Resource related conflicts in managed care

January 01, 0001

Resource related conflicts in managed care

This group of Israeli and American researchers systematically described doctor-patient conflicts. They analysed 291 videotaped routine encounters with 28 general practitioners, using an novel adaption of computer software to provide quantitative empirical data on the conflicts and on the communication process demonstrated. Seven focus groups (56 GPs) provided qualitative insights that helped with analysis.

The researchers report: "Conflicts were identified in 40% of consultations, 21% of these were related to the rationing of health care resources. In conflictual encounters, both the opening and closing phases of the encounter were shorter than in non-conflictual encounters. In coping with resource rationing, the commonest strategy was to accept the dictates of the system without telling the patients about other options. When conflict of this type occurred, doctors showed more opposition to the patients rather than empathy."

The authors concluded: "Doctors often face conflicts in their routine work, but resource-related conflicts are especially difficult and expose the dual loyalties of the doctor to the patient and to the system. Insights derived from this research can be used to design training interventions that improve doctors’ efficacy in coping with conflicts and ultimately allow them to provide better patient care."

This research identifies areas prone to conflict between patients and physicians, especially in managed care settings.

For the full abstract, click here.

Family Practice 27(1):93-100, January 2010
© 2010 Oxford University Press
An anatomy of conflicts in primary care encounters: a multi- method study. Michael A Weingarten, Nurit Guttmand, Henry Abramovitch, et al. Correspondence to Michael A Weingarten: [email protected]

Category: HSR. Health Services Research. Keywords: Conflict, physician-patient communication, managed care, medical education, physician-patient relationship, mixed methods study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 12 March 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.