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Bridging the gap: Connection, communication can ease clashes between generations of derms


National report - With four generations of dermatologists rubbing elbows in medical schools and residency programs, and three generations working side by side in practice and other settings, it's no wonder that doctors of all ages are feeling frustrated.

Key Points

Experts say generational differences are causing more than just discord in the medical field and other professions. Unaddressed, problems associated with varying work styles and expectations can have far-reaching effects on recruiting and retention.

While definitions of the generations vary, and individuals within generations can differ, Devon Scheef and Diane Thielfoldt, co-founders of the Learning Café, a consulting company specializing in generational issues, define today's working generations as:

The older generations - silent and boomers - are known for having a strong work ethic, sometimes putting their careers before marriage and family.

"In terms of personality, the baby boomers are going to be those that are described as the 'me' generation - very accomplished, very competitive. They are defined by their work (and working hard to get where they are)," says Carlos Garcia, M.D., a dermatologist in Oklahoma City and associate professor and director of dermatologic surgery, department of dermatology, University of Oklahoma.

The Gen Xers, on the other hand, seek work-life balance, he says.

Gap: How can older, younger practitioners connect?

They are more apt to view a job as a job, says Dr. Garcia, who speaks on intergenerational differences at meetings of the American Academy of Dermatology. Gen Xers will ask their superiors what they should do, promise to carry it out efficiently and consider that their contribution.

The younger generations (Xers and millennials) are not interested in going the extra miles to prove their worth. They do not want long hours or weekend or night work, he says.

Ironically, while Gen Xers tend to relish independence, baby boomers like to micromanage, according to Dr. Garcia.

"So, baby boomers will tell you what to do and, on top of that, say, 'I'm going to be looking over your shoulder to make sure that you do it.' Xers ... reject that," he says.

And while the older generations are more likely to respect authority as the end-all, younger generations tend to question it.

The fallout

The differing generations bring different perspectives - and expertise - to their medical practices.

At age 86, and still practicing dermatology five days a week, Jerome Z. Litt, M.D., of Beachwood, Ohio, says the general dermatology that he has practiced is becoming a lost art.

Dr. Litt, assistant clinical professor of dermatology at Case Western Reserve University School of Medicine, says when he was trained, dermatologists limited their surgical efforts to the excision of tumors, destruction of warts, and biopsies of strange or complicated lesions or dermatoses.

"There were very few cosmetic companies - no lasers, of course, at that time - and therapeutic options were greatly limited. Only penicillin and sulfa drugs were available; no corticosteroids whatsoever (until 1953 or 1954). We were treating syphilis and other sexually transmitted diseases, and most of the time, we were diagnosing and treating in the proverbial dark," he says.

"We were using X-ray therapy for acne, psoriasis, tumors and a variety of other dermatoses," Dr. Litt tells Dermatology Times.

Nowadays, he says, "I believe that there is too much stress on cosmetics ... (and) not enough time is spent with patients; too long a wait for seeing new and old patients; no 'quality control' and no 'pride of workmanship.'

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