Conflict in the healthcare industry has occupied newsrooms in the United States for many years. Some of the rivalry arose as a result of the political standoff over affordable health care, as well as the shaky launch of federal health insurance. Yet, disagreement is not an uncommon occurrence in the health-care system as a whole (Cherry and Jacob, 2016). It can be described as a fragmented environment with multiple stakeholders with competing agendas and interests (Cherry and Jacobs, 2016). Despite this, conflict resolution and the basis of negotiation are rarely taught in business or medical schools. Over two decades, professionals and management bodies of various organizations have always engaged each other in health care negotiation and conflict resolution. The organization conflicts have always been treated as important as work assignment and as complex and mergers in hospitals.
As an intern in the National referral hospital in the outpatient section, it could not take one too long to identify and speculate how fellow staffs were operating under a conflicting environment of prioritizing tasks and delegation among the physician assistants and the specialists. Most of the patients who attended the hospital for an orthopedic office were reported to be suffering from minor, and simple non-displaced fracture or sprain. Generally, such body malfunctions can be treated by a properly trained professional in the field or physician assistants (PA). But, in a busy hospital such as the national referral facility, patients can typically be seen more easily and much quickly by a physician assistant rather than the main specialists. The care facility aimed at creating a case where such outcomes of quality and satisfaction of patients could be given a priority and maintained at a lower cost. It could be an easy and wonderful move to make in the facility (Leaning Guha-Sapir, 2013). Unfortunately, such shifts in the levels of responsibility were never accepted at ease. Despite the fact that the physician assistants wanted to prioritize and give attention to small matters affecting patient and relieve the specialist onto much tasks. A clash arose as specialists were not ready to delegate or even seek for a helping hand on the service deliver. The effort of prioritizing necessary obligations by physicians was in vain due to selfish interest of the specialist. Based on the understanding of all the happenings, this type of conflict can be described in a personal view as a conflict due to prioritizing work.
During the work period, conflict arose since both patients and physicians had come into a situation that they expected to interact with each other all the time. This is because physician assistant were free most of the time and could give priority to their concerns. Unfortunately, the Doctors in the facility had prized their autonomy in the clinical works and the relationship that they had with the patients they treat. The autonomy also included the fee for services model reward on them for attending and taking care of the patient for themselves. Also, some patients wanted to be treated by master doctors, or in most cases a board that is composed of certified specialist instead of the normal primary care practitioners (PCP). It therefore meant that they were not concerned about how faster they can be attended to, but instead, who attended to them.
On the other hand, the primary care physicians had a strong and valued relationship with the specialist in the care facility network, and always focus on the main goalkeeper role rather than going beyond the scope of the care services they provide (Wilson, 2016). Therefore, they thought it was necessary to give priority to less demanding health issues to reduce the number of waiting patients. In line with prioritizing work, the chief Insurers of the hospital also wanted to take a full control over cost and of course apply them with others to exert pressure to take over simple cases from the specialist who offers them at a high cost. They would then give the services to physicians who are less expensive or other non-specialist caregivers. But the resulting conflict has never made anyone happy in the facilities (Moorhead et al. 2014). Orthodox are always afraid of losing their patients and at the same time patient tend to be anxious about getting the lesser care. The primary care physicians worry about their relationship with the specialist and fear that it may erode. At the same time, the insurers and the administrators get into contact with the full resistance from all parties that they perceive as very time consuming, expensive and frustrating. Therefore, delegating duties or prioritizing work in order to shift duties such as less demanding task to physician assistants and more demanding tasks to specialist was not faced a lot of resistance.
The type of conflict that was seen in this care facility can be grouped into various stages according to Finkelman (2016). The ability to identify the stages of how the conflict develops can be significant in providing insight into the necessary interventions that can be used to solve the problem. According to Finkelman, conflict occurs in increasing levels of severity. It is easier to deal with it at the earlier stages since the solutions are quickly found. At the later stages, people have it difficult to solve the conflict and may in most cases need the incorporation of external sources to mediate solution among the parties.
Discomfort stage is the initial stage where individual typically become aware of an existing problem. Nothing specific must happen to these people, but some sort of tension has been created, and awareness made that some things are going wrong somewhere in a relationship. At this stage, little or nothing at all is done to the unidentified problem since no one is actually sure of its existence (Finkelman, 2016). Discomforts are part of the everyday life. Even good relationship may have a moment of discomfort, and as a result, people need to look for a mutual objective solution. Failure to find the solution, due to one party sticking to his or her views and opinion, the conflict is likely to escalate. Referring to the case of a care faculty issue, the discomfort stage can said to be the moment when the patient starts expressing perception of dissatisfaction from the service deliveries (Finkelman, 2016). But the main cause of dissatisfaction is not known by the stakeholders.
