I’m going to tell you all a secret: I enjoy conflict.

No, I don’t enjoy creating conflict, and I certainly don’t enjoy being involved in conflicts with peers or my students. But I love studying it, mainly “why” conflict happens and how it impacts our organizational systems and daily interactions. Perhaps I’m naïve and hold an idealistic view that if we solved specific problems, the world would be run more effectively, and people would have more time to improve themselves and their environments. Wild, right?

I began looking into workplace conflict in hospitals in 2019 while shopping around for a dissertation topic, combining my knowledge from two fields of expertise: Vascular sonography and conflict resolution. Little did I know this task would become Herculean in scope as I quickly discovered how allied health professionals were marginalized in literature exploring conflict in hospitals.¹ I found this odd and wanted to dive into this topic, puzzled by this literature that should have known conflict did not occur in a vacuum. Additionally, all the unresolved conflicts in healthcare would inevitably spiral out of control, leading to systemic conflicts that were much harder to resolve.

Many folks use the word “systemic” without understanding complex systems theory.² Have no fear; I won’t bore you to tears with an explanation of systems theory and the differences between open and closed systems. However, I will explain that not only are you a system, but our healthcare professions are systems, our medical imaging departments are systems, and hospitals are systems. Sometimes, these systems work in harmony, but sometimes, they do not function as intended, leading to two types of social conflict: interpersonal and interprofessional.¹ These conflicts demoralize hospital staff and probably impact patient care delivery from physicians, nurses, and allied health professionals who could be suffering from stress and burnout.¹

We are all familiar with interpersonal conflict; it is unavoidable and, in many ways, necessary for personal growth. It is interprofessional conflict that should warrant more attention, particularly in hospital settings, as there is a tendency for healthcare professionals to be tribal in their group behavior, meaning they stick with their “own” and have an in-group preference. Medical imaging departments are not exempt from this phenomenon.¹ Based on existing literature exploring conflict in hospitals,^3,4 most reported conflict is interpersonal and intraprofessional, meaning the conflict most often occurs between peers, eg, nurse versus nurse. Interprofessional conflict reported in the literature also involved nurses versus physicians and occasionally involved allied health, including medical imaging professionals.¹

The origins and antecedents of conflict within medical imaging are multifactorial: They combine personal factors specific to individuals with work-related issues exacerbated by high-stress, unpredictable work environments.¹ Interprofessional conflict is particularly troubling as it suggests a difference in professional values between professions or a divergence of interests between patient care and the need to generate revenue.¹ In those situations, a phenomenon known as “dual agency”¹ may explain some interprofessional conflicts as medical imaging professionals struggle to advocate for patients while also serving the interests of their employers. This does not explain all of the interprofessional conflict, but it does suggest a need for medical imaging professionals to consider their roles in the larger healthcare system and if they are truly serving the best interests of their patients.

So, how do we address workplace conflict in medical imaging? Unfortunately, I see no “one size fits all” solution, but I propose a template for resolving many issues that contribute to conflict: Dispute systems design.⁵ Dispute systems design is a tailor-made analysis of a unique, conflict-prone environment that could identify problem elements within the system and provide opportunities for long-lasting resolution. Managing conflict is a misnomer, as the key to lasting conflict resolution is collaborative conflict resolution between conflicted parties.⁶ I am confident that introducing dispute systems design into hospitals and medical imaging departments can elicit many positive changes, potentially reducing burnout and staff turnover.

References

1. Moody RC. Medical Imaging Professionals Experiencing Workplace Interprofessional Conflict: A Phenomenological Study. Davie, FL: Nova Southeastern University; 2023.
2. Meadows DH. Thinking in Systems: A Primer. White River Junction, VT: Chelsea Green Publishing; 2008.
3. Almost J, Wolff AC, Stewart-Pyne A, McCormick LG, Strachan D, and D’souza C. Managing and mitigating conflict in healthcare teams: an integrative review. J Adv Nurs 2016; 72:1490–1505. doi:10.1111/jan.12903
4. Kim S, Bochatay N, Relyea-Chew, et al. Individual, interpersonal, and organisational factors of healthcare conflict: A scoping review. J Interprof Care 2017; 31:282–290.
5. Rogers NH, Bordone RC, Sander FE, and McEwen CA. Designing Systems and Processes for Managing Disputes. Frederick, MD: Wolters-Kluwer; 2013.
6. Katz NH, Lawyer JW, Sweedler M, Tokar P, and Sosa K. Communication and Conflict Resolution Skills. 3rd ed. Dubuque, IA: Kendall Hunt Publishing; 2020.

Robert Moody, PhD, MS, RVT, is an Assistant Professor of Cardiovascular Sonography at Nova Southeastern University (NSU) in Fort Lauderdale, FL.