Successful hospital and health systems are rooted in a mission-driven focus. But that focus must include a continued sense of vitality, creativity, relevance and forward thinking if hospitals and health systems are to continue their success into the future. Who better to contribute energy, new perspectives and a vested interest in the future than the next generations of leaders?

Generations X, Y (millennials) and even Z, are already making significant changes in the business world, from new technologies and startup companies to changing the typical workplace environment and the way business is conducted. These generations are also exerting their influence as decision-makers in health care, making personal and family health decisions as well as playing an increasingly prominent role in the health care decisions of their parents and grandparents.

Missed Opportunities

Despite the opportunity to gain invaluable input and new thinking from young leaders, the composition of most boards fails to reflect the four generations found in today’s workforce. Furthermore, hospital and health system boards are aging. According to the American Hospital Association’s Center for Healthcare Governance 2014 National Health Care Governance Survey Report, the percentage of board members younger than 50 has dropped from 29 percent in 2005 to 21 percent in 2014, while the majority of hospital trustees were 51 to 70.

If your board is missing the diversity of age, you may also be missing the commitment, passion for service and fresh thinking of your community’s next generation of leaders.

The Case for Age Diversity

Younger board members should be recruited for the potential they bring to the board and a rapidly increasing need for future-focused thinking and vision. Natives to the digital age, Gen X and Y leaders can contribute knowledge and expertise that may not exist with older trustees.

Young leaders are able to provide technological insight and foresight, consumer decision-making, social media and environmental trends. They offer the potential to raise the organization’s visibility and build new channels and networks of community support using nontraditional methods. Young leaders offer fresh ideas, perspectives and approaches, and typically aren’t afraid to ask questions. When embraced, their new ways of thinking are an opportunity to add vibrancy and depth to board discussions and deliberations.

Yet, most boards aren’t inviting young leaders to serve with them. In some instances, current board members may perceive that young leaders lack the experience deemed necessary for board service. For others, it may be a fear that the young generation may “rock the boat” too much.

Work-life balance is important to younger generations, and the volunteer time required of board service can pose a challenge. Yet, according to the report “Top 100 Findings from the Millennial Impact Project,” time is a factor but not a preventer of board service, and the types of organizations that inspire millennials to volunteer mirror those that inspire them to give financially. Fifty percent of the project’s millennials indicated they are most likely to volunteer in support of human services.

The fifth finding on the list helps to clarify the gap in governance service: While nearly 62 percent of respondents said they are not involved in board service due to lack of time, 40 percent said they simply have never been asked.

Essential Succession Planning

Boards must overcome the practice of limiting board recruitment to executives from older and more experienced generations. In an environment characterized by transformation, market disruption and rapid technological advancements, boards need young members for whom the digital world is second nature with all its applications and possibilities.

Young trustee candidates should demonstrate a readiness to be active board participants and have the maturity and sense of accountability for the responsibilities they will assume as a trustee. They should possess enough confidence to speak up and engage collaboratively and constructively with other trustees in board discussions. The ability to analyze issues, formulate an opinion and clearly articulate a position without defensiveness are characteristics that all trustees, young and old, should possess.

The next generation is committed to contributing value to its community through time, money, skills and abilities. Ensuring a vital board now and into the future requires making a place for the next generation at the board table today, and acknowledging that young leaders are also donors, volunteers and active members of the hospital’s community with the desire, talents and expertise to contribute.

Attracting Young Leaders

Finding young board members requires new thinking. Boards must deliberately look to organizations that employ or interact with the talent pool of young leaders. This may include startup companies, nontraditional workplaces, local volunteer organizations, faith-based organizations, or young professionals associations.

Young trustees can contribute valued perspectives even if they aren’t in the C-suite — yet. Boards must be willing to bring in young professionals with the skills and expertise desired, but who may occupy a less prominent position in a company.

To fill a pipeline with potential leaders, hospitals might consider sponsoring or co-sponsoring a board training program to ensure that not only the hospital’s board, but also the community’s other nonprofit organizations have a growing pool of trained board candidates ready for service. Hospitals and health systems can nurture and evaluate the “board readiness” of emerging leaders by inviting them to serve on task forces or committees.

Many new trustees, not just the young, arrive on the board with little or no prior board or health care expertise. A comprehensive, well-planned orientation program and warm welcome is critical to their successful service on the board. Experienced board members serving as mentors can offer new trustees support, background information and insights. They can recap critical issues and identify subtle nuances. Mentors that successfully engage new trustees also can help to prevent potential feelings of isolation that new and particularly younger board members might experience.

Intergenerational Success

Generational differences, perspectives and experience all have the potential to create challenges for effective board operations. The first step to avoiding or preventing problems is to ensure that diversifying the age of board members is a sincere effort. Early identification of opportunities for new trustees’ engagement and participation in the work of the board is important. An attentive board chair can create opportunities for young trustees to voice their opinions without putting them on the spot by asking all board members to express their thoughts and viewpoints on key issues in round-robin discussions.

No one, young or tenured, should discount the value of fresh perspectives and new ideas that younger trustees can offer. For their part, younger trustees must also give credence to the concerns and experience of more seasoned trustees. All trustees will need to recognize, respect and account for the fact that each age cohort may have a different communication style and varying comfort levels with the use of technology. As with any endeavor, positive communication, attentive listening and mutual respect among trustees is the foundation of success. 

Cindy Fineran ( and Nicole Matson ( are senior consultants at the Walker Co. Healthcare Consulting LLC, Wilsonville, Ore.

Defining the Generations

World War II, the Silent Generation: Born 1922–1945

Baby Boomers: Born 1946–1964

Generation X: Born 1965–1979

Generation Y (millennials): Born 1980–2000

Age Diversity is a Board Asset

• Is your board benefiting from younger members?

• How many generations are represented on your board? Are there three or even four generations?

• Are any of your current trustees from Generations X or Y (millennials)?

• Does the board have a trustee succession plan? Does it include actions for building a pipeline of young trustee talent?

• What’s keeping the board from seeking and including younger members of the community as trustees? Are these barriers valid? What can the board do to overcome them and invest in the next generation of leaders?