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It is common knowledge that the utilization of conflict resolution offers the essential plans to cut down arguments and encourages nonviolent clarifications. Melinda G. Lincoln (2001) elaborates on this point by asserting, "Diffusing heated arguments, identifying issues, setting emotions aside, and learning new ways to communicate enables the disputants to incorporate the processes and problem-solving skills of mediation, negotiation, and collaboration. The impact of illustrating, modeling, and blending conflict resolution education and communication skills facilitates the use of valuable listening and reasoning skills. Analytical thinking, re-framing main issues, and empathizing or understanding another's point-of-view creates an atmosphere of tolerance for successful negotiation and agreement to take place in a peaceful society (Melinda G. Lincoln, 2001)."
Kimberley Strom-Gottfried (1998) provides a comprehensive definition of "conflict." She writes, "Conflict is variously defined as a direct disagreement of ideas or interests, a battle or struggle, antagonism or opposition, and incompatibility and interference (Kimberley Strom-Gottfried, 1998)." The term "conflict" is frequently used in healthcare environment because of the complex dynamics of the professional settings. This poses serious problems for healthcare professionals who have not been trained to manage conflicts with healthcare settings.
This paper looks at the emerging trends within the concepts "Conflict Resolution" and the various strategies that have been adopted in the managed-healthcare field. It is important to note here that the pioneering theoretical era of conflict resolution strategies had been the 1990's. Almost all the techniques being used today have been strongly anchored and researched in the managed-healthcare settings in the 1990's. The utilization of these techniques has produced noteworthy results for the healthcare managers within the managed-care settings. This paper explores some of the most successful techniques that have been productively employed by the healthcare managers within the managed care settings.
Defining the scope of managed care
Kimberley Strom-Gottfried (1998) defines managed care as, "a range of strategies for ensuring that services are carefully structured and scrutinized to assure both fiscal responsibility and acceptable quality of care. Managed care is now the primary model under which health and mental health services are delivered in the for-profit, nonprofit, and public sectors."
While many scholars have asserted that the concept of "conflict resolution" should not be taught to the managed care professionals because they will not encounter grave workplace conflicts. This is because, they believe, the managed care settings offer very little room for disagreements and that it is a simple and straight forward task of supervision. However, Kimberley Strom-Gottfried (1998) writes, "Although conflict is not inevitable in managed systems, some professional groups, client populations, areas of the country, and sectors of service may experience more difficulty adapting to the changes managed care brings than others. Disputes can occur when members of a treatment team differ about the services needed for a patient approaching discharge from a hospital or residential facility. Disputes can occur between a provider and a utilization reviewer, who disagree about whether certain services are 'medically necessary' or covered by a client's benefit plan. And they can occur between a worker and a supervisor, when the worker objects to precise performance standards and the supervisor views them as essential for accountability and funding. As the climate for the provision of health and mental health services becomes increasingly competitive, as budgets become tighter and expectations increase, the stakes in such disputes go beyond the substance of the disputes themselves."
Comprehending the conflict within managed care systems
Managed care systems are very complex and dynamic healthcare settings and as a result need careful and thorough examinations. Regrettably, very little research exists on the subject of conflicts within managed care settings. This has created a gap between the quality of services expected by the patients and the reality on ground. However, some scholars have gone out of their way to deliver what can be regarded as ground-breaking and revolutionary research work in this field. Kimberley Strom-Gottfried (1998) classifies the origins of conflicts with the managed care settings. She writes, "inconsistencies in data; relationship issues; value conflicts; structural problems, such as unequal power or resources or geographic or physical barriers; and conflicts about interests." These classifications have been considered as the most common situations for the mushrooming of conflicts within managed care settings.
Fundamentals of Conflict within managed care settings
Understanding the basic fundamentals of any conflict is important because no conflict can be resolved nonviolently unless the managers have fully understood the primary elements of conflict. Now, in order to understand the fundamentals of conflict resolution within managed care, it is important to assess two leading research studies. Mayer (1995) and Umbreit (1995) research work on this subject is still considered to be the most influential as it paved way for a deeper and profound understanding of the fundamentals of conflict within managed care. Mayer recognizes two fundamentals of conflict with managed care settings: "(1) the objective differences between the participants and (2) the emotions and perceptions attendant to the conflict. It is essential that both aspects of conflict be recognized and addressed, because crafting a solution to the dispute without allowing for some degree of emotional release will not ultimately resolve the conflict. Similarly, attending exclusively to feelings of aggravation, hurt, and anger without moving to a satisfactory outcome is an ineffective resolution (Mayer, 1995)."
In relation to the study of Mayer (1995), Umbreit (1995) found, "communication breakdowns often create or contribute to conflictual situations. Misinterpreting one's message and meaning, failing to actively listen to both the content and feeling elements of a message, and not devoting full attention to the speaker can all affect the escalation of a conflict or the inability to address it (Umbreit, 1995)."
One of the reasons conflicts emerge is because of contrasting interest of different parties. In order to successfully resolve the conflict, interests of all the parties should be carefully determined and resolved. Kimberley Strom-Gottfried (1998) describes three fundamental categories of interests. She reveals, "Whatever the type, interests generally fall into three categories, although often more than one interest is at stake in any given dispute. Psychological interests relate in some ways to the emotional elements of a conflict. These interests have to do with the need to be taken seriously, to be heard, and to feel treated fairly. To understand the importance of psychological stakes, one need only look as far as labor disputes or international crises to find examples of potential agreements forestalled because of the wounded feelings of participants. Procedural interests reflect the importance of process - the way in which decisions are reached or actions are carried out. Issues such as timing, what data are taken into account, and the steps in coming to a conclusion all reflect procedural concerns. Substantive interests are often the sole focus of attention in disputes. They involve the outcomes, behaviors, and "bottom lines" that must be met for the disagreement to be settled."
Principles and Practices of Conflict Resolution
Thomas and Kilmann (1974) offered the most innovative and the most widely used strategies of conflict resolution that are being used not only in the managed care settings but also innumerous other workplace settings. Their strategies include five different styles and each style is considered to have its own advantages and disadvantages. These styles are adopted in accordance with the context of the situation being dealt with. Health care managers have found these techniques to be extremely successful, despite the fact that they had been presented almost three decades ago. Their five styles of conflict resolution are; "(1) avoiding ("I leave and you win"), (2) accommodating ("I let you win"), (3) compromising ("We both win some and lose some"), (4) competing ("I win and you lose"), and (5) collaborating ("We both win").( Thomas and Kilmann, 1974)"
Another strategy for resolving conflicts within managed care settings is to detach the concerned people for the problem. This is an extremely complex strategy and involves highly skilled communication experts. The person resolving the conflict not only has to put himself/herself in the position of the concerned party by asking the right questions but also ensure that he/she does not spark negative emotions as it will derail the entire process. Kimberley Strom-Gottfried (1998) writes, "A negotiator must listen well and put himself or herself in the other's place, perceiving the situation from that perspective without making presumptions about that perspective based on his or her own fears and biases. This may be accomplished by asking how they see the situation and by seizing opportunities to defy negative expectations. If a supervisor expects only to be challenged about a new service standard or policy, the adept negotiator would empathize with the difficulties inherent in implementing such a policy and ask the supervisor his or her thoughts about how it can reasonably be accommodated. Embedded in this strategy are the skills of being in touch with one's own emotions, not reacting defensively when others express strong emotions, and communicating in a nonjudgmental and non-inflammatory manner. When dealing with difficult people over difficult problems, the temptation is to avoid them…[continue]
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