The modern workplace is quickly changing. The rapid evolution of technologies in modern workplaces are creating new ways to get work done.  The old model of the place of work usually involved going into the office at 8 AM, most communication was face to face or via telephone calls. Then once 5 PM would hit, it was time to commute back home.

Today that is not the general case.  Communication is now mainly through emails, text messages, and teleconferences.  More employees are working in places other than their office. In the 2017 report called “State of the American Workplace” Gallup found that 43% of employees are now working remotely.  Gallup consistently has found that flexible scheduling and work-from-home opportunities play a significant role in an employee’s decision to take or leave a job.

Similar trends due to technology are occurring in modern healthcare. The number of emails physicians receive as employees of health care systems can be staggering. Patient questions are now being routed through their online “Patient Portal” to the doctor or the clinical team.  We are also seeing a move to increase telemedicine into patient care.  At the same time, the rapid implementation of computerization in healthcare is one of the leading causes of the physician burnout epidemic.

As more people are working from home, organizations are cutting real-estate costs by moving to open floor or hybrid floor plans to allow more people in a workspace. Another reason why C-suite executives are moving to the open floor model is so their employees can be more agile and collaborative.   This model is based on the hope that it will enhance team work and communication.

Underlying the changing structure of the modern workplace is a changing demographic. In 2015, data from Pew Research Center showed that Millennials (Born in 1981-1997) for the first time make up the majority of the workforce surpassing Gen X’ers (Born 1965-1980) and the decreasing Baby Boomers (Born 1946-1964).  Millenials make up about 34% of the current labor force, and it is predicted they will be 75% of the workforce by 2025.

Another layer that is even further underlying the changing work structure and generational changes is an evolving attitude from employees of what a job should be. Many have a defined set of expectations in their role or organization that they work in.  They desire meaning and purpose. They want to do what do they best and use their talents and strengths.  They want to learn and grow. Therefore the opportunity for professional development is highly valued by today’s workforce.  Last but not least, they want work-life balance.  All of these work attitude changes are seen more so in Millenials followed by Generation X employees.

As the job markets continue to expand, many employees have a sense of optimism.  Today, we are in an “employees” market, not an “employers” market.  Nearly half of workers say this is a good time to find quality jobs, and over half of the employees surveyed by Gallup are searching for new jobs or watching for better jobs.

Unfortunately, many companies and organizations are not effectively retaining or attracting employees.  Only 21% of employees strongly agree that their performance is being managed in a way that motivates them to do great work.

At the same time, employees are now superconnected through many websites and social media sites so they can readily and easily find out which organizations are the “good” versus the “bad” places to work.  Furthermore, some who can’t find what they want are turning to more independent and non-traditional approaches of work such as contracted employees or free lancing.

Organizations will need to adapt.  As more of the boomers retire, more and more Millenials are going to outnumber previous generations in the workforce vastly.   Remember that in less than 10 years, 3 out of 4 employees in the workforce are predicted to be Millenials.

So what are some CEO’s doing to adapt?  Employee engagement seems to be the answer. Employee engagement is the emotional commitment the employee has to the organization and its goals.

Unfortunately, many organizations are not doing well in engaging workers.  According to Gallup, only a third of U.S. employees say they are “engaged” at work. Meanwhile, the world’s best organizations have employee engagement rates of 70%.

Gallup 3

Why do CEO’s care about engagement? The theory is simple, engaged employees are more likely to be high performing.  These employees are psychological “owners” that drive company performance and innovation.  They are the employees that have higher service, quality, and productivity.  In turn, the organization will have better customer satisfaction, higher sales, higher profits, and higher stock prices.  This will ultimately make the company’s shareholders very happy.

You are probably asking yourself “Why in the world is a doctor writing about employee engagement?” The simple answer is that I am a physician-employee of a large healthcare organization.   As an employee, I provide services (i.e., surgery, chemotherapy, etc.) that need to be of high quality and value so presumably being highly engaged is crucial for the organization.  According to a 2015 survey of major health care CEOs, physician engagement ranked as the greatest opportunity for performance improvement.

There are numerous benefits of having engaged physicians because it is associated with improved quality of care and lower costs.   As a result higher engagement, I am more likely to provide higher quality care and better care to my patients.

