Leading Across Generations

bridge over water

New thoughts on an enduring topic

By Mike Osler, PT, DPT

Imagine this scenario: A busy workday comes to an end. Two co-owners of a private practice sit in the back office catching up on notes, phone calls, and stats from the day. Frustrated by staff behavior, the conversation goes something like this:

“What’s with those Millennials, anyway? I cannot believe she has the nerve to ask for a raise after being here for six months!”

“I know, just last week her last two patients canceled, and she left early! I never would have done that when I was a new grad.”

“Well, on the other hand, I’m stuck here with you-know-who, and he is way behind on his documentation! He is still pecking the keyboard with two fingers, talking about how they did it at the hospital 30 years ago.” “Sometimes I wonder if we have the right people on our team.”

Has your practice experienced similar scenarios or shared these frustrations? Perhaps a clinic manager in his 50s looks down on a younger employee asking for more time off. Perhaps young therapists have left your organization because their older manager just didn’t “get” them. How have you responded? What needs to change? And, who needs to change?

Gaps between generations can erode the teamwork and culture of a private practice. A dysfunctional team will lack the trust and collaboration to thrive. The impact is not just poor operational and financial performance of the business, although these are real implications. The greater impact of leaders who fail to bridge generational gaps will be a frustrated, underdeveloped staff, and a community of potential patients more likely to have suboptimal experiences in the clinic.

How can a private practice owner lead successfully across multiple generations? Let’s start with a few foundational principles.


For generations to interact together as part of a meaningful team, they must first agree all generations add value. They will hold different perspectives. A leader’s responsibility is to ensure these perspectives are viewed as just that: different. The more a leader withholds judgement, the less labels such as “right” and “wrong” are used. Each generation has been shaped by the unique experiences of their lifetimes. For example, growing up in an era of lightspeed technology and immediate responses from social media platforms, Millennials (born 1981-2000) are more likely to expect immediate feedback after an interaction. Many members of Gen X (born 1961-1980) may struggle to trust co-workers as they were more likely to be raised by divorced parents or two working parents leaving them at home alone. The next generation, Gen Z (born 2000-2015), may prefer communication on the fly and find regular meetings unnecessary and boring.1 Again, none of these perspectives are right or wrong, they are simply different ways of viewing the world based on life-shaping experiences.

Tables displaying generations by birth year and major influences


It is no secret an effective strategy to understand another’s perspective is active listening. To bridge generation gaps, leaders must move beyond basic active listening techniques of eye contact, open posture, and summarizing what was said. Genuine listening involves asking curious open-ended questions, truly seeking to understand what is important to another person. Leaders should think about how life experiences have shaped perspectives and beliefs. Leaders should also question if younger employees are really asking for something all that different from older employees.2 But don’t stop there – actually ask team members themselves what experiences have shaped them, and ask what is most important to them at work and in life.3 Bridging generational gaps will require placing yourself in the other person’s shoes when listening. Only then can a leader begin to appreciate what is most important to team members, keeping in mind it is likely to be something different than what is most important to them.


Be careful not to overgeneralize staff and paint them with a broad brush as an “entitled” Millennial or “rigid” Baby Boomer. Remember judgment is a two-way street.4 If gaps between generations persist in your clinics, you may be the issue! After all, if you catch yourself complaining about “those darn Millennials,” remember the oldest Millennials are turning 40 in 2021 and now make up more than half of the workforce.5 A strong intergenerational leader strives to understand each team member while recognizing generational traits fit neatly into 20-year intervals. For example, the youngest Gen Xers will begin to remember older Millennials and the oldest Millennials may still carry some Gen X traits. Consider the impact of a significant event such as 9/11. Some Millennials were nearly 20 years old while others were newborns, meaning the influence of such an event cannot be generalized to everyone in the generation.


Being open to different perspectives, listening, and respecting individual nuances is a great starting point to bridge generational gaps. But if a practice owner stops here without taking action based on lessons learned, leading across generations is merely a mental exercise. Be willing to experiment with changes in the practice based on feedback from the generations represented on your team. Non-negotiables for the practice aside, be willing to trial changes to time-off policies, adjusted compensation models, scheduled work hours, and allocation of continuing education resources. The strongest leaders can build on the lessons learned from the conversations above to create a shared sense of purpose for everyone in the organization.6 The trust and connection across generations will elevate the performance of the practice, growing your people, and attracting future employees.

Generational gaps may feel insurmountable at first, but after face-to-face conversations, the differences may be less significant than first believed. What motivates different generations of people at work ultimately has more similarities than differences. Most people, regardless of generation, are searching for the same things in life: to be valued and cared for, to contribute to meaningful work, an opportunity for learning and development, a balance between personal professional obligations, and to be compensated fairly.4 Individuals may emphasize one area more than another, however, the core priorities change very little.

So, what does this mean for private practice owners? For starters, the time to develop the next leaders of the organization is now. What is important to them and how your organization looks may be slightly different than what was important to you. A mistake would be waiting another five to 10 years for a generation to “grow up” when it is more likely they just need to be understood and appreciated now. As you curiously listen, be sure to withhold judgment and appreciate their unique perspective on the world. Once the strengths and values of each person become apparent, a leader can address the needs of a team by using the complementary strengths, skills, and perspectives of different generations.

There is a temptation to complete this article with a practical list of what each generation values and how to communicate to address those values. However, such a list risks reinforcing stereotypes and undermining individual differences. Stop, listen, and value the perspective of those on your team. Be willing to implement changes based on strengths and values – regardless of age.

action item

1Erickson T. Gen Y in the workforce. Harvard Business Review. https://hbr.org/2009/02/gen-y-in-the-workforce-2. Published February 2020.

2Valcour M. Hitting the intergenerational sweet spot. Harvard Business Review. https://hbr.org/2013/05/hitting-the-intergenerational. Published May 27, 2013.

3Georges L. How generational stereotypes how us back at work. TED Talks. https://www.ted.com/talks/leah_georges_how_generational_stereotypes_hold_us_back_at_work. Published April 2018.

4Davey L. The key to preventing generational tension is remembering everyone wants to feel valued. Harvard Business Review. https://hbr.org/2018/07/the-key-to-preventing-generational-tension-is-remembering-that-everyone-wants-to-feel-valued. Published June 16, 2018.

5Fry R. Millennials are the largest generation in the US labor force. Pew Research Center. https://www.pewresearch.org/fact-tank/2018/04/11/millennials-largest-generation-us-labor-force/. Published April 11, 2018.

6McChrystal S. Listen, learn…then lead. TED Talks. https://www.ted.com/talks/stanley_mcchrystal_listen_learn_then_lead. Published March 2011.

7Goler L, Gale J, Harrington B, Grant A. The 3 things employees really want: Career, community, cause. Harvard Business Review. https://hbr.org/2018/02/people-want-3-things-from-work-but-most-companies-are-built-around-only-one. Published February 2018.

8The whys and hows of generations research. Pew Research Center. https://www.pewresearch.org/politics/2015/09/03/the-whys-and-hows-of-generations-research/. Published September 3, 2015.

Mike Osler

Mike Osler, PT, DPT, serves as VP of Growth & Development of Rock Valley Physical Therapy in Iowa and Illinois. He can be reached at mike.osler@rockvalleypt.com and @mosler4610.

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