When I reflect on my medical career to date, I am reminded of both the positives and the negatives, with the latter sometimes overshadowing the former, unfortunately. I am painfully aware that like all doctors, I could face a complaint or significant event at any time, although I hope that my years of training and experience and some degree of competence will mitigate against this. Although most of my training revolved around clinical practice, what my formal training failed to tell me about was how to deal with potential conflicts, something that seems foremost in the minds of many doctors these days. Thankfully I have never had any formal complaints or concerns, but, inevitably I have been involved with conflicts, some of which resulted in adverse outcomes for at least one of the involved parties.
It is this experience of internecine strife that prompted me to learn more about areas of medicine not generally covered by clinical training. Things like law, health policy, risk management and conflict resolution spring to mind immediately, with all these becoming of increasing importance to maintaining, succeeding and thriving in a modern medical career. I would particularly recommend that all doctors know something about all of these areas, not only for professional reasons (including meeting requirements for annual appraisal and revalidation) as specific knowledge here may well save one’s career. Knowing what the law says and following it is particularly useful, although I am aware that doctors have an oft-complicated relationship with the law, and not all medics are inclined or able for whatever reason to develop fully and maintain any form of legal knowledge. Also, even when one has some legal knowledge, working in environments where such knowledge is not shared, understood or appreciated may in itself lead to conflict.
I therefore think that all doctors should know about conflict resolution and its various forms. Many doctors have heard about negotiation, arbitration and mediation, but how many know what these actually mean and how they can help to preserve one’s career, well-being and sanity? Here I will say some brief things about mediation and how it works. In essence, mediation involves dispute resolution in which a neutral mediator helps to settle disputes by acting as a go-between where two parties differ in their seemingly intractable views. The mediator helps the parties to reach a mutually agreeable outcome, but does not assert his or her own viewpoint. The aggrieved parties find the solutions themselves, and this approach may well be successful in many of the sorts of disputes that doctors face. Obviously both parties must be amenable to discussion, participation is voluntary and of note the mediation need not be face-to-face, as the mediator can shuttle between rooms or venues. Clearly this can be helpful where disputes are particularly emotive, and mediation has been shown to be highly effective – so much so that ACAS, the Advisory, Conciliation and Arbitration Service, reports an 80% success rate for its mediations*. Furthermore, the BMJ supports mediation, citing advantages such as cost-saving, speed, flexibility and control**. Given this, it is a wonder to me that more doctors do not know about the advantages of mediation, but maybe reading this blog will alter this, so stay tuned…
*ACAS (2016). Mediation. <www.acas.org.uk/index.aspx?articleid=1680> Accessed 29 August 2016
**BMJ (28 September 2015). Mediation – an alternative way of resolving practice disputes. <www.bma.org.uk/advice/employment/gp-practices/gps-and-staff/resolving-practice-disputes-with-mediation> Accessed 29 August 2016
Consultant psychiatrist with extensive medicolegal, managerial and judicial expertise acting as medical consultant to ASM and an accomplished linguist and academic.