Urgent message: Are Millennial employees breathing fresh energy into the urgent care workplace or are they a new breed of workers who don’t go along with established workplace norms? Your perspective may influence how you fair in their ascendance.

Rachel Sossoman, MSHR, SPHR, SHRM-SCP


Millennials—Americans born between 1981 and 1996—became the largest demographic group in the U.S. workforce at 56 million strong in 2017; this year, they will overtake Baby Boomers as the largest segment of the entire U.S. population, according to Pew Research. Some urgent care operators may see this as a serious problem. Even the most flexible operators are likely to acknowledge this evolving multigenerational mashup presents a challenge. Fortunately, there is not only hope, but competitive advantage in the coming years for culturally savvy urgent care operators who adapt to the unique needs of the multigenerational workforce.

What Is the Problem (Assuming There Is a Problem)?

No problem can be solved without first understanding it. That said, one major challenge of identifying cultural problems in a multigenerational workforce is just that: identifying the problems.

Culture is defined as “the attitudes and behavior characteristics of a particular social group.”1 In organizations (and urgent care is no exception), the social norms of that group, and thus, the organization’s culture, are defined by people. Who gets to decide the cultural norms for the group? According to the Stanford Encyclopedia of Philosophy, social norms form when individuals interact.2 Eventually, a collective mindset coalesces, formed by a consensus of a majority, producing a social order of sorts. Once norms are established among a group, praise and blame are given to its members relative to conformity or nonconformity with the established norms.

Enter Millennials, also known as Generation Y. In 2007, the Pew Research Center dubbed Millennials the Look at Me generation, alluding to the prevalence of social media use among Millennials, commonly associated with an inflated sense of self-importance.3 Culturally speaking, Millennials are often at the center of generational conflict in the workforce due to perceived attitudes and behaviors that conflict with workplace norms. Fairly or unfairly, workplace behaviors commonly attributed to Millennials often lead them to be assigned the culprit’s role when cultural friction arises. This spotlight on Millennials isn’t without some merit, as there are cultural norms unique to Millennials that make this group visible in workplaces when collective norms differ from theirs.

The characterization continues with egotism, one of several perceived behavioral characteristics that have catapulted this generation into the spotlight. Other perceptions of Millennials include, but are certainly not limited to, a general lack of communication skills outside of tech-savvy methods such as texting; disloyalty in the form of frequent job-hopping; and emotional instability that some say results from receiving too many “participation trophies” as children.

On the other hand…

An article from the Journal of Business and Psychology entitled Millennials in the Workplace: A Communication Perspective on Millennials’ Organizational Relationships and Performance analyzed both empirical studies and popular literature on the group, and uncovered some suspect findings for anyone who believes Millennials are to blame for the multigenerational culture conundrum: most shockingly, that popular media have misclassified Millennials as lazy, disloyal, self-absorbed and impatient, and as a result, contributed to widespread stereotypes based on information that was “more opinion than evidence-based.”4

The research-backed reality is less sensational and hardly reported in popular media, according to the authors. Assimilating into an organizational culture with established norms and cultural stereotypes against Millennials inhibits their ability to assimilate into the group.4 Is it possible that Millennials really aren’t the culprit for our workplace woes? The article purports that Millennials are no different from any “outsider” attempting to assimilate into a culture that differs from that outsider. If that’s the case, then any generation, culture, ethnicity, gender, group, person, etc.—not just Millennials—can become the outsider in a workplace culture.

By this measure, multigenerational conflict can be reframed as a result of the unwillingness to consider challenges to established norms instead of one generation’s misconduct in the workforce.

There is one major advantage to defining the problem this way. Consider the Pew research on Millennials in the workforce and its implications for workplace norms. If norms are formed by the majority, then Millennials, the largest group in the workforce as of 2017, are in a prime position to define (or redefine) workplace norms. By eliminating one generation or the other as the suspected culprit of cultural problems and reframing differences as an opportunity for growth, urgent care centers can ensure that all cultures and generations have a voice in their respective groups.

