TOPIC 7.

CONFLICT MANAGEMENT IN A MEDICAL ORGANIZATION

Plan
7.1. The Concept and Nature of Conflict.
7.2. Types of Conflict.
7.3. Causes of Conflict.
7.4. Conflict Management.
7.5. Typology of Conflicts in Medical Institutions.

7.1. The Concept and Nature of Conflict

To understand the nature of conflict, it is necessary to define the term conflict. Like many
concepts in management theory, conflict has numerous definitions and interpretations. Conflicts,
whether between individuals or organizations of any ownership structure, are unpleasant yet, as
practice shows, inevitable. Isoroku Yamamoto, Marshal and Commander-in-Chief of the
Imperial Japanese Navy during World War II, stated: “A wise man will always find a way to
avoid war.”
Conflict can be described as the lack of agreement between two or more parties, which can be
individuals or groups. Each party strives to assert its own perspective or goal while preventing
the other party from doing the same.
For example, during a meeting, two medical representatives might advocate strongly for their
respective pharmaceutical products or medical devices, insisting that their proposal deserves a
larger share of the organization's resources.
When people think about conflict, they often associate it with disputes, threats, aggression, and
hostility. Consequently, there is a common perception that conflict is always undesirable, should
be avoided whenever possible, and must be resolved immediately upon arising.
However, conflict may also signal poor management or ineffective organizational performance.
Effective communication within an organization can often prevent conflict from arising.
At the same time, modern managers recognize that some conflicts are not only possible but also
desirable, even in organizations with effective management. Many conflict situations reveal
multiple perspectives, a greater number of problems, and alternative solutions. These allow
managers and subordinates to express their viewpoints. In subsequent discussions, the most
accurate and mutually beneficial resolution can be developed for all parties involved.
In such situations, differing opinions also constitute conflict. However, this type of conflict is
constructive rather than destructive.
A conflict arises when opposing positions on an issue, conflicting goals or methods of achieving
them, or mismatches in the interests and desires of the parties come into play.
Every conflict situation includes the following components:
 Conflict parties and
 Conflict causes, i.e., the subject and object of the conflict.
For a conflict to begin, an incident is necessary—when one party acts against the interests of
another. An incident may arise at the initiative of the conflict parties or independently of their
will and desires due to objective circumstances or accidents.
Conflict situations can also arise either due to the participants' actions or as a result of objective
conditions, irrespective of their will or intentions.
In every conflict’s development, one can observe:
 The emergence of a new conflict situation,
 Its resolution, and
 The end of the incident.
Any change in the situation can lead to resolving the conflict and possibly initiating a new one.
Based on the data provided, conflicts can be classified as:
 Functional: These enhance organizational efficiency.
 Dysfunctional: These reduce group cooperation, organizational effectiveness, and
individual satisfaction.
The effectiveness of a manager in handling conflict determines its overall role. Hence,
understanding the causes, nature, and types of conflict is essential for conflict management.
In a functional (constructive) conflict, the opposing parties may include commercial
organizations, different branches of government, district and city administrations, teams, and
managers.
The functional outcomes of such conflicts include positive components achievable through
skillful conflict management, such as:
 Improved decision-making processes,
 Increased collaboration,
 Greater involvement, and
 Enhanced exploration of alternatives.
In a dysfunctional (destructive) conflict, opponents may include:
 A manager and their subordinate,
 Managers at adjacent levels of authority, or
 An employee and a group.
The dysfunctional outcomes of such conflicts include negative components, such as:
 Assigning more value to winning than solving the actual issue,
 Dissatisfaction, and
 The formation of an adversarial image.

7.2. Types of Conflict

The classification of conflicts depends on factors such as their nature, intensity, number of
participants, and resolution methods. Based on their orientation, conflicts are divided into
horizontal, vertical, and mixed.
 Horizontal conflicts occur between individuals who are not subordinate to one another.
 Vertical conflicts involve parties where one is subordinate to the other.
 Mixed conflicts combine both horizontal and vertical components within the conflict
situation.
One of the primary characteristics of conflict is its scale. While conflicts between two
individuals or internal personal conflicts are undesirable, they tend to be less impactful on the
surrounding environment. The danger of conflict increases with the number of participants
involved.
There are four main types of conflicts:
1. Intrapersonal conflicts
2. Interpersonal conflicts
3. Conflicts between an individual and a group
4. Intergroup conflicts

Intrapersonal Conflict
An intrapersonal conflict arises from a person's conflicting goals or a mismatch between their
goals and abilities. This type of conflict is, to some extent, universal.
Example: A production manager may be instructed to increase the output of pharmaceutical
products, while the quality control manager insists on improving quality through a slower, more
deliberate process. This creates conflicting expectations for the same employee, demanding
contradictory results.
Intrapersonal conflict can also occur when organizational demands clash with personal values or
needs. It may result from overwork, underwork, low self-confidence, dissatisfaction with work,
or stress.

