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  • Anna Liotta
  • Missy Padoll, CRICO


I’m Missy Padoll. I am thrilled to be speaking today with Anna Liotta to discuss generational codes and how we can most effectively speak to people who fall into these different generational groupings that you have done so much amazing work in. So, thank you for joining us.

A) Oh, it’s my pleasure to be here.

Q) In addition to being an award-winning author, Anna Liotta is also a national spokesperson. I personally had the pleasure of seeing her capture the attention and energy of an entire room at a conference I attended recently. So, you called your book, Unlocking Generational Codes. In a nutshell, what are these codes and how do we crack them?

A) When we are about age eight, our brains start to make logic. We start to understand the world around us, and between the ages of eight to 18, there are things that happen. There are events, there are leaders, there are icons that we are observing, we’re really being immersed in. And when there is an event and it’s paired with an emotion, it creates an imprint, but we don’t know it, but it starts to create a code that we think is how the world works.

Q) So for most of us, we tend to think of a single generational gap, but you’re talking about several gaps at the same time and that we have to be, or impressions as you call them. So, we have to be able to understand each of these individually. Can you sort of lay those out for us a little?

A) Ok, let’s start with the different generations that we have alive right now. There are six generations alive and a seventh one beginning to be born.

  1. Our oldest generation is our GI Generation, and they’re born before 1927.
  2. Our Traditionalists were born between 1927 and 1945.
  3. Our Baby Boomers were born between ’46 and ’64.
  4. Gen Xers were ’65 to ’77.
  5. The Millennials, who are originally as placeholder name called Gen Y, were born between ’78 and ’99,
  6. and now the Globals, that’s the name that I’ve actually coined for them, and we’ll talk a little bit about why they see themselves as global citizens and that name fits them so well. They are born 2000 to 2016.
  7. So, 2017 and 2018 is a whole other generation being born.

So, now we come to the codes, where do they show up? They show up in your communication styles, they show up in your orientation to the world, they show up at how you relate to discipline and authority, how you relate to your environment that you thrive in and your success factors. So, across C-O-D-E-S, are all of those elements the codes show up in.

Q) So, how do providers adapt this in a special way for their communication and decisions with their patients?

A) One of the things that’s really important is to be able to shift into the generational code of the patient that you’re serving. And that means we have to understand the micro level of coding as we’re engaging. So, for instance, when we are talking a Traditionalist or even a Baby Boomer patient, they want us to come in, sit down, look at them in the eye and visit with them to have a conversation that may not start with their medical need first. It might start with listening to stories about their family and having a longer conversation about the non-medical side of it before we get to the medicine. We need to create time for that and we also need to train our younger doctors around the importance of that and how much that actually applies to their health issue.

Now a Gen Xer comes in, a Gen Xer will appreciate if you roll in with your computer, you listen to them and you cut to the chase, get to the bottom line right away and you’re taking notes while you’re listening to them. They want to know that you are not going to walk out of the room and try to recapture from memory everything they just told you. They appreciate that you are taking notes in real time and you’re getting it down, and then you actually repeat back to them, so this is what I’ve heard you said. You’ve told me this, this and this and this. And assume that they actually understand their health when they come in. They want to be in that transparent, bottom line, cut to the chase with their healthcare provider. That increases their trust and their compliance.

The Millennial comes in and they also want to see that you’re taking things in real time, but the thing that you might see sometimes with Millennial doctors is that they don’t have the same level of eye contact with a Baby Boomer or Traditionalists or even a Gen Xer because they’re much more comfortable with moving directly into the digital capture without looking up. Now, this can be a challenge with patients because the Boomer or the Traditionalist patient might say, I didn’t feel like they heard me, and the Millennial’s thinking, wait, I took down everything you said, but this is where the training of eye contact and stopping to visit with them becomes a really important thing because we know compliance goes down in patients when they didn’t feel like their doctor listened. We know that the longitudinal application of whatever we recommended goes down if they didn’t feel connected. And so, for our Millennials who grew up with devices being an active part of their training and practice and referencing, we actually have to teach them that for a moment you set the device down. You might actually need to wait before you pick up to capture it.

So, you have to switch into the code of the patient in front of you and have practices in place to support both.

Q) Where do you recommend people start if they want to learn and apply this to their communication flow, their interactions with others, their healthcare work, whatever line of work they happen to be in? I’m sure this would be useful information. So, are there some basic how-to’s?

A) Yes absolutely. One of the how-to’s is to start with questions not answers. So, it starts by asking people, tell me a little bit about it, what it was like for you?. And that is an interesting journey. Every single practitioner has the opportunity with their peers, with their patients to ask the questions, what makes you feel most comfortable, why does that make you feel most comfortable, how would you prefer that I do this?

And this shows up in the channels that we communicate with, the follow up. How would you prefer we follow up with you about your information? What is the channel that you feel most comfortable on? Is it face to face, is it phone, is it text?

