title: Dysfunctional health service conflict: causes and accelerants.
abstract: This article examines the causes and accelerants of dysfunctional health service conflict and how it emerges from the health system's core hierarchical structures, specialized roles, participant psychodynamics, culture, and values. This article sets out to answer whether health care conflict is more widespread and intense than in other settings and if it is, why? To this end, health care power, gender, and educational status gaps are examined with an eye to how they undermine open communication, teamwork, and collaborative forms of conflict and spark a range of dysfunctions, including a pervasive culture of fear; the deny-and-defend lawsuit response; widespread patterns of hierarchical, generational, and lateral bullying; overly avoidant conflict styles among non-elite groups; and a range of other behaviors that lead to numerous human resource problems, including burnout, higher staff turnover, increased errors, poor employee citizenship behavior, patient dissatisfaction, increased patient complaints, and lawsuits. Bad patient outcomes include decreased compliance and increased morbidity and mortality. Health care managers must understand the root causes of these problems to treat them at the source and implement solutions that avoid negative conflict spirals that undermine organizational morale and efficiency.
authors.affiliation: Department of Health Science, Towson University, Towson, MD 21252, USA. wnelson@towson.edu
authors.forename: H Wayne
authors.initials: HW
authors.lastname: Nelson
mesh_terms: D003220:Conflict, Psychological; D006282:Health Personnel; D006296:Health Services; D006801:Humans; D007400:Interprofessional Relations; D017008:Negotiating; D010559:Personnel Management / Q000379:methods; D014481:United States