Media formats available:

In the last several years, the growing influence of the Millennial generation has begun to take shape in our specialty. This manifests most evidently in the daily operations of a medical practice, which is made up of individuals whose personal experience and generational attitudes give them unique perspective. Because our field includes many highly intelligent people of older and younger generations, it's very important to realize that many different viewpoints can be valid.

While older folks (i.e. Baby Boomers) are clearly steeped in a non-digital background, this allows a fresh perspective on certain newer technologies that are intuitive to the Millennial generation. For example, advertising on digital platforms may be second nature for younger generations, but probably will not resonate with the older customers or patients of many dermatologists. Having said that, it is increasingly important to become fluent with the mind of Millennials, because they will be customers and/or patients in the near future. Moreover, the ideas of the Millennials will prepare the practice for success in the future. In order for a practice to expand its patient base, dermatologists must adapt to new technologies and approaches as they appear.

Ahead, we share vignettes and pearls based on our own experiences in managing a practice with a variety of generational perspectives:


In our practice, we've seen numerous examples of Millennials who have come to interviews dressed in anything, ranging from open-toed shoes to shorts. This would have been unheard of years ago. However, it's very important to look at the individual without any prejudice and with an eye toward whether that individual can and will blend their style to the overall tenor of the practice. Clearly if the practice is made up of a younger, hipper group of individuals, some lifestyle expressions may be perfectly acceptable that would not be acceptable to upscale older groups.

In our practice, we have had great success with some of the Millennials who were completely unorthodox in their interview, due to our needs and to their willingness to compromise with dress. For example, we have had individuals who came to interviews with flip flops and tattoos on more than 50 percent of their bodies who turned out to be some of our better workers. Because we understand that tattoos and piercings can be unsettling for some customers, depending on the job, we've kept a steadfast rule for any individual that tattoos and piercings be covered and clothes be appropriate for the job.


Our practice has evolved over time, changing from a pure vacation approach to a paid time off approach, due to ongoing needs of our staff. We have found that the work-life balance equation is ever more important. Recently we have added extra vacation days to our employee benefits due to the importance of having competitive plans when recruiting staff. This has led to a significant increase in the quality of applicants, and an easier time filling positions. We believe we have benefited by having more staff in order to cover events such as maternity leave and other paid time off. Most important, overall staff happiness has been higher.

Time off is more important to Millennials than other generations than it has been to other generations. The emphasis on happiness is important to every generation and there is something to learn from Millennials when it comes to focusing on balance and family.


We have found that Millennials are much more likely to participate in social media, making it extremely important to delineate how HIPAA rules impact staff members' ability to interact and disseminate information to patients. Now that our practice has integrated social media, responsibilities for posting fall on the lap of Millennial workers, who typically know more about the format than most older workers. However, we should also remember that having the ability to work a Facebook account doesn't imply an understanding of the importance of maintaining patient privacy.

Careful, scrupulous training is required for all employees when it comes to using social media. We have seen instances in which non-medical employees didn't understand the importance of privacy or understand the various levels of privacy. In their training, staff members should learn about the importance of interacting with patients despite the constant use of technology. And, when using the technology, they should understand that personal boundaries are essential, particularly in light of the willingness of Millennials to share almost anything.


All generations are looking for middle ground when it comes to communicating and working together. But it clearly is a struggle in most practices when we live together and work toward the goal of excellent patient care. Millennials don't understand the reasons Baby Boomers do things and the rationales behind decision-making processes. Conversely, Baby Boomers have all too often dismissed Millennials as insignificant. We need to learn from each other to avoid the appearance of huge generation gaps.

While we all have our weaknesses and faulty tendencies, to stereotype someone based on a larger generalization regarding her or his generation can only lead to more misunderstanding. For example, many Baby Boomers have an image of Millennials and sub-Millennials as folks who are glued to their phones. While we've certainly encountered this with some staff members and patients, we should remember that 1.) this may not be reflective of that person's age group; and 2.) surface details may be dictating more than they should. Sometimes the patient involved with his phone is listening more than you think, and young people themselves may be more frustrated by heavy use of phones than the older generation.

There will likely always be some gaps in understanding. Most of us—young or old—can recall an instance in which generational differences resulted in tensions or failed understanding with a co-worker, a patient, etc. But no matter how difficult, it is critical that we keep an open mind, listen, and try to learn from each other. Our specialty will be shaped be future generations, and we can only move forward if we learn to adapt to new ways of seeing things clinically as well as socially.


1. Success is often hard and requires much planning. Baby Boomers have lived by that motto, and it has served them well for the most part. While accidental successes have been noted in the media, more commonly, success is tedious and long in the development stage.
2. Baby Boomers have a great deal of information and advice to give. If approached in the right manner, they can be great allies in helping Millennials rise through the ranks.
3. Baby Boomers are generally making decisions regarding management positions for organizations for now and the distant future. It would make sense for Millennials to try to analyze things from the Baby Boomer point of view in order to both understand their perspective and to interact in a mutual learning environment.

1. Baby Boomers are not proficient with social media and have a rudimentary knowledge of how to use it to promote. It is important to find a Millennial friend and go online with them.
2. Baby Boomers may control the world now, but Millennials will take it over in the not too distant future. Judging from the adeptness with which they harness technology, it may be much quicker than we think.
3. Millennials are fun and their minds work in ways that Baby Boomers haven't ever expected or experienced. It will brighten your day to interact with Millennials who are digitally native and fearless.

Joel Schlessinger, MD is Course Director of Cosmetic Surgery Forum

Jenny Lewis is Founder of Lewco Consulting www.lewcoconsulting. com.

Nancy Schlessinger, MS is Vice President of Lovely Skin

Completing the pre-test is required to access this content.
Completing the pre-survey is required to view this content.

We’re glad to see you’re enjoying PracticalDermatology…
but how about a more personalized experience?

Register for free