Is “Learn from Your Elders” Being Replaced With “Learn from Your Youth” in Healthcare?


Mark's Note: Today's guest post was written in partnership with the Society for Health Systems, an organization I highly recommend to those who work in healthcare improvement. I recommend and participate in their annual conference and I hope you'll join us in the future. I'm also a newly-named Diplomate member of the society. Today's blog post by John Elliott is the first in what will be a monthly series of contributions from senior SHS members.

By John Elliott

“Learn from your elders” is a phase I've heard spoken on many occasions throughout my life. I was born late in the baby-boom generation, which ended that day in February 1964 when the Beatles crossed over the pond and stepped on American soil. Millennials, on the other hand, like my son, daughter and their spouses, have always lived during the information age and entered the workforce around the time the digital age was maturing at the turn of the 21st century. With all the changes currently in the healthcare industry and showing no sign of regressing, I say:

“Learn from your youth.”

Most healthcare engineers who are early in their career have grown up with cell phones, PCs, smartphones, digital photography, digital shopping, etc.; thus, at work they are very comfortable working with massive amounts of information and making the information work for them. The baby boom generation entered the workforce pre-information age, the Gen X'ers at the up-start of the age and Millennials as the age is maturing.

The Millennial generation has so much potential, particularly as the healthcare industry is entering this new era, an era where information is king.  When I first began my career, much of my information during a project came from my own observations and learning from the front-line staff and management. Of course, much of what I learned came from perceptions I made and those of the staff performing and managing the work. Yet, in a recent project working with an engineer closer to my son's age, he didn't talk to anyone.

First, he went straight to the database (a Cerner Patient accounting database) and pulled the last year's information. During an afternoon, using some analytical tools and his own thought process, he was able to verify the issue in question and tell me where he thought the obstacles were and quantified the problem. By noon the next day, we had an action plan of attack. This enabled us to verify the issue with management and staff using “hard” credible information. My way would have resulted in days of observation and setting up interviews to get to the point where we could define the true issue…. then use the database to verify it.

The smartphones are in the beginning stages of making diagnoses. These devices can already monitor one's heartrate and pulse, recommend healthier lifestyles, calculate calories burned, and count steps taken in day. The patient is becoming much more informed on their health and about how to pay for their healthcare. The rapid movement from pay-for-volume to pay-for-value will require the use of much different metrics for gauging productivity and profitability.

Because the patients are much more informed, the day that they simply do what the doctor tells them are long gone. In the book The Patient Will See You Now by Eric Topol, MD, he basically explains how to use artificial intelligence algorithms to diagnose one's health and the reduction in costs associated with this type of diagnosis.

It's the students currently being trained in our academic institutions and the early careerists who have the comfort level and knowledge of how to manage all this information and to do it effectively. How can we learn from each other?

The answer to that question will be critical as the industry transitions into a new payment model and new relationships between practitioners and patients.

I would suggest some of the following recommendations:

  1. Since Millennials have lived through the transition from analog to digital, learn how they communicate with each other. They are first-generation digital natives. Understand their technology.
  2. As we live longer, life after our working years is generally much longer than our parents and grandparents. My kids live a much more balanced lifestyle than my wife and I.
  3. Understand the perspectives of each generation. How does a baby boomer look at work and life as compared to our current early careerists? While we might understand the work necessary to reach some conclusions, the early careerists understand the “how” in the digital world to get to same conclusion but with less of the “necessary” work.
  4. Understand the diverse ways of learning…. I like to read books and a physical “newspaper.” Millennials get all they need over the phone and can funnel out unnecessary information. They read for need and speed, while I read for knowledge.

My father was a physician and my son is currently a second-year internal medicine resident. It is interesting to get those two in the same room to discuss how to be a good diagnostician. My father is better at talking and probing with his patients, while my son is better at reading what the analytics say. The future of healthcare engineering is in the hands of the Millennials and Generation Z practitioners. They will be the ones with the experience in clinical integration, clinical variation, predictive analytics, artificial intelligent diagnostics and algorithms. I can only hope to be a participant in any of these methods of cost reduction and improvements.

As a student, I joined the Institute of Industrial Engineers and could connect with other engineers in the field, those with the experience to tell me what to expect in the workforce. When I directed my career out of manufacturing and into health care, I once again relied on the expertise of the few engineers in the health care industry. I have been a member of the Society of Health Systems (SHS), an entity of what's now called the Institute of Industrial and Systems Engineers, since I entered the health care industry.  I found it valuable:

  1. to establish mentors in the healthcare engineering field and in the health administration field, like those you will find within SHS's Experienced Professionals committee,
  2. To use those with more experience and in the field longer to help connect with others in the field, and
  3. To re-focus or re-adjust my approach on things…. whether a peer or a mentor, all professionals need others to help guide their career.

About the author: John Elliott is a healthcare engineering consultant with over 30 years in the healthcare industry, almost 25 years in the healthcare engineering management area. He has extensive knowledge in healthcare process improvement and labor management. He has impacted over 60 hospitals and health systems in the academic, for profit and the not for profit healthcare sectors. Mr. Elliott is a Diplomate with the Society of Health systems, an entity of the Institute of Industrial and Systems Engineers and a Fellow with the American College of Healthcare Executives. He is a Lean/6 Sigma certified Black Belt with The Process Improvement Group and the American Society of Quality. John resides in Ridgeland, MS.

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. I believe a key underlying fact is the need for leadership that can adapt to the constant changes in our world today. True transformation begins with understanding the culture of an organization that is made up of many who view work and life through different lens as pointed out in the article. Being able to speak the language of your audience, with authentic listening is so critical. The element of emotional intelligence is playing a more defined role with the communication styles of multiple generations in my opinion. This is a great read that brings the awareness for change to the forefront. Excellent reflection.

    • Thanks for your comment, Rick.

      In my reading of John’s post, one thing that came to mind was the idea of “respect for people.” We should respect all of our colleagues and treat them with respect, regardless of their age or experience level.

      I love hearing about organizations that set up “two way” mentoring relationships, where a younger person learns from an older employee and vice versa. We all bring different perspectives to work, regardless of generational labels.

      Organizations and leaders that respect and engage more people will be more successful than organizations that think all of the wisdom and ideas are at the top of the organization.

      It would be interesting, also, to hear about age discrimination in places like Silicon Valley that seem to value youth by default. I say this as the oldest person (and with the most grey hair) on our KaiNexus team :-)


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