Culture and Employee Engagement

Culture and engagement are two different concepts that are inextricably linked. According to Deloitte, culture can be summed up as “the way things get done around here,” while engagement can be described as “how people feel about the way things work around here.”5 The former describes norms; the latter describes individual/collective commitments to those norms. In a Culture and Engagement Perspective whitepaper, Deloitte describes both culture and engagement as “critical to business performance,” with “actively managed” cultures producing 147% higher earnings per share along with employees who are 87% less likely to leave.5

Global research by Gallup highlights the gap between culture and employee engagement in the United States, finding that a mere 33% of employees in the United States define themselves as “engaged” at work. That leaves a whopping 67% who are actively disengaged. Of that 67%, 16% are beyond disengaged, to the point of actively sabotaging the company.6

Why does engagement matter? According to the data, the short answer is: cost and risk. The same Gallup study purports that the costs of cultural dysfunction in the workplace can be “catastrophic.” A 2017 study conducted by the Engagement Institute—a collaborative effort among the Conference Board and Deloitte, among other organizations—revealed that disengaged employees cost upwards of $550 billion per year.7 Urgent care is not exempt from the costly perils of dysfunctional cultures. What’s more, volatility stemming from shifting reimbursement models and payer mixes renders urgent care quite vulnerable if internal costs cannot be controlled. In a market with record low unemployment, turnover alone can be highly disruptive.

By comparison, the Gallup study revealed that organizations with engaged employees enjoy 37% lower absenteeism, 48% fewer safety incidents, 41% fewer quality issues, 10% higher customer satisfaction, 21% higher productivity, and 22% higher profitability. The benefits of an engaged workforce are as clear as the liabilities of a disengaged workforce.6

Employee engagement and workplace culture are directly linked and executives know it. However, according to Deloitte, while nearly nine out of 10 executives believe culture and engagement are very important, only 12% of companies believe they understand their culture.7

In other words, we know there are cultural issues stemming from our multigenerational workforces, we just aren’t sure what they are–and even if we do know (which we don’t), fewer than half of us are prepared to tackle the challenge of engagement.

How Can Urgent Care Engage a Multigenerational Workforce?

  1. Build trust, influence change. How well do leaders and managers “walk the talk?” Culture and workforce engagement begins with urgent care leaders forming and communicating cultural expectations collectively with The greater the employee involvement in decision-making, the greater the likelihood of employee trust in the leadership and engagement in the company. What better example of an essential cultural behavior in urgent care, for instance, than cross-functional teamwork among employees involved in patient throughput? Teamwork is also an essential behavior for cultivating functional multigenerational cultures. If they aren’t already, behaviors such as teamwork should be incorporated as clear performance expectations for employees, and employees should be held accountable to them. Likewise, leaders must champion the value that different generations bring to the workforce, and set the expectation for an environment that’s generationally inclusive.
  1. Define core values. If utilized properly, there is hardly a better avenue than core values—the intrinsic beliefs that organizations follow in all facets of work—to define cultural norms for an organization. Core values are the guiding principles that influence behavior when coworkers and supervisors aren’t there to direct it, and are a powerful tool to influence cultural norms. Core values are directly linked to pride in the organization, an emotion that strongly correlates with employee engagement. It isn’t enough to post core values on a website or letterhead, however. They must be regularly communicated and incorporated into all facets of work, from vacancy postings to training to job descriptions. Core values are helpful recruiting tools, as well, communicating to prospective employees a cultural message that candidates wouldn’t otherwise know.
  1. Foster inclusive relationships with employees. A meta-analysis of workplace engagement studies published by groups such as Gallup, Towers Watson, and Hewitt Associates, among others, revealed that the direct relationship with one’s supervisor was the strongest of all drivers of employee engagement.6 The onus is on leaders to set the tone for inclusivity. Utilize multiple feedback channels to gauge employee attitudes toward their direct supervisors. Engagement surveys abound, and they offer benchmarkable questions that address the supervisor’s leadership skill, as well as recommendations for development.
  1. Recognize and refrain from buying into stereotypes. Sure, some Millennials may prefer texting to other types of communication, but that doesn’t mean all Millennials do. Even if all Millennials did prefer texting, it doesn’t mean they should be marginalized for it. Insert culturally savvy leadership. When work groups marginalize a coworker, leaders must quickly identify the underlying cause of the marginalization, and if it’s cultural, correct behaviors accordingly. Some of the biggest drivers of employee engagement transcend generations. Take recognition, for instance. A LinkedIn survey revealed that 70% of employees, regardless of generation, would work harder in exchange for recognition.8 Their preferences for the specific type of recognition may vary, but their desire for recognition is the same. Inclusive cultures look for the commonalities and eliminate the stereotypes, and effective leaders influence that culture.
  1. Listen. Communication goes both ways, and employee communication style preferences vary widely, but the desire among employees to have a voice is universal across generations. Upward communication is a catalyst of innovation, and can be a sign of a healthy work culture. Are employees thanked for feedback, or marginalized for speaking out in your urgent care operation?
  1. Offer relevant incentives. Generational or otherwise, different employees value different incentives. Find out what incentives employees prefer by asking them. Then, offer incentives that cater to the diverse needs and desires of your workforce. There may be surprising cost savings, as not every employee is interested in climbing the corporate ladder. Some employees, for instance, may prefer schedule flexibility, training opportunities, or public recognition to promotions or large bonuses. Employees whose preferences are taken into consideration are more likely to be engaged.