The second stage is the Incidents stage. At this stage, minor event and happenings start to occur. Even though the events may sound minor in themselves, the negative impact that they have may cause mistrust and a lot of tension in the facility. The manner at which things are said or done in the facility or organization gives a clear impression that the problem exists. The involved parties in most cases start to get irritated with each other. The fluctuations begin to revels when it comes to competition and cooperation (Finkelman, 2016). Even though they may have one interest, the wishes and opinions may be very different. In line with the conflict between the physician assistant and the specialist, tension can start revealing itself when patients start boycotting the services of un-specialized physicians or due to the failure of management to delegate duties to their juniors. Tension will start to emerge among these people, creating threat which when not resolved, can escalate to another level.
The third level is the misunderstanding stage. A lot of disagreements pile up to bring about the problem. The stakeholders involved may get confused due to past event with some developing false interpretations to the incidents. For instance, the physician assistant on addressing the issue of delegation of some duties while at the same time specialist determined to take everything into their account may cause disagreement (Finkelman, 2016). They may start blaming the specialist for the dissatisfaction of patients while the same time the specialists blaming the physician assistant for not being competent enough to offer required services to clients. Such conflict may move from this stage to the forth one, which is the level of Tension and conflict. The parties involved start to view each other with a lot of tension. The level of mistrust is very high, and the relationship between individual is broken. For example, the insurers want to spend less on treatment cost, but the specialist cannot give their work to physician assistants, as they do not want to lose contact with the client (Finkelman, 2016). Here, everyone sees each other as selfish, breaking their mutual relationship. In addition, tension brings a lot of crisis. The hostility builds up with the event getting to serious levels. For instance, patients may stop coming to hospitals. The specialist may treat their staffs unkindly with insurance failing to settle huge bills. This is a total mess in an organization. Generally, the conflict of self-interest is caused by the problem of delegation and should be looked at keenly to avoid consequences.
Conflict can cause massive destruction in performance and should be solved using very organized strategies. In the case of the above addressed problem, it is important to assemble all the representatives of all the parties in the conflict (Finkel, 2015). And as mediators, one should seek the help of nursing leader in this. Immediately after coming up with a committee of representatives, the fist strategy is to have each of the stakeholders articulating their self-interest. The interests are then heard by all the leaders and the mediator and decide what each party need to receive from the exchange. The second strategy is enlarging the interest, where the self-interests are looked at their overlap to create an agreement. In the mediation experiences, the agreements always overturn the disagreements (McKibben, 2017). The third strategy is the collaboration of the interest. The stage involves collaborating to come up solutions to the disagreements. The last strategy is aligning the interest. Here, the nursing leader and the mediator can align and certify the larger set of agreements and the disagreement set aside for negotiations in later days (Hirschauer, 2015). These approaches are very effective and efficient and can be used to solve conflict within the shortest time possible.
Conclusion
In conclusion, conflict resolution is significant for the long-term sustainability of an organization. Healthcare being a delicate facility that needs a lot of coordination and strong workers relationship cannot withstand conflicts in everyday performance. To solve conflict such as personal conflict, the inclusion of stakeholders is important as people can only embrace the solutions that they can take part in creating. Therefore, if an individual in a facility tries to impose something on the other person, the natural inclination of the person’s imposes a situation that will automatically resist. It is also important to note that, a little time taken in upfront to engage people in a joint problem solving can save on too much headache and work hours.
Reference
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Finkelman, A. (2015). Leadership and Management in Nursing: Core Competencies for Quality Care. Pearson.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.
Leaning, J., & Guha-Sapir, D. (2013). Natural disasters, armed conflict, and public health. New England journal of medicine, 369(19), 1836-1842.
Hirschauer, S. (2015). Séverine Autesserre. Peaceland: Conflict Resolution and the Everyday Politics of International Intervention.
McKibben, L. (2017). Conflict management: importance and implications. British Journal of Nursing, 26(2).
Moorhead, S., Johnson, M., Maas, M. L., & Swanson, E. (2014). Nursing Outcomes Classification (NOC)-E-Book: Measurement of Health Outcomes. Elsevier Health Sciences.
Wilson, D. R. (2016). Healthcare Manager's Perception of How Empowerment is Experienced Working Among Their Employees. Conflict Resolution & Negotiation Journal, 2016(2).
