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"Work on developing a cooperative relationship, so when conflict comes, you believe you are allies."    -  Dean Tjosvold

The Interpersonal Side to Conflict

In today’s diverse cross-cultural, multi-generational workforce, conflict is inescapable. In healthcare, multidisciplinary practice adds yet another layer of complexity where our professional differences can promote misunderstanding.

The sources of conflict are multiple, often interrelated and fueled by faulty assumptions, disparate perceptions, unclear expectations or poor communication. Conflict can be experienced on four different levels: Intra-personally; Inter-personally; Intra-team or Inter-team. An intra-personal conflict maybe the response a shy team member experiences when called to speak up at rounds. An Inter-personal conflict involves a personality clash between two team members and can quickly escalate into an Intra-team conflict where team members take sides. An Inter-team conflict is when two interrelated teams have a disagreement. All levels of conflict ultimately have negative consequences and can interfere with effective team functioning. Typically, conflicts are either Content or Relationship based. Conflicts that are Content based generally stem from a difference in beliefs, values, procedures or goals. Often the goal itself may not be the source of the conflict, but how team members prefer to achieve the goal may differ significantly, and be a source of conflict. For instance a Physician and a Physiotherapist will agree that a patient needs to be mobilized but there may be very different ideas on when and the best method to do so.

Differing perceptions and motivations do not automatically mean there will be a conflict. In fact, if the team has a healthy culture with effective communication norms, differences can actually enhance team functioning.  So rather than be avoided, conflict that is Content based should be effectively managed whereby interpersonal relationships are strengthened from the exchange of diverse ideas. Unfortunately however, this is not always the reality. In the quick paced and often hierarchical environment of healthcare more often than not, conflict goes underground ultimately impacting team functioning. In fact, staff burn out more from unresolved conflict than they do a lack of motivation or energy.  

If disagreements are not managed in a respectful and inclusive manner, they can rapidly evolve into a Relationship based conflict which is much more damaging and harder to resolve. Relationship conflicts are interpersonally based and usually concern issues of respect, affiliation and control. If perceived as a threat to one’s ego or self-esteem, the conflict can quickly escalate and damage interpersonal and professional working relationships.

When we feel disrespected or that our professional expertise has been negated, and our self-worth questioned, the impact of conflict is much more profound. The interpersonal indicators of conflict include silence, apathy or resistance in meetings; overt sabotage; struggles for position or power; gossip and back-biting; disagreement and hostility. If this type of conflict is not dealt with, or poorly managed, it can ultimately lead to a team of individuals whose sole focus is on protecting themselves and who are either angry, apathetic or inaccessible. Therefore, the goal of conflict management is to increase the gains from a Content conflict and manage differences in a positive way while simultaneously preventing the escalation to a Relationship conflict.

"Conflict resolution at an early stage is less costly (emotionally and financially), and more manageable than trying to deal with its repercussions" 
- Barbara Casson