Symptoms as such are not our enemy, but our friend; where there are symptoms there is conflict, and our conflict always indicates that the forces of life which strive for integration and happiness are still fighting.
Aldous Huxley (from “Brave New World”)
Introduction
The traditional professions, among which the medical profession is a vivid example, has been under tremendous pressure from an array of internal and external influences and forces, affecting everything from the quality and content of medical services rendered to affordability, from development to profitability. Factors that affect the general corporate world have made their effects felt in the medical profession, which despite popular romantic notions, we should remember, remains a business as well as one of the traditional vehicles for the attainment of other laudable goals. We see all the usual suspects, such as educational challenges, soaring production and maintenance costs, management failures, the influence of artificial intelligence on the entire profession, and many more.
Several medical professionals or organizations that I have had conversations with on this rather wide range of sub-topics mostly experience the last few years as exhibiting not just an increase in the intensity and complexity of these challenges, but also in the range of such challenges, some of which are experienced as professional existential problems. These challenges are intense, and there seems more of them, at least anecdotally. In these conversations, and for purposes of our discussion here as well, I am taking a rather wide view of who are included in the term “medical profession”, as I believe that the problems, and solutions, that we need to grapple with affect several interlinked aspects of the medical profession, and that it is there, in that wider view, that our best prospects of improvement lie.
A few unique medical conflicts
Several of the challenges facing the global and local medical profession(s) can of course be categorized, assessed and dealt with as economic challenges, or supply and demand, business management, educational, technological, scientific and other categories, and to a certain extent that is necessary and prudent. As we will see in the section below, dealing with a few strategies, too narrow or too wide a focus can bring with it its own challenges and lost opportunities. Like the legal profession, the medical fraternity has high expectations to contend with, at least as far as conventional public perception of their role, skill levels, performance and delivery levels and affordability is concerned.
A plethora of challenges in this regard, including education, service delivery, costs of technology and maintenance, corruption, managerial inefficiencies, changed consumer habits and so on have all created a joint perfect storm of pressures on the medical profession, with medical aid assistance, in its various forms and levels, being either unaffordable or deemed to be inefficient for normal, everyday use by the public. Various socialist and other systems of medical aid provision for the general public all seem to be deficient in important aspects, as we can see from the general state of the South African health system. Efforts to transform this into the NHI panacea are assured to create a range of important conflicts prior to and after any eventual implementation. Artificial intelligence also promises big as far as solutions for these problems are concerned, from diagnostics to medical access, increased affordability and so on. At the same time it also of course threatens crucial areas underpinning the medical profession, such as the employability of specialists, profitability, ethical concerns and so on.
We deal with this at great length in my book Hamlet’s Mirror: Conflict and Artificial Intelligence (see reference section below). From my own consulting work, as well as informal discussions with medical professionals across a wide spectrum of involvement, conflict as management tool, as a lens for understanding engagement between different levels of professionals and service providers, has been sorely neglected, if not completely ignored. Hospitals and medical practices, as examples, simply have a set of outdated and incomplete rules and practices in place to deal with conflict, even on a very rudimentary understanding of the concept, and these events are treated haphazardly, mostly as dread irritations to be avoided as far as possible, and then to be gotten rid of as soon as possible.
This extends even to much of medical insurance and malpractice philosophies. The high-pressured environment of the medical profession, in all of its modern manifestations and contributors, brings about a range of classical conflicts between people and their different interests, and also, to add to the weight of that during these challenging times, a few relatively unique conflicts caused by a profession that is either to focused on the science and delivery of medical assistance only, or too focused on trying to be cost effective, either option creating its own unique set of conflicts that could be seen, and dealt with, as medical profession conflicts. The medical field is traditionally, and up to the present, rather spectacularly underqualified to deal with these conflicts, at a time where one would have hoped that they are armed with these modern skills in order to efficiently, and confidently, face the storms ahead.
Factors complicating and exacerbating medical conflicts
The medical profession’s focus has always, quite rightly, been on human suffering, illness, death, prevention and healing, science and the art of human well-being. It has belatedly been dragged, sometimes rather reluctantly, into medicine as business, where profitability and affordability started affecting what some regarded as the exclusive domains of ethics and medical science. Human conflicts has, rather ironically in my view, never really played its correct role in the science or art of medicine, not even in the arenas of psychology and psychiatry.
A few suggested modern conflict strategies for the medical profession
The medical profession is going through its own necessary metamorphosis of exploration, growth and better understanding of its role in the modern world. I look forward to an increased collaboration between the fields of medicine and conflict in service of humanity, as both these disciplines seek to stay ahead of sweeping changes and challenges. From that place of appreciation and respect for this wonderful profession, I would suggest the following real-world conflict strategies to aid it along that necessary journey.
