these two mission-driven fields, conflict
resolution and health care, which share a
common goal of reducing suffering and
making the world a little bit better, still have
so little collaboration?
I believe a key reason is the culture of
health care. It is a culture that too often
allows people to say, “I am a health care pro-
vider. Resolving conflicts isn’t something
I was trained for, it isn’t something I know
how to do, it isn’t my job.”
Ask health care providers how they feel
about the conflicts they face, and you are
likely to get a lot of blank stares (read: “I am
oblivious to the conflicts around me”) and
deer-in-the-headlight looks (read: “I rec-
ognize the conflicts and I hate them”).
Heart stopped beating? I’ll say “No prob-
lem. I’m your guy.” Collapsed and can’t
breathe? “I’m on it.” Broach a difficult con-
versation with a coworker? “Umm.... Sorry,
I’ll go find someone else who can take of
that for you.”
But usually there is not someone else to
take care of it for us. And as a result health
care often feels like a conflict jungle, a daily
gauntlet of challenging situations in which
health care providers do whatever we need
to do to survive—some of us run and hide,
some of us puff and roar, and nearly all of us
wish that we were a little better equipped for
When it comes to conflict, health care
needs a culture change. And conflict resolution specialists can help bring this about.
A DIFFERENT APPROACH
TO CONFLICT MANAGEMENT
For the past several years I have been
working with colleagues to design, teach,
and study training programs for interdisciplinary health care professionals on conflict
management skills. What we are finding is
that it is possible to change the culture of
health care to make front-line health care
professionals more conflict-sensitive, more
willing and able to address the conflicts they
face every day. But to do so, more conflict
resolution specialists need to engage with
the health care field in new ways.
Clinical conflicts, including
frequent conflicts between
patients and providers that
may be complicated by highly
technical medical sciences.
Team-based conflicts, involving large, fluid teams working
under severe time constraints
in contexts of complex and
intense power dynamics.
Medico-legal conflicts, an
often-feared domain hovering
in the background of many
interactions in health care.
Conflicts within the health care
domains, which add multiple
layers of task-, relationship-,
and process-oriented conflicts.
Conflict Management Entry Points
CONFLICT MANAGEMENT ENTRY POINTS
There are multiple dimensions of health care that offer entry points
and opportunities for conflict management work:
All these occur against a background of complex social and ethical
issues arising from the astounding amount of money involved with U.S.
health care (with estimates that in the coming years $1 out of every $5
that changes hands in the U.S. will be associated with health care), the
fact that peoples’ lives truly are on the line, and the guiding principle of
health care as a calling to serve others, which is a cornerstone of many
health care professionals’ personal and professional identities.
Conflict resolution specialists have made excellent inroads in certain aspects of health care, particularly around liability issues, adverse
event disclosure conversations, and teaching negotiation skills to non-clinicians in health care leadership roles. Unfortunately, some of these
interventions have unintentionally reinforced the notion that addressing conflicts is the domain of conflict specialists. Increasingly we need
to move beyond that model towards activities that ingrain basic conflict
management skills in clinicians’ every day interactions. This requires
reorienting towards prevention and early intervention and raising expectations that health care providers take the lead on conflict engagement,
with less emphasis on third-party intervention.
To achieve this we need to mainstream conflict management training
and conflict coaching in health professions education. This is an area of
large unmet need and therefore of opportunity for conflict management
trainers. Based on the work my colleagues and I have done, I offer some
recommendations for conflict resolution specialists who train and coach
health care professionals on conflict management skills.