little is know about their generational characteristics.

Currently, a great deal of effort is being spent on determining “which” healthcare services an individual within a given population may need. Programs like population health management, driven by value-based compensation, are being developed to implement evidence-based, cost-effective care that we hope will result in optimal patient outcomes at a reasonable price. We have come a long way in this journey and soon will have valuable genetic resources to improve patient outcomes and bring new meaning to the concept of “personalized” healthcare. Successful physicians will consider not only “which” care should be given but also “how” it can most effectively be delivered to individuals from diverse generations.


Paul McLeod, M.D.
Chief Medical Executive
McKesson Business Performance Services



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