Also, my patients are more likely to have better experiences and health outcomes. Although the subject of patient reported experiences and health outcomes have been an area of controversy among health policy experts, more and more scientific studies are showing that in fact both better patient experiences and better patient outcomes are strongly correlated.

Physician engagement can also improve patient safety.  According to Gallup as shown in the figure below,  work units in the top quartile of engagement in their organizations have 58% fewer patient safety incidents than work units in the bottom quartile.Gallup Safety

Improving engagement will also reduce the risk of burnout.   As physician burnout has been trending to epidemic proportions with over half of American doctors experiencing symptoms of burnout, improving physician engagement can be one strategy to reduce it.

So it is not hard to see all the numerous benefits downstream because of improved physician engagement and how it will ultimately result in more successful physicians and healthcare organizations. So it is not just places like Apple, Goldman Sachs, or Google where employee engagement is a highly valued commodity.  Healthcare organizations can also reap similar rewards by improving their relationship and engagement with their employees.

How can any organization, not just in healthcare, improve employee engagement?  Like anything that requires improvement, you will need to measure it first.  For years, Gallup has been measuring engagement using Gallup’s Q12 shown below (Shown below).

Gallup 2

But just measuring “engagement” is not enough. You need to act as well.  Leaders should create a culture in the organization that values engagement.  It is important that the cultural shift is led by its leaders and executives and communicated and committed all the way down to its newest employees.

And here is the thing, employees want to be more engaged at work.  As I stated from Gallup’s survey of hundreds of thousands of today’s workforce, employees want meaning in their job, they want to develop and to be coached, they want to use their unique strengths to do what they are best at.  At the same time, they are not going to settle being unfulfilled or not doing good work.  The job market is in favor of employees,  and if employers don’t invest in them or help them grow, employees won’t hesitate to look elsewhere.

What can leaders in organizations due to stay competitive?  There are likely many solutions and improvement ideas.  I’ll summarize and highlight the recommendations from Gallup’s 214-page report.

  • At the top level, leaders should keep the organization’s core identity and values in mind, but at the same time develop a plan that will shift their culture over time to the “ideal” culture that promotes engagement.
  • Importantly, for any cultural change to take hold, employees need to be fully invested and buy into the culture change.  Leaders can get better employee buy-in by communicating a compelling vision.  CEOs that communicate their vision clearly and consistently on how their organization will gain success in the future is critical.
    • For all of his leadership faults, one thing that made Steve Jobs exceptional was how effectively he was able to communicate his vision to his employees and shareholders.  One of my favorite videos of Steve Jobs is this one from 1995.  This clip, in essence, is what engagement is all about.  Steve Jobs was such an effective communicator because he shared stories with such clarity, purpose, and authenticity.  Not surprisingly, according to Gallup, the most successful CEOs with high engagement organizations can communicate compelling visions, provide meaningful experiences for their employees, and demonstrate an authentic commitment to the organization.
  • In addition to communicating a compelling vision, leaders in highly engaged organizations invest in their managers.  High performing managers are critical players in improving engagement.
  • In order for managers to be highly effective, they must move from the role of a “boss” to a “coach.”  They should pay attention to needs of their employees by having frequent conversations with them.  Get to know those you lead.  Figure out what makes them tick, what are their strengths, and what will motivate them to do their best work.
  • Great managers measure where each employee stands regarding engagement and then creates individualized development plans.  If managers are not good at coaching, then astute leaders invest in getting these managers trained to become effective “coaches”.
  • Employees will also need to take responsibility.  Employees should pay attention to what being “engaged” looks like.  One way to do that is to assess yourself on where you stand on the Gallup Q12.  Employees will also more likely become engaged by asking for the “tools” they will need to do their work.  They will also need to discover and develop their personal strengths so they can do their best work.  Importantly, you should not shy away from being proactive or communicating often with managers.
  • At the same time, you should also be realistic about your needs.  Some days we are asked to do work that is not our ideal work.  We may not always get what we ask for. Similarly, we may not always be asked for our input or opinions.  By understanding what gives you meaning, having the tools and means to do our best work, and having a culture where you are able to improve yourself, those around you, and your organization may ultimately be what may matter most in our modern workplace.


I am a gynecologic oncologist, a husband, and a father. My blog is mostly about our healthcare system and well-being, but occasionally I get inspired to write about other "stuff" too.

2 Comment on “The Pursuit of Engagement in Today’s Workforce

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