By 2025, Millennials Will Dominate Lab, Pathologist Workforce

Younger hires want guidance, latest tech, work-life balance

CEO SUMMARY: Within five years, members of the millennial generation will make up 75% of the physician workforce in the United States, rising from about 24% in 2017. That three-fold increase represents a strong demographic trend that will require changes in the steps all clinical laboratories and pathology groups take when seeking to attract and retain clinical laboratory professionals and pathologists born between 1981 and 1996.

Second of Two Parts

SINCE MEMBERS OF THE MILLENNIAL GENERATION entered the workforce, anatomic pathology groups and clinical laboratories have found that recruiting, hiring, and retaining these professionals can be much more challenging than hiring members of earlier generations.

“Demographic changes are bringing millennials into the healthcare workforce in greater numbers,” said Rich Cornell, President and Founder of Santé Consulting, a recruitment firm in St. Louis that specializes in filling positions in anatomic and clinical laboratories at the director level and above.

“Members of the millennial generation— those born between 1981 and 1996—are not as focused on career planning or as driven by career goals as those in generation X— meaning 1965 to 1980—or as single-minded about work and their careers as were members of the baby boom generation—those born from 1946 to 1964,” he added.

“Most leaders in the lab industry have yet to appreciate the effect millennials will have on the laboratory workforce,” observed Cornell. “Many of them don’t realize that by 2025, millennials will comprise 75% of the physician workforce in the United States, according to a recently published study in JAMA.

“To put that proportion into perspective, consider that less than 24% of all physicians with an active license in the United States were millennials in 2017, according to the Federation of State Medical Boards,” he said. “Therefore, a physician workforce that is 75% millennials by 2025 represents a transformation in the laboratory workforce.

“This trend makes it imperative that the management of pathology groups and clinical laboratories understand how to attract, hire, and retain millennials,” Cornell advised during a presentation at THE DARK REPORT’S Executive War College in New Orleans in May.

Part one of this series was based on Cornell’s presentation and published in the June 10 issue of The Dark Report, as “Fewer Pathologists Means Tighter Market for Jobs.” It covered the current market trends in pathologist hiring, compensation, and subspecialist demand.

Part two deals with how the millennial generation is about to have major influence on the staffing and operation of the nation’s clinical labs and pathology groups.

“The demographic wave of millennials means that—to fill open positions—clinical lab directors and pathology groups will need to recognize that millennials have different career needs and interests than those of previous generations,” commented Cornell.

“Generational differences are most visible in the fact that the younger millennial physicians aren’t as interested in traditional partnership-type settings, compared with Gen Xers or baby boomers,” he said. “Instead, they pay more attention to worklife balance, compensation, quality of life, and having access to the latest technology.”

A strong interest in the latest technology extends to all forms of computers, reporting platforms, microscopes, digital pathology, and processors that they expect to find in clinical laboratories and pathology groups, Cornell explained.

Interest in Technology

“Because of their deep interest in technology, any lab or group making an offer to millennials will need to include a technology package,” he said. That package should include at least a new computer, a laptop, and a new microscope. Those are all standard.

“When these younger physicians visit pathology practices, they sometimes express concerns that some groups have antiquated equipment,” Cornell commented. “If the scopes are older, millennials may not give serious consideration to a job offer from that pathology group.

“They tell us, ‘If I’m going to work for that pathology group, then I want the latest and greatest microscope with digital technology,’” he said. “Millennial pathologists pay close attention to the tools they use and the technology behind those tools.”

In placing millennial pathologists, Cornell identified other conditions of employment. “Physicians in the millennial generation want at least five to 10 days annually for continuing medical education, five paid sick days a year, and three personal days,” he said.

“In addition, they want paid time off— including three to four weeks of vacation time,” he added. “As a result, we see more pathology groups offer four weeks of vacation for new hires.”

One factor that may hurt pathology groups when recruiting millennial pathologists is a conservative tendency toward paid time off. “Today, these millennial physicians are well aware of what physicians in other specialties get, in terms of paid time off,” Cornell noted. “They know that pathology is fairly conservative with time off, as opposed to radiology or anesthesia. For example, I know an anesthesiologist who gets 12 weeks off every year.”

Interview-to-Hire Ratio

While the first step when recruiting young pathologists is to understand what millennials want, the next step involves assessing how recruits react once they interview at your laboratory. That process starts with an assessment of a pathology group’s interview-to-hire ratio to assess how many interviews it conducts before it gets one new hire.

