generationalThe World According to Generation Z. This was the title of a recent HCA Healthcare Cultural Inclusion Series (CIS) BRAVE conversation featuring “post-millennials” from our organization’s summer internship program.

BRAVE, which stands for Bold, Relevant, Authentic, Valuable and Educational, is a series created by  HCA’s Cultural Development and Inclusion. The series allows our colleagues to have dialogue around difficult topics, and express their opinions, fears, and concerns in a safe and respectful setting.

“We create dialogue around topics like these with a goal to help us strengthen our culture of inclusion and respect,” Sherri Neal, vice president of HCA’s Cultural Development and Inclusion, said.  “We can all learn something new and gain more insight from those who will be our future colleagues and leaders and also from those who have paved the way.”


Generation Z, born between 1995 and the 2000s, is the most ethnically-diverse and largest generation in American history.  Currently at HCA, however, millennials, those born between 1981 and 1996, have the highest presence in our workforce, followed by Gen Xers (1965-1976) and Baby Boomers (1946-1964). Traditionalists (1909-19045) and Gen Zs are a small percentage, but not for long.

“In my opinion, Generation Z really values equity and the idea that each person deserves a fair shot to succeed,” said Andriana Johnson, a Gen Zer and summer intern at HCA. “We recognize the playing field is far from level for everyone. As a result, we tend to be in favor of initiatives that give people opportunities that they otherwise may not have been able to access.”

Neal offers the following insights for forging generational engagement and harmony in healthcare among the different generational groups.

  1. Make a conscious effort to manage your own generational bias.A Baby Boomer, Neal describes herself as a “cusper,” sharing characteristics with Baby Boomers and GenXers, yet also often thinking through the lens of her millennial children.

“Millennials represent the lowest rate of healthcare consumption, but perhaps they’re just different kinds of consumers of healthcare,” she says. “The world is technology for them, so they can always look on the internet to validate a doctor’s advice, whereas I would probably just listen to and trust the authority figure.”

“Some might say of the millennial checking her phone, ‘Wow this person is rude,’ ” Neal continues. “But that’s not necessarily true. The way millennials process information is to multi-task. They’re looking for quick turnaround and fast interaction.”

Neal underscores that everyone receives and processes information based on many factors, including generational biases.

  1. Ask a lot of questions to decipher generational expectations. Each generation has unique characteristics that inform expectations and behavior, Neal says. “If 80 percent of your patients are traditionalists, find out what’s important to them. From what lens are they viewing healthcare? Do they want to go slowly through all the steps behind a decision, or do they just want the fast answer and then go on their way?”

Neal gives the example of a traditionalist with a Gen X primary care physician. “A traditionalist will get along with a Gen X doctor who treats her with respect and understands how she values hierarchy,” Neal says. “Traditionalists often rely on the healthcare system as the authority. They are very formal and often want to be referred to as Mrs. or Mr. They evaluate healthcare on how well their healthcare providers understand these unique needs.”

Neal also points out that many traditionalists are uneasy with the pace of change. “Once when I was in the hospital visiting an older family member, a younger nurse came in and flew through the list of medications my family member needed to take. My relative asked no questions, but when the nurse left the room, she asked me to take a picture of the cup of pills. The family member said, ‘I’ll need this later. I couldn’t keep up with everything she said.’ ”

  1. Start a dialogue and commit to learning more about different generations.“Everyone has to be intentional about creating a culture of inclusion,” Neal urges. “It doesn’t always come naturally, but the better you get at closing the communication gap, the better you’ll be able to relate to different generations and the more progress we’ll all make.”

HCA Healthcare launched the Cultural Inclusion Series (CIS) in 2007 to provide greater cultural understanding and a platform for informal diversity education. The program is an International Innovation in Diversity award winner.

HCA 50th Anniversary
In 1968, HCA Healthcare was conceived by two physicians and an accomplished business leader — Dr. Thomas Frist Sr., Dr. Thomas Frist Jr., and Jack Massey. This year, HCA celebrates its golden anniversary and the culture of caring established by our three founders 50 years ago. To help us celebrate our 50th year, we’ll share stories here that reflect HCA’s mission – above all else, the care and improvement of human life – and our pledge to improve life and make history for the next 50 years and beyond.