Interpersonal Conflict
Interpersonal conflict arises when individuals protect their personal interests, making this one of
the most common conflict types.
Example: In organizations, such conflicts often involve managers competing for limited
resources or for the approval of senior leadership. Since resources are finite, each manager seeks
to persuade leadership to allocate resources to their project instead of another's. Similarly,
conflict may arise between two candidates vying for a single promotion.
Another form of interpersonal conflict involves clashing personalities, where individuals with
incompatible temperaments or characters cannot work harmoniously together.

Conflict Between an Individual and a Group

This type of conflict occurs when an individual’s interests conflict with those of a group. Groups
establish certain behavioral norms, and the expectations of the group may completely contradict
those of the individual, leading to conflict.
Example:
 A demanding leader may conflict with their team.
 A dishonest or unproductive employee may provoke resentment among colleagues,
undermining the group’s overall performance.

Intergroup Conflict
Intergroup conflicts involve parties defending the interests of their respective groups while
opposing those of the other group. Organizations consist of various formal and informal groups,
and even in successful organizations, conflicts between these groups may arise.
Examples:
 Conflicts between unskilled workers and professionals.
 Disputes between employees and management.
 Tensions between administrative leadership and labor unions.

Hidden and Open Conflicts

 Hidden conflicts involve two parties who initially avoid showing signs of their
disagreement. Over time, these may escalate into open conflicts.
 Open conflicts are characterized by clear confrontations, such as disputes and arguments.
The interaction is governed by norms appropriate to the situation and the level of
participants, which may include international, legal, social, or ethical frameworks.

Other Conflict Types

Conflicts can also be classified by their origin:
 Spontaneous or accidental conflicts occur without prior intent.
 Chronic conflicts persist over time without resolution.
 Deliberately provoked conflicts are initiated intentionally.
By their impact on the organization, conflicts are categorized as:
 Constructive (creative): These contribute to organizational development.
 Destructive: These hinder cooperation, reduce effectiveness, and foster dissatisfaction.
By their causes, conflicts can be divided into:
 Objective conflicts, stemming from external circumstances.
 Subjective conflicts, arising from personal perceptions or emotions.
By their resolution domain, conflicts can be classified as:
 Business-related, resolved in the professional domain.
 Personal-emotional, resolved in the interpersonal or emotional domain.

7.3. Causes of Conflict

Every conflict has its specific causes and factors that lead to its emergence and development.
The emergence and progression of conflicts can be attributed to four main groups of factors:
1. Objective factors
2. Organizational and managerial factors
 3. Socio-psychological factors
4. Personal factors
The first two groups are primarily objective, while the third and fourth are mostly subjective.

Objective Causes of Conflict

Objective causes refer to the circumstances of social interaction that result in clashes of views,
opinions, or interests. These causes form a pre-conflict environment, which constitutes the
objective foundation of a pre-conflict situation.

Organizational and Managerial Causes of Conflict

These causes relate to the establishment, development, and functioning of groups, organizations,
and collectives. They can be divided into:
 Functional-organizational factors
 Structural-organizational factors
 Personal-functional factors
 Situational-managerial factors

Socio-Psychological Causes of Conflict

Socio-psychological causes stem from direct human interaction and the degree of their
involvement in specific social groups. These include:
 Diverse approaches to assessing events
 Psychological incompatibility
 Uncoordinated interactions
 Competitive nature of relationships
 Strained interpersonal relationships

Personal Causes of Conflict

Personal causes are linked to the psychological characteristics of individuals and the mental
processes that occur during their interactions with others. These may include:
 Low conflict tolerance
 Perceiving a partner’s behavior as unacceptable
 Low levels of empathy
 Poor social and psychological competence
 Excessive or underestimated expectations
 Personality temperament

The Manager’s Role in Conflict

In some cases, the manager themselves may be the source of conflict. Many undesirable
conflicts are provoked by managers through their behavior and decisions, especially if they:
 Are vindictive or hypocritical
 Publicly display their likes and dislikes
 Misunderstand the concept of leadership, mistaking it for authoritarianism
 Exhibit vanity, rudeness, or poor interpersonal communication
Conflicts often arise due to a manager’s inability to act within the framework of regulations and
directives. Such managers prioritize their personal interests, create an environment of
permissiveness, and fail to maintain self-discipline.

Impact of Managerial Inadequacy

A manager’s inadequacy—such as the inability to assess situations correctly, find proper
solutions, or understand the perspectives and emotions of others—often generates conflict.
Factors such as egocentric behavior, neglect of organizational norms, and mismanagement
contribute significantly to the escalation of conflicts within an organization.
7.4. Conflict Management
Conflict management is a deliberate activity aimed at controlling, predicting, preventing, and
resolving conflicts. The effectiveness of management depends on the appropriate choice of
methods and principles, as well as the timeliness of intervention.