Depending on their generation, we’re going to start seeing some trends, but as a practitioner, we actually have to become facile across channels. It comes in how we have our office set up. Do we prefer a super formal office for our practice or do we have a more informal office that’s more kid friendly for our Gen Xer parents and our emerging Millennial parents? In our onboarding practices with a patient, do they prefer to have a first sit down where we don’t even talk about the specifics of the medical issues that they’re coming in or in that first onboarding conversation, do they want us to cut right to the chase? All of these different things, we can ask more questions of our practitioners and of our patients and just by asking the question, we’re going to be able to fine tune how we serve their generational code.

Q) And so, what’s the risk if you don’t understand generational codes or if you haven’t just discerned the nuances of this type of communication through your own experiences in life?

A) I think there’s two big risks, either your patients leave you or they sue you, your talent leaves you or they sue you. The worst is that they so felt misunderstood that they’re more likely to take action of a legal nature to get your attention, and that is just not what we want to happen because they tried at some point to signal you that they weren’t feeling heard, their code wasn’t being served, and then if they don’t, they go to a litigious nature. So, the worst is they just leave, they just pick up and leave and you don’t know why. And that’s one of the things, you know, that the big risk is before they ever even get to you, sometimes the risk is they didn’t choose you and you don’t know why. Then the risk is they left you and you don’t know why and the final risk is they sue you and you don’t know why.

Q) In our, in our malpractice cases, we see a number of medical errors that arise due to a breakdown in communication or communication failures among providers. And we attribute a lot of those are ready to provider speak verses nurse speak or hierarchical intimidation, but it seems as if generational codes may also have skin in this game so to speak. Can you speak to where you think that may also have an impact in the breakdown in teamwork communication that can lead to error?

A) Yeah, I think it’s a really insightful question because in the traditional codes around medicine, the ability to speak up and to say something was not as encouraged as it is today. And yet, we still have legacy practices when we get into high pressure situations, particularly when we get into a time sensitive situation as surgery or that kind of thing. We have a lot more practices in place to say anyone in the room can speak up if something is happening, and yet we have some code practices which is the person with the most seniority in the room is really the most listened to. And so, when it comes to generational codes, we have to be far more explicit about the ones that have been there in the past that we no longer honor, and that’s what doesn’t happen a lot.

We don’t often acknowledge that there are practices that used to be in place that we know no longer serve us, and that’s when, if we don’t name it, call it out, address it, it still kind of operates. And so, for our Baby Boomers, a lot of times it might sound like they haven’t been here long enough to know what I know. They might not say it with this formal word but they’re saying, I have crystallized intelligence. I have a collection of contextual intelligence which then gets into the problem for both Gen Xers and Millennials that they see something, they want to say something, but there’s also some pressure around them not to, and that’s where we get into miscommunication and errors arise. And when it arises, people say: Well, I said something to someone and they didn’t want me to, you know, bring it forward because it would have disrupted something. So, I shut up. And now, we see somebody who’s also on the verge of leaving us because they no longer feel like in the community, in the culture they’re able to actually speak up and address the errors as they come up. They will start to muster out.

Q) So, is there anything about this point in time that makes healthcare or the public in general more or less receptive to changing our thinking and behaviors based on generational codes? In your book, you write that resistance is futile. I love that. What exactly did you mean by that?

A) Well, in my book, Unlocking Generational Codes, we talk a lot about the demographics that are happening and right now, it’s even more intense. We’ve got the silver tsunami of our Baby Boomers, and they will be using healthcare, and we’ve got the Gen Xers in the prime earning years of their life. They are at the highest peak of power in calling the shots on organizations and institutions where they will have their medical services provided. If they’re the leader and they’re saying, these are the ones we’re providing. And then we’ve got Millennials. Right now, our Millennials are 45% of the workplace. They will grow to 50% by 2020 and by 2025, Brookings Institute says they’ll be 75% of the workplace. So, the urgency and the resistance is futile is the shifts that we’ve got happening with the needs of our Baby Boomers and aging care and the impact of our Millennials just in sheer numbers makes us have to understand each other cause we’re working side by side, we’re living side by side, we’re serving side by side. But each one of them is getting frustrated and what they want is to have respect. And if you can at least show them that you’ve thought to understand them, that you’ve asked questions, that you’re listening and engaging and that you are adjusting to their generational code—if they are your patient, if they are the person that you are wooing as talent—that will go so much farther down the road to having a competitive advantage, having a collaborative, continuous relationship that impacts your bottom line in a positive way. You’ll be generationally savvy.

Q) Thank you so much, Anna. This has been fascinating and I am so grateful for your time and insights on this subject that impacts us all.

A) You’re so welcome. Thank you so much.

Q) Anna Liotta is the creator of Generationally Savvy Communication Solutions. Her book, Unlocking Generational Codes, is available on Amazon and if you want to learn more about her work in this area, you can go to annaliotta.com. I’m Missy Padoll

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