The world of health care has changed dramatically during the past two years. It was already experiencing various pressures, and with the arrival of the COVID-19 pandemic, existing problems, like increasing costs and worker shortages, were exacerbated. Tasked with caring for patients amidst the ongoing threat of COVID, health care workers experienced extreme and prolonged pressures. It was difficult for them to deliver routine health care and at the same time manage an ever-increasing number of COVID-19 cases. Health care workers who risked exposure to the virus while continuing to care for patients bore a heavy emotional burden that continued long after the number of COVID cases began to recede. As a result, health care systems struggled with employee burnout and turnover as they adapted their procedures to comply with the latest federal and local guidelines.
At the root of the systems that manage health care, disputes are abundant. Whether the conflict exists between a doctor and a patient, an administrator and a nurse, an outside contractor and a hospital, or a doctors’ group and a hospital, to name a few, hiring a neutral third party to mediate a dispute is a better method for resolving it.
Traditionally, many health care systems have managed disputes internally through either human resources or a process controlled by its administrators. The flaw with this type of mechanism is that at least one party will feel the system is stacked against them. Bringing in an independent mediator ensures that the process will be fair and unbiased. An independent third-party mediator who is not employed by a health system will be well received by an employee or patient, who will likely feel they will be treated fairly. First, an outside party brings a unique and fresh perspective to a problem, as he or she has no stake in the outcome. Second, it will be easier for a third party to give the parties the attention and focus their conflict warrants. Third, the health care system will benefit, because someone else will be responsible for creating, managing, and implementing the mediation; the health care system need only send someone with authority to the mediation to represent its interests.
A professional mediator will artfully tailor the mediation process to the circumstances of each individual dispute. By creating a process that considers the specific needs, interests and concerns of all participants parties to a conflict, the mediator can aid them in resolving their dispute and adopting preventive measures to avoid future conflicts. Remember, mediation is not a one-size-fits-all approach; it can be adjusted for the parties involved.
Integral to the mediation process is deciding who should attend the mediation session, which may involve many considerations. For example, in planning a mediation between a nurse and several members of a hospital’s administration, the mediator anticipates the imbalance that would occur if several health care officers met with one employee at a mediation session. In this case, the mediator might suggest that the employee be able to invite a trusted family member to be with them at the session. This minor adjustment can make a significant difference in how the employee perceives the process. It is the mediator’s job to anticipate the needs and interests of the parties and to use his or her expertise to improve the process for all.
Mediators are adept at building trust and relationships with adverse parties. The first thing a mediator does is listen to and try to understand the perspectives of each party. Because they have a stake in the outcome of the dispute, administrative employees or officers cannot take on this role. By relinquishing control of the process, parties can communicate better and attempt to repair an often distrustful and adversarial relationship. Further, all parties benefit from having a mediator work to facilitate creative and longstanding improvements to the status quo.
Nowhere are the constraints and conflicts bigger than in the delivery of medical care during ever-changing regulations that incorporate information about the prevention and treatment of different rising and falling strains of COVID-19. Because frustrations are everywhere in digesting this new information, conflicts and clashes in the workforce are becoming more commonplace and more difficult to resolve. Everyone has a different way of incorporating regulations into their day-to-day practices. Health care workers often have no recourse, and as a result, their frustrations and conflicts can fester. There is no mechanism for diffusing this tension or improving relationships among staff, which can lead to patient care suffering. Due to these ongoing pressures, many workers have chosen to leave or retire, which has contributed to the Great Resignation. The lack of health care workers has increased the strain on existing personnel and created internal conflicts. There are frequent clashes between highly paid temporary workers brought in to address staff shortages and existing staff. For example, a travel nurse may clash with a nurse who was trained at the hospital and is vested in the community. Mediation offers a mechanism for resolving personality conflicts among health care workers and creating better working relationships.
Venting to a neutral party may be the only chance to improve systems and communications going forward. Our priority during these turbulent times should be aimed at maintaining and cultivating existing relationships. With the pressures and ongoing constraints of COVID-19 in the health care field, this requires being able to evaluate existing relationships and needs. Once evaluated, it may be necessary to pivot and make changes to improve these relationships, and to monitor training and procedures to better meet the existing circumstances.
Using a third-party mediator to resolve difficult conflicts is an effective way to work together and improve our health care system.
First published in ACR Family News Quartely and the Collaborative Review of the International Academy of Collaborative Professionals, February 2008. In his “Letters to a Young Poet,” the Czech poet,...By Chip Rose
Disputing Blog by Karl Bayer, Victoria VanBuren, and Holly HayesSarah Rudolph Cole, John W. Bricker Professor of Law and Director of the Program on Dispute Resolution atMoritz College of Law,...By Beth Graham
Texas Conflict Coach Audio Blog by Pattie PorterIf you’ve been told not to take conflict personally, you only have half the story. Before you can do that, you have to...By Patricia Porter