4.2.a. Understanding Conflict
Engaging people who disagree with us is a chance to examine the beliefs and values we normally take for granted. One way to equip citizens for productive discussions is to convey to them the practice of philosophy." - Plato
Before we explore how to act when conflict arises, we must first establish exactly what we mean by conflict, its implications, and best practices for how to identify and respond to it. In this module, we refer to conflict in two senses:
- Conflict as a single, isolated event within a specific case.
- Conflict as an ongoing, progressive challenge that arises within a primary health care team across cases, and thereby affects the team’s overall communication, collaboration, and shared decision making.
We will move away from the common conceptions of conflict management and conflict resolution towards the concept of conflict transformation. Conflict resolution and conflict management methods focus on reducing or defusing crisis moments.
Conflict resolution leads people to believe that there is a finite beginning, middle, and end to a conflict—this is a misunderstanding of the ongoing and inevitable nature of conflict.
Conflict management, though still a prevalent approach to addressing conflict, assumes a default hierarchy wherein a team leader is the first resort and the only person charged with finding a solution. This is problematic in the health care setting as the default team leader is often assumed to be the physician. This leads to power imbalances, unintended allocation of responsibility, and hierarchy across the disciplines: all of which are known causes of conflict (1,2).
In an interprofessional health care setting conflict transformation is the process of recognizing conflict, or the potential for conflict, and reframing the conversation, or care plan, to facilitate sustainable cooperation and collaboration.
Conflict is the beginning of consciousness" - M. Esther Harding
The first thing to understand about conflict is that it is inevitable (3,4). When we accept conflict as inevitable, we can better anticipate, recognize, and address it in a timely manner. Secondly, and equally as important, is that the potential for conflict is inherent in the nature of teamwork, because individuals enter into a team with their own established (and often differing) roles, scope, sense of accountability, values, experiences, and expectations (3). These are informed by their health professional education, practice, peers, as well as the context of their personal background and life experiences.
Conflict occurs between care providers, but also between providers and the people they are caring for.