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Resolving disputes with physicians

Case Management Weekly, November 27, 2007

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When it comes to conflict between case managers and physicians, much depends on whether there is a clear plan of care for the patient. According to Debra Gerardi, RN, MPH, JD, the chair of the Program on Healthcare Collaboration and Conflict Resolution at Creighton University in Omaha, NE, problems can pile up because physicians and case managers tend to have different views of collaboration.

"Physicians tend to think of collaboration as 'anticipating needs and following through on what was ordered'; nurses define collaboration as 'joint decision-making and respect for contribution,' " she says. "Until we develop some collective understanding around what collaboration means, we will continue to generate conflicts resulting from unmet needs."

Although training can improve comfort when entering a conflict, Gerardi admits that it alone will not cut the amount of time case managers spend dealing with conflicts.

Assessing when to step into a conflict is crucial, and Gerardi says case managers should ask themselves three questions before taking action:

1. Is this a recurring situation that is affecting patient care?
2. Does interacting with this person or this situation keep me awake at night?
3. What is my intent in wanting to resolve this situation?

Source: You can read Gerardi's full guide to resolving conflict between physicians and case managers in the December issue of Case Management Monthly.

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