“When a clinical laboratory or a pathology group wants to know how it can attract top talent, it first needs to understand its strategy for hiring,” Cornell explained. “To do that, we track the number of candidates who interview and compare it to the number of successful hires. That’s known as the interview-to-hire ratio.

“Next, the pathology group must know what it spends on interviewing,” he added. “The average interview costs between $1,500 and $2,000 per candidate. And if you’re hiring several physicians, you may need to budget at least $1,500 for each interview. For example, if it takes four interviews to hire one individual, you’ll spend $6,000 for each open position, just on interviews.

Watch for Stress or Boredom

“In addition to accurate interview budgets, labs or path groups seeking to fill multiple positions must watch for stress or boredom among interviewers,” he warned. “A pathology group is likely to have two or three people involved in the interview process. Over time, it’s not unusual for the individuals interviewing candidates to get burned out.

“Those individuals can go to only so many dinners and interview only so many candidates before the process becomes mundane. When that happens, they could lose interest,” he commented. “That factor alone will affect your group’s ability to hire people and its interview-to-hire ratio.

“Another factor that affects the interview-to-hire ratio is whether the open position is for a specialist or a sub-specialist,” explained Cornell. “If it’s for a sub-specialist, does that mean the group wants a pathology fellow just coming out of training? If you want to hire a fellow, then you’ll need to understand the recruitment cycle for fellows, which is synchronized to the academic calendar.

“We worked with a large single-specialty group that was struggling with their interview-to-hire ratio,” Cornell recounted. “For three openings, they interviewed five individuals, made three offers, and got three rejections. That’s a bad sign.

Facing Facts

“When we were called in, we determined that the group was trying to recruit younger, early career physicians, but had old-school physicians as the face of the practice,” he said. “Those older physicians were retiring but remained as part of the interview process. During the interviews, they would say things like, ‘We’ve always done it this way.’ Or, they’d say, ‘When I was young, we did it this way and that’s always worked for us.’

“What the candidates heard was that the practice environment was stifling and no younger physicians would want to join that pathology group,” Cornell recounted. “We suggested that the practice change its messaging so that everyone was talking about the benefits of working there.

“To do that, you have to coach your staff about how to interview and what each one’s role is during each interview,” he recommended. “If you don’t coach your team on their roles and how to interview, then it’s likely that everyone doing the interviews will ask the same questions and your messaging will be confusing.

“The key is to assign different roles to different members of the group,” he said. “The president of the group, for example, should talk about the practice’s vision and the business dynamics of the group. If possible, have a sub-specialist similar to the person you want to hire talk about the community and how to fit in within the practice and the area.

“Once we got everyone’s support for these ideas, this group filled its three positions and did so with a good interview-to-hire ratio,” he commented.

As Early as 2025, Millennials Will Represent 75% of Workforce Employed by Nation’s Labs

IN JUST A FEW SHORT YEARS, A MAJOR DEMOGRAPHIC WAVE is poised to transform the workforce employed by anatomic pathology groups and clinical laboratories. In six years, by 2025, the millennial generation—with more than 74 million individuals—will represent 75% of the nation’s workers. Because millennials have distinctly different characteristics than the earlier generations of Gen Xers and baby boomers, pathologists and lab administrators will need to recognize those differences with changes to how they attract, recruit, and retain millennials. The chart below shows the projected numbers for each of the five generations by the year 2025.

The Workforce in 2025

Projected size of U.S. labor force (in millions) by age, for the year 2025

Source: Dept. of Labor, Chart © The Wall Street Journal

Assessing Experience

“In the case where the pathology group wants to find a practicing physician, does it want someone who’s worked for only two to five years?” he asked. “That’s actually the time when most physicians are considering new job opportunities. Also, if the goal is to hire more experienced pathologists, then the group may need to pay more compensation to attract physicians with the desired experience.

“Another consideration is whether a lab or pathology group is open to recruiting physicians who are exiting the military for private practice,” Cornell commented. “If so, these people can be great hires. Because of their experience in the military, these candidates interview well, they dress well, and interact well with others.”

Networking Success

One question many clinical laboratory and pathology group directors ask is how to find new candidates for job openings. About 39% of positions in pathology are filled through networking with other professionals in the field.

