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How internal medicine residents resolve conflicts with attending physicians
N J Farber1, J L Weiner, E G Boyer
1Department of Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania 19023.
Summary
Internal medicine residents primarily use negotiation to resolve patient care conflicts with attending physicians. Career plans and medical school background influence conflict resolution strategies, highlighting the need for tailored approaches.
Area of Science:
- Medical Education
- Conflict Resolution
- Internal Medicine Residency
Background:
- Physician-patient relationships are central to medical training.
- Effective conflict resolution skills are crucial for resident development.
- Understanding factors influencing resident conflict management is essential.
Purpose of the Study:
- To investigate how internal medicine residents resolve conflicts with attending physicians regarding patient care.
- To identify specific conflict resolution methods employed by residents.
- To explore demographic and career-related factors influencing these methods.
Main Methods:
- Survey administered to 43 of 49 internal medicine residents in 1988.
- Utilized ten case scenarios to assess conflict resolution preferences.
- Employed Likert-type scales to measure the likelihood of using various conflict-addressing methods.
Main Results:
- Negotiation was the most frequent strategy; ignoring or withdrawing was least common.
- Procedure type impacted conflict resolution choices.
- Residents pursuing general medicine or non-medical careers were more agreeable than subspecialty aspirants (p < .005).
- Osteopathic graduates were more likely to withdraw than allopathic graduates (p = .05).
Conclusions:
- Conflict resolution between residents and attending physicians is often achieved through negotiation and interaction.
- The choice of resolution method is influenced by procedure, medical school origin, and career aspirations.
- These findings underscore the variability in resident approaches to clinical dilemmas.