1. Re-assess the role of conflict in your world
Try to expand your view of what conflict is. A modern understanding of conflict shows that it runs through our professional and personal lives like a golden thread, as much as we may want to water it down, or stick more polite labels on it. Competition, profitability, brand management, continued education, supply chains, research, funding, managing service providers, patient care….all of these run on potential conflict. Anywhere in human endeavour where people’s interests are, or may potentially become, at loggerheads should be approached as conflict arenas. This does not require you to be aggressive or combative, quite the opposite is true, but it does need you to stop treating the symptoms of these crucial areas and start understanding, and dealing with, the causes of the outcomes that you want improved.
2. Invest in some conflict training
Modern conflict management (under which imprecisely used term I include conflict management, resolution and transformation) has in recent years become a multi-disciplinary field of study and practice, completely distinguishable from the position a decade or two ago, with its general “why can’t we all get along” approaches. Effective conflict skills lead to conflict confidence, and this in turn leads to measurable conflict outcomes. It is here where the medical profession, in the widest sense of the word, stand to benefit from various levels of coaching and training, from institutional to team to individual levels. Here I advise tailor-made programs, designed not for general application, but for industry and specific application. These programs can range from formal study to long-distance courses, seminars and workshops, team and individual coaching and encompassing all of the direct and indirect aspects of a particular medical practice or industry.
3. Do some work on persuasion as a medical tool
With these expanded views of the relevance and application of conflict skills, and its clear benefits, come the further realization that persuading people, whether it is a medical board, insurance company or difficult patient, constitutes its own complex level of conflict, and here again modern conflict management enables the practitioner, through skills relevant to inter alia nonverbal communication, identity conflicts and micro-sociology (to name but a few), to persuade others, and to prevent, guide, minimize or improve conflict outcomes. We can all benefit from being more persuasive when we need it, and the medical profession is no exception.
4. Expand your medical skills by adding advanced conflict tools
The upgrading of an individual or team’s conflict skills can, to an extent, be done through personal study and with minimal expenditure of time. This in itself constitutes an improvement in the conflict skills of such people, and is to be supported even at the most basic of levels. Any improvement in an important life skill is to be applauded and encouraged. But individuals or teams can also decide to increase such conflict skill levels, through the mechanisms and options mentioned above, and here the results are even more dramatic and rewarding. Knowledge of, and the application in professional or personal conflicts, of concepts such as conflict escalation and de-escalation, timing and sequence, the many strategies of complex conflicts, understanding and managing grievances in conflict, complex systems thinking in conflicts and so much more again can only bring benefit during your career.
5. Build conflict management into your brand
Modern consumers have very different expectations of their professional service providers, and online and brand battles have become potentially toxic and career ending, if not at least exceptionally harmful to reputation and earnings. Again, this is not its own separate category – understand conflict and you understand the levers and buttons of these modern minefields, and you know how to successfully navigate them, with or without expert advice and consultants to represent you. The benefits are immediate and gradual. Once people start experiencing you as someone who knows how to handle yourself in conflicts, you will find a very different type of response to difficult situations. If people start to experience you as a problem solver in conflict situations, doors will open and solutions will become available that are simply not there for the one nail – one hammer type of conflict approach, or for the conflict avoidant.
6. Streamline your internal practice processes
These benefits extend to your staff and colleagues. A team that understands conflict at an above-average level can see, prevent and handle problems on an advanced level, again a result simply from an expanded view of what conflict is and entails.
7. Include conflict management in your holistic medical advice
Unresolved conflicts, cyclical and even generational conflicts, conflict avoidance and a general fear of conflict have awful, costly and preventable consequences in the life and health of individuals and organizations. Becoming skilled in conflict at some level, being able to assist others with this source of anxiety and suffering, and understanding these important levers all contribute to manifestly better workplace and personal environments. There is an unfortunate number of hocus pocus peddled in some alternative medicine areas, while the scientific and measurable benefits of skilful conflict management must still, in my view, be adequately incorporated in the medical profession.
Conclusion
This very brief summary of some improvements that modern conflict skills and strategies can bring to the medical profession has hopefully piqued some interest in the topic, and if these few thoughts can start a robust debate on such points the medical profession can only benefit. I hope to experience that day.
Summary of main sources, references and suggested reading
1. Dangerous Magic: essays on conflict resolution in South Africa, by Andre Vlok, Paradigm Media (2022)
2. Hamlet’s Mirror: conflict and artificial intelligence, by Andre Vlok, Paradigm Media (2023) deals extensively with the threats, potential and strategies arising from AI in the medical profession.
3. Relevant articles (including my future work on this subject) for your consideration and their source material can be found at www.conflict-conversations.co.za
(Andre Vlok can be contacted on andre@conflictresolutioncentre.co.za for any further information)
(c) Andre Vlok
November 2024