“That means word-of-mouth is effective much of the time,” Cornell commented. “After that, about 25% of pathologist positions are filled by using a physician recruiter. About 13% of pathology jobs are filled directly through a residency program, and 5% of open positions are filled from listings on an internet job board.” Pathology positions also are filled through journal advertising (5%) and through a specialty society (2%), he added.

When seeking to recruit a millennial, pathology groups and clinical laboratories may want to consider the advice sales managers offer to their staff members. “In sales, managers recommend that salespeople should, ‘always be closing,’” Cornell suggested. “That means continually asking the prospect if he or she has what’s needed to make a decision about buying or not.

“This principle also applies when interviewing candidates for your pathology group or clinical lab,” he added. “When hiring millennials, keep in mind that they expect you to work quickly and efficiently. Millennials expect a direct, focused interview, and an instant feedback and offer process.

Move Expeditiously

“Therefore, work fast or at least proceed with deliberate speed,” he said. “Groups should recognize that millennial physicians expect everything to happen in real time—meaning as quickly as possible. When dealing with millennials, you may find that they do not operate with an hour clock. Instead, they’re working with a stopwatch.

“Old-line pathology groups and clinical laboratories and, in particular, academic pathology programs, need to be aware of this imperative,” noted Cornell. “Therefore, it’s best to do everything possible to ensure that the interview and offer process goes quickly and smoothly.

“This is equally true for those pathology groups that have a mentality of ‘if we built it, they will come’—meaning that the group expects that whenever it has a job opening, everyone will want to work there,” he explained. “That’s not true anymore, particularly in academic settings and in large pathology groups.

“Labs and pathology groups fail to move quickly for many reasons, but chief among them are two factors that could cause the loss of a desired candidate,” he advised. “The first reason why a lab loses a top prospect is because the hiring process took too long.

“The second reason is the need for the pathology group and clinical labs to have multiple committees review candidates, and decide on each potential hire which prolongs the process,” he said.

Meeting Younger Candidates

“In addition to moving quickly, another way to help top candidates feel comfortable with your lab is to ask a millennial on your staff to meet with younger candidates whenever possible,” Cornell said. “As mentioned earlier, millennials may relate to others in the same age and be more willing to ask about the work environment and how younger physicians fit in with others on staff.

“Also, I recommend that everyone in the lab who meets with job candidates should be able to explain the groups’ hiring process and the group or lab’s expectations for all new hires,” he added.

“In fact, many younger physicians require having the contract terms printed out and ready for review when the time is right,” Cornell suggested.

Offer Plenty of Guidance

“Once a group or lab hires a millennial, it will want to retain that individual, of course,” he advised. “Keep in mind that hiring and retention go hand-in-hand in every successful practice.

“To that point, millennials expect guidance from their new colleagues, particularly in the beginning,” he said. “Therefore, it’s important for your lab’s key staff members to meet with each new hire regularly and set appropriate expectations for improvement. Also, give plenty of guidance and consider having a more experienced physician serve as a mentor.”

As leaders in both clinical laboratories and anatomic pathology groups develop staffing strategies for their respective labs in coming years, it will be important to keep focused on the fact that, in less than six years, 75% of physicians and lab staff will be members of the millennial generation. That fact will have significant ramifications in how labs hire and retain staff.

Over the past 15 years, both clinical laboratories and anatomic pathology groups regularly anticipated the retirement of baby boomers—for decades, the dominant generation in the workforce. Now, the next six years will see the youngest baby boomers retire. This will give Gen Xers the opportunity to take up the prime leadership positions in labs until they reach retirement age.

What Millennials Seek in a New Job

WHEN MILLENNIAL PATHOLOGISTS LOOK for positions in anatomic pathology groups and clinical laboratories, they have at least six concerns about any new position, said recruiter Rich Cornell, President and Founder of the recruitment firm Santé Consulting.

1) Competitive compensation: Salary is particularly important because they have substantial debt from medical school.

2) Competitive benefits: Studies show that millennials want good benefits so that they can start saving money early in their careers.

3) Leadership opportunities: They tend to be team-oriented and are looking for a future career path.

4) Technology: Millennials want the latest technology, including cellphones, laptop computers, and microscopes. Such technology is important because they want instant gratification and ease of reporting results.

5) Mentorship: They value a feel-good environment that comes from teamwork and having a trustworthy confidant within the group.

6) Work-life balance: Life outside of work is important, including paid time off for family.

Contact Rich Cornell at 636-777-7885 or


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