Conflict Resolution

Conflict resolution skills are important in emergency medicine for interactions with patients, peers, physicians in other specialties, and other hospital staff. The issues of conflict differ; the dynamics, however, are similar.

Some people believe intrinsically that their concerns, no matter how minor, are more important than anyone else's. Demanding patients or families are best handled by acknowledging their expectations and attempting compromise. Sometimes, it is effective to acknowledge that the patient has been heard and his or her perspective considered, yet the physician has a different perspective and position. Although firmness may be necessary, rarely will anything be gained by hostility or by confrontation.

Administrators, nurses, and consultants may be other sources of conflict; often, ongoing personality conflicts exist, provoked by the intensity of the work environment. One needs to focus on finding the "common ground," which is the patient's needs.

Not every conflict is a battle that must be won. Healthy conflict resolution requires physicians to know when to stand up and when to negotiate or retreat. Malpractice Litigation Support

Those concerned with physician well-being are beginning to explore malpractice litigation stress support groups. Several common attributes exist in the various models that have been proposed.

The group is educational. Risk management personnel describe what to expect at each step and clarify the meaning of legal terms. Physicians who have contended with lawsuits provide support by sharing their experiences. Hearing that others have felt similarly can be the initial crack in the wall of isolation built by the physician-defendant. Family members can provide insight into the process their family is experiencing and their emotional responses. This will often improve communication at home.

Information is available on how to establish litigation stress support groups, and many state medical societies already have such groups in place. Physical Health

Most physicians do not get regular preventive health care. This may be due both to the tremendous time constraints of practice and to denial of one's vulnerability to illness. Either way, a physician can wind up caring less for self than for the patients.

Exercise helps maintain physical health and relieves emotional tension. In addition, setting aside the time for one's own health, within one's busy schedule and conflicting priorities, confirms with action the belief that caring for oneself is an important use of time.

The diets of many emergency physicians contribute to both poor health and fatigue: high in fat, sugar and caffeine, usually eaten quickly, without time to sit. Anticipating an urgent interruption also prevents one from relaxing.

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