According to Josh Bersin, founder at Bersin, Deloitte Consulting LLP, “Moving the ‘diversity discussion’ beyond gender and race to also discuss generational diversity and inclusion is a major theme for the next few years.”5 In other words, an organization must reframe its definition of “diversity” to include generational diversity if it hopes to achieve a culture that values the contributions of each member. Much in the same way that organizations have historically redefined norms to eliminate discriminatory behaviors against other groups, they must also redefine norms to eradicate the same stereotypes across generations—including, but not limited to, stereotypes against Millennials. Culturally savvy urgent care centers that invest time and resources in eliminating stereotypes, generational and otherwise, and fostering a culture of inclusion will be poised to thrive in the years to come.


  1. Dictionary.com. Available at: https://www.dictionary.com/browse/culture. Accessed August 9, 2019.
  2. Social norms. Stanford Enyclopedia of Philosophy. Available at: https://plato.stanford.edu/entries/social-norms/. Accessed August 9, 2019.
  3. Pew Research Center. A protrait of “generation next.“ Available at: https://www.people-press.org/2007/01/09/a-portrait-of-generation-next/. Accessed August 9, 2019.
  4. Myers KK, Sadaghiani K. Millennials in the workplace: a communication perspective on Millennial’s organizational relationships and performance. Journal of Business and Psychology. 2010;25(2):225-238.
  5. Culture vs engagement. Available at: https://www2.deloitte.com/content/dam/Deloitte/us/Documents/human-capital/us-cons-culture-vs-engagement.pdf. Accessed August 9, 2019.
  6. Reilly R. Employee engagement now. Workplace. Available at: https://www.gallup.com/workplace/231581/five-ways-improve-employee-engagement.aspx. Accessed August 9, 2019.
  7. Bolden-Barrett V. Study: disengaged employees can cost companies up to $55B a year. HR Dive. Available at: https://www.hrdive.com/news/study-disengaged-employees-can-cost-companies-up-to-550b-a-year/437606/. Accessed August 9, 2019.
  8. Moody K, O’Donnell R. Enhancing engagement in the 5-generation workforce. HR Dive. Available at: https://www.hrdive.com/news/enhancing-engagement-in-the-5-generation-workforce/519244/. Accessed August 9, 2019.


Rachel Sossoman, MSHR, SPHR, SHRM-SCP is Director of Human Resources, Mercy Urgent Care, Asheville, NC. The author has no relevant financial relationships with any commercial interests.

The Millennial Conundrum: Fostering an Engaged Multigenerational Urgent Care Workforce
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