Principles of Conflict Management

1. Principle of Competence
o Only competent specialists (with theoretical knowledge or practical experience)
should intervene in conflicts.
o Without a deep understanding of the nature and dynamics of a conflict, any
management efforts may prove counterproductive.
2. Principle of Cooperation and Compromise
o It is advisable to aim for constructive conflict resolution through cooperation and
seeking compromises.
o People should be allowed to defend their interests while avoiding radical changes
in the substance of the conflict.

Stages of Conflict Management

1. Early Diagnosis
o Effective conflict management measures are most successful at early stages.
o Early diagnosis helps prevent escalation and minimizes the conflict.
2. Forecasting
o This involves scientifically based assumptions about potential conflicts and their
development.
o Errors in forecasting reduce management effectiveness, so it is essential to
account for all possible negative trends.
3. Prevention
o Organizing the activities of social interaction participants in a way that minimizes
the likelihood of conflicts.

Methods of Conflict Prevention

1. Objective Conditions
o Creating a favorable environment for employees. Unhappy, unrecognized, or
unhealthy individuals are more likely to engage in conflicts.
o Fair distribution of resources. A lack of resources is a common trigger for
conflicts.
o Normative procedures. Clear rules for resolving typical pre-conflict situations
reduce the likelihood of escalation.
o Material environment. Favorable living conditions contribute to harmonious
relationships.
2. Organizational and Managerial Conditions
o Structural-organizational conditions. Regularly aligning the structure of the
organization or social group with its tasks.
o Functional-organizational conditions. Optimizing interactions between
structural elements of the organization and its employees.
o Personal-functional conditions. Ensuring employees meet the demands of their
roles.
o Situational-managerial conditions. Making optimal managerial decisions and
providing fair evaluations of employees, especially subordinates.

The Role of Emotions in Conflict Management

Excessive emotions complicate the conflict management process. Removing the emotional
aspect allows conflicts to be viewed as situations that require rational solutions.
Key Thought:
“If you take emotions out of a problem, it becomes just a situation!”

7.5. Typology of Conflicts in Healthcare Institutions

Definition and Context
Conflicts in healthcare institutions are influenced by the growing medicalization of society,
where medical concepts and practices increasingly permeate various spheres of life. Conflicts
directly impact patient health, even when resolved constructively.

Causes of Conflicts
1. Objective Causes:
o Expansion of medicalization and the medical market.
o Social control attributed to medicine.
o Adoption of new technologies in medical practice.
o Shifts in the status of the medical profession.
2. Subjective Causes:
o Healthcare workers unprepared for a "service provider" role.
o Low conflict management competence.
o Job dissatisfaction and inadequate pay.

Participants in Healthcare Conflicts

 Medical personnel and teams.
 Patients and their representatives.
 Healthcare institutions.
Conflicts with patients are the most frequent and emotionally charged, often exacerbated by
dissatisfaction with service quality, costs, or communication issues.

Types of Conflicts
 Interpersonal Conflicts: Destructive by nature, as patients often experience heightened
emotional and psychological vulnerability.
 Institutional Conflicts: Arising from organizational inefficiencies, such as limited
resources or reform challenges.
 Pharmaceutical Conflicts: Balancing professional duty, moral principles, and
commercial interests.
 Specialized Conflicts: Common in fields like dentistry, where cost-quality mismatches
and inadequate communication prevail.

Conflict Resolution Methods

1. Pre-Litigation: Resolving conflicts through direct communication between patients and
medical staff or administration.
2. Litigation: Involving courts or arbitration to achieve a binding resolution.

Key Insights
 Conflicts reflect broader socio-economic and organizational issues.
 Effective management includes fostering communication, involving staff in decision-
making, and maintaining trust in patient-provider relationships.
 Managers must adapt strategies to different conflict types, focusing on collaboration and
organizational development.
Conclusions
1. Definition of Conflict:
A conflict is the lack of agreement between two or more parties, which may include
individuals or groups. Every conflict situation involves key components: conflicting
parties and the causes of the conflict, i.e., the subject and object of the conflict.
2. Types of Conflicts:
The four main types of conflicts are:
o Intrapersonal
o Interpersonal
o Between an individual and a group
o Intergroup
Additional categories include spontaneous, accidental, chronic, and deliberately
provoked conflicts.
3. Causes of Conflict:
The emergence and progression of conflicts are influenced by four groups of factors:
o Objective
o Organizational and managerial
o Socio-psychological
o Personal
4. Conflict Management:
Managing conflict is a deliberate activity involving all stages of its occurrence,
development, and resolution. It can be conducted by the participants themselves or by a
third party.
5. Conflicts in Healthcare:
In healthcare, conflicts are studied in the context of the evolving social status of medical
institutions, the economic conditions of healthcare staff, interpersonal relationships, and
the bioethical aspects of medical practice.