Learning & professional development: In the conflict zone: Practical steps for navigating clinician disagreement

Don't find fault, find a remedy. Pause Hospitalists work in an environment where continuous forward momentum often equates with success: shorter stays, earlier discharges, and rapid throughput. We unconsciously carry this pace into interpersonal disagreements. When conflict emerges, the brain's salience system activates, heightening emotion, triggering instinctive reactions, and reducing cognitive flexibility. A brief pause—often as simple as a slow, intentional breath—interrupts this cascade, allowing us to shift from impulse to intention and creating space to respond rather than react.1 Name the conflict In medicine, identifying a problem is the first step toward solving it. Internally, we may wonder: Why is the consultant not evaluating my patient? Why won't the pharmacist dispense this restricted antibiotic? Why is the nurse calling again? Yet we rarely name the tension directly. A simple statement such as, “I feel frustrated with our interaction—can we talk about it?” elevates the conversation above the specifics of the immediate clinical task and brings the disagreement itself into view. This act of “affect labeling” also reduces emotional intensity by shifting activity from the salience system toward cognitive networks that support regulation and problem-solving. Meet IRL Much of hospital communication overwhelmingly occurs through secure messaging platforms. Electronic communication, however, often amplifies misunderstanding and intensifies reactions—a dynamic known as the “online disinhibition effect.”2 Moving a charged conversation into the real world, whether by phone or in person, restores natural social cues, reduces misinterpretation, and signals that the interaction is important enough to address without electronic filters. Assess the understanding gap Resolving conflict requires building a shared understanding of the issue—not determining who is right. “I” statements allow both parties to voice their perspectives without blame. Reflecting feelings back to the other person (“It sounds like a timely response to the patient's pain is really important to you”) helps de-escalate tension, establish mutual respect, and create space for dialogue. In this approach, conflict becomes something to explore collaboratively rather than something to avoid, reinforcing that each person's viewpoint matters in reaching a solution. Lead with a shared purpose Once the contours of the conflict are understood, the next step is to move toward resolution anchored in a unified goal. The most effective solutions come from aligning around shared purpose. The clearest and most universally compelling goal is improving the patient's care, which aligns with a collective commitment as health professionals. Yet other shared motivations, such as reducing staff burnout, increasing efficiency, improving patient satisfaction, or supporting professional recognition, can also help both parties feel invested in a collaborative solution. Debrief The past does not have to stay in the past. Debriefing—widely used after critical events—can also help clinicians recover from the smaller but frequent interpersonal challenges inherent in daily practice. Debriefs may occur with colleagues, with the individuals involved, or even with trusted friends or family. Core components include summarizing the situation, examining emotional reactions, and sharing coping strategies. Through reflection, the inevitable conflicts within our work can yield insight, resilience, and stronger teams. The authors declare no conflict of interest.