Employee Engagement for the Millennial Age


A cultural shift in management can galvanize organizations to move from “losing less” into “gaining more” in productivity and in profit.

By Ben Fung, PT, DPT, MBA*, and Gene Shirokobrod, PT, DPT*

Employee disengagement is estimated to cost over $450 billion to the U.S. economy—with $30 billion specifically attributed to Millennials, annually.

Being the largest segment of the workforce,1 Millennials bring with them a mindset that values company loyalty and team morale in ways that may be unfamiliar and at times disruptive to traditional approaches in practice management. While it may be popular to categorize employee engagement as a cost-containing strategy to staff turnover, a cultural shift in management can galvanize organizations to move from “losing less” into “gaining more”—in productivity and in profit.

In the early 1990s, the first mention of the term “employee engagement” was made in the Academy of Management Journal by William A. Kahn.1 What was once plainly considered good morale and an expected service to company loyalty has become its own field of study within business management. Of course, there are varying opinions as to if and how employee engagement should be addressed. Nevertheless, there are two numbers that are consistently mentioned in terms of the costs of disengaged employees: (1) that a disengaged workforce cost U.S. companies an estimated “$450 billion to $550 billion, annually,”2,3,4 and (2) that turnover costs can quickly eclipse an employee’s per annum salary equivalent, given vacancy and revenue loss—with statistics beginning with figures such as “50 percent of salary for entry level staff.”5,6,7

This, of course, is compounded by recent shifts in workforce demographics, and thus in workers’ behaviors and social values.

Enter “Millennials,” and cue the ominous orchestral music.

Compared to any other workforce demographic by age group, Millennials are the most likely to job-hop with turnover costs to the U.S. economy specifically attributed to Millennials estimated at $30.5 billion, annually.8 Already the largest demographic in the workplace, by 2020 Millennials will represent 50 percent of the workforce and 75 percent by 2030.9 Beyond this, many have casually observed that the Millennial mindset has caused entire culture shifts within companies; Millennial Age values have been spreading and are being quickly adopted by post-Millennials, Generation X, and Baby Boomers.

Whether this can be blamed on social media or is simply “a sign of the times” does not alter the fact that new strategies must be implemented in employee engagement so that both employers and employees can move away from “losing less” toward “winning more.”10,11,12

This article focuses on addressing employee engagement as a profit generator, rather than a cost container. It seeks to view the current crisis in employee engagement not as the product of a demographic age group, but rather as a shift in cultural values within our workforce—thereby making available strategies that transcend brackets of age, empowering managers to directly address the variables that can positively or negatively affect the operational savvy of a business unit and its bottom line.

What Does Your Organization Do to Market for Top Talent?

Talent retention and recruitment lies at the heart of the employee engagement discussion. Just as winning sports teams attract high-level recruits, so does a company that has a winning culture. Similarly, if a team suffers several losing seasons, management tends to trade out players and dedicate increased resources to recruiting “winners.”

Ironically, beyond job fairs and conference booths, surveys have demonstrated that few companies are implementing a precise strategy to market their companies in a way that is attractive to top talent. This creates a dilemma: It is difficult to attract top talent when top talent keeps leaving your company.13,14,15 And it is difficult to retain top talent who can continue to attract top talent when the current cultural composition of a company fails to create an environment where winners are rewarded, recognized, and otherwise made to feel appreciated.

Talent surveys have consistently shown that company culture is the definitive order winner to prospective employees, even above a competitive salary. There is, of course, a dual benefit that solves the very dilemma mentioned previously: A favorable company culture retains top talent as much as it attracts top talent. Therefore, marketing for talent becomes a top priority when it comes to an employee engagement strategy. It is not enough to keep “good people,” you must continually add to their numbers by recognizing excellence, by crafting opportunities for advancement, by encouraging identified champions to shape and grow the company’s culture, and by cultivating trust through transparent communications which may touch on topics previously considered taboo.


If a company is to successfully engage employees in this Millennial Age, it must create an attractive employer brand, just as companies seek to create a consumer brand that generates marketplace demand for more customers. Doing so requires that companies intentionally create exceptional candidate experiences as well as employee experiences.14

Companies can convey these qualities through recruitment webinars and on social media where culture champions can both accurately convey an organization’s culture and win the attention of the workforce.16,17,18,19 In essence, the best way to engage employees is intentionally creating a culture that cares as much about employees as it does its paying customers—after all, people and profit should not be antagonistic focal points. If anything, they should be synergistic, and it is this balanced pursuit that Millennial minds are drawn to—it’s not just busywork that your company is after, and your employees are not just cogs in a wheel to “crank out more patients.”

There is a mission. It is defined. And they believe in it, strongly.

Why Should Your Employees Care About Your Mission?

“Why are we seeing more patients?”

“Why are we being told to bill a certain way?”

“Why am I paid only X-percent of the revenue I generate?”

“Is it even legal for me to…?”

“How is it fair that…?”

If you haven’t been hearing these questions, it isn’t because they aren’t being asked by your employees. It’s because they are asking these questions and seeking the answers outside of your organization. Terrifying? It should be.

These questions and ones far more concerning are being constantly pitched to online forums and more commonly via social media. Mind you, these are not small audiences—we are talking about professionally oriented forums and groups that have thousands, and some, several tens of thousands of users registered as members to said groups. Among these members are employees, employers, general audience members, attorneys, compliance officers, and yes, you guessed it: auditors.

