Conflict Resolution In Medicine

Conflicts are an inevitable part of human interaction.

Whether the conflicts are addressed or hidden, acknowledged or denied, they are present in both our personal and professional lives. 

Although conflicts can be distressing, there is nothing inherently wrong with them. 

Conflict is not the same thing as bullying (bullying is bullying).

Conflict by itself is not an indicator of a toxic workplace.

In fact, conflict, when handled appropriately, can even be a positive experience and an opportunity for growth.

So how do we resolve conflicts adaptively?

If your immediate response is “compromise,” that’s sometimes right. But often if we approach conflict resolution with intentionality, we can do better than what Merriam-Webster defines as “settlement of differences by arbitration or by consent reached by mutual concessions.”

Consider the story of the orange.

Two people are arguing over an orange. Each person comes to the dispute with rigid ideas about their entitlement to the orange.

The conflict intensifies.

Finally, they decide to compromise and split the orange in half.

At that point, one individual squeezes the juice from their half to have a drink.

The other person zests the rind of their half into the batter they are mixing.

They compromised by splitting the orange evenly and fairly, but neither understood what the other wanted. If they had, they could have reached a resolution that was better for both of them.

Win-win solutions feel better than “mutual concessions,” but are only possible when we understand both what we want and what the other person wants.

It can be helpful to start with a foundation of explicit acknowledgment of our shared humanity. In the piece on emotional self-regulation and de-escalation, I talked about the “just like me” technique.

We all engage in self-talk, a running narrative of our lives and the situations in which we find ourselves.  To use the “just like me” technique, you add the words “just like me” to your self-talk.

So, for example, you say to yourself: “This person is really getting upset.”

Then you add: “just like me” so that your new self-statement is “This person is really getting upset, just like me.” 

“Wow, this person really believes that they’re right” becomes “Wow, this person really believes that they’re right, just like me.”

When you have acknowledged the likelihood that both you and the person with whom you are having conflict are experiencing similar emotions, you can look to find common ground. 

It’s very unlikely that the person on the other side of the conflict has goals that are diametrically opposed to yours. Think about the number of people you know who would identify “safe patient care” as a significant value. Do all of those people agree on how to deliver that care (or even how to define it)?

To find common ground, you first need to know what it is that you want. Be as specific and detailed as possible.

For example, consider a conflict in which it is your perception that you have been carrying more of the workload than a colleague. What is your desired resolution? At this stage, you are just identifying what you want and not considering feasibility or reasonableness.

Do you want them to carry an equal workload moving forward?

To compensate for your previous overwork by doing more themselves now?

To carry an equal workload and apologize?

You don’t really care what they do, you just want to have less work burden for yourself?

If your colleague started doing an equal share of work but the workload suddenly dramatically increased, would that resolve the conflict? It might; even as toddlers, we have a strong sense of fairness. Of course, it might not if what was really bothering you was the amount of work itself and not the distribution of it.

Knowing what you want is only part of the process for conflict resolution. You also need to know what the other person wants. A deep and nuanced understanding is the key here.

To return to the story of the orange, each person would have initially responded to the question of what they wanted by saying “the orange.” It is only through exploration that they could have learned that one wanted the juice and one the rind.

Knowing what we want does not mean that we will get it; knowing what the other person wants does not mean that we will give it to them. This knowledge is just the base for our continued conflict resolution efforts.

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