What does this have to do with your company’s mission? To the Millennial mindset, the mission of your business is not the same as the one listed on your company’s website. “The mission” is that which employees perceive as your company’s top priorities and “why” its managers pursue them.

Is your company prioritizing people, or profit? Does your company care about how many patients are being seen, or how the care affects the quality of a patient’s health indicators? Is your organization committed to corporate responsibility? Do your leaders share similar views on social matters? The fact is: Those who subscribe to the Millennial Age and its cultural values care very much that the mission of the company is aligned with their personal missions in life.20

It isn’t necessarily that your company’s mission needs to be perfectly matched with theirs. Rather, they simply need to know why they should care. And those reasons may not even be one that they agree with. It merely matters that a company’s management team is willing to openly, transparently, and perhaps vulnerably engage in discourse on why a company is operating as it is—it’s not necessarily the answer or reason that holds meaning but the willingness to share those thoughts that makes for an engaging workplace.

For the Millennial mindset, caring about the mission isn’t about agreement—it is about authenticity. Employees must trust in the authenticity of your mission.

To this, your employees will feel engaged when they experience those moments when a company, particularly as represented by its managers, is seen as trustworthy. This trust is based on communication from a place of collaboration, not one of authority. Ultimately, trust is what “the mission” is about: trust that your company “has their back,” just as much as you trust that “they” (the employees) will work in earnest to contribute value while protecting the best interests of the company.

How Does Your Company Reward Loyalty?

Historically, health care companies have been structured as corporations that have kept true to a culture of company loyalty and a strong work ethic. Chains of command, tiers of staff seniority, and years of experience have been unquestioningly valued. Idioms such as “keeping one’s nose to the grindstone” can be considered representative of this mindset.

However, such understandings are very much discongruent with this age of Millennials. And there are financial considerations that may need to be reevaluated if we are to follow the evidence where it leads, not what conventional wisdom has otherwise prescribed.

Traditionally, company loyalty was rewarded with regular raises, improved paid time off (PTO) accrual, first dibs in work schedules, and being prioritized for promotions—much of which has been deemed unsustainable, particularly in health care. This same mindset has also been named in causing dilemmas and collateral damage in terms of cost of labor where staff seniority may actually be incurring a disproportionate expense, an expense that may not necessarily reflect ability, production, performance, or team excellence.10,11 In fact, companies have been warned against promoting based on seniority due to systemic concerns such as: (1) stifling motivation within a workforce, (2) decreased initiative of otherwise able leaders, (3) fueling resentment while damaging work ethic, (4) creating recruitment difficulties, and as a result, (5) creating a culture of mediocrity within an organization.12

The fact is, many companies have situations where loyal employees are paid very well. They are paid well because they’ve been patient, not because they’ve performed—this is commonly enabled when company policies inadvertently reward the meeting of minimal human resource requirements and promoting those who have mastered the art of “not rocking the boat.” Unfortunately, innovation and progress are rarely activities that keep a boat still in the water. For many companies, how they are rewarding loyalty is actually hurting their business; creating for themselves scenarios where cost centers cannot afford to attract, nor to retain, top talent—creating a negative loop of a perpetually disengaged and disenfranchised workforce.

This is compounded by the fact that those who identify with the Millennial mindset see such patterns within a company, once again, as a discongruence of personal values; for many, rewarding mere seniority is no different than encouraging mediocrity.21 As such, companies must consider reevaluating how they reward their employees—particularly how the value of loyalty is measured and recognized. For some organizations, this may require an entire overhaul of pay grades, roles and responsibilities, and compensation packages en masse. And there is no doubt that exploring these options will create its own set of management headaches. However, this is where the evidence is leading: that for the Millennial Age, rewarding and recognizing high-performing employees creates higher levels of productivity, and thus profitability, in any given company.21,22

Closing Thoughts

Turnover and engagement are playing different ball games on the same field, operating with different rule sets despite existing in the same arena. As such, companies that continue to view employee engagement as a deterrent to staff turnover are finding themselves in a position where they are very likely creating for themselves a dangerously oversimplified approach to the dilemmas facing their workforce.

The workforce culture of the Millennial Age regards engagement as purpose, passion, and principles.

First, their purpose in working with and for a company must resonate with the purpose by which they’ve chosen to pursue their current career path. Second, engagement is elevated when the reasons for how and why they function within a company align with their personal passions. Third, the principles by which a company operates must at the very least be transparently communicated. After all, it isn’t that the Millennial mindset within the workforce is isolated to the demographic age group alone—it has become a societal culture. Thus, it is of intrinsic value to employees that a company’s principles are not in conflict with their own—that management teams are, at the very least, willing to share their rationale behind operational details regardless of how much their teams may agree. Finally, companies that seek to forge an engaging workplace must carefully and intentionally craft employee experiences that reward and recognize excellence in an open and accountable fashion.
























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Ben Fung, PT, DPT, MBA, and Gene Shirokobrod, PT, DPT, are cofounders of UpDoc Media. They can be reached at ben.fung.dpt@gmail.com and gspt@me.com.

*These authors have a professional affiliation with this subject.

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