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There’s an old story that presents the dilemma of the orange. You and I have one orange between us and we both want it. How do we resolve this? The most common and obvious answer is to cut the orange in half and each take a piece. That would be an example of compromise. If we look at this in a different way and consider why we each want the orange, we may discover that you want to get orange juice from the orange and I want the rind for baking.

In considering the underlying reasons for why we want things, new options come to light to find mutually beneficial outcomes. This is the goal of collaboration. So often, when we think we are collaborating, we are actually compromising.

The reason this is significant is that in compromising we have to give something up to get resolution and in doing so we often give up that which has value to us. This is especially critical in healthcare where everyone’s roles are interdependent and the quality of patient care is dependent upon the working relationships that exist. When there are any residual feelings of having given up something of importance, there is a natural tendency to ensure that the next time around, the same thing does not happen again. This results in a downward spiral of negotiations where the patient usually senses the tense working environment and receives the outcome of less than optimal decisions.

Other common approaches to conflict resolution include competition, accommodation, and avoidance. We live in a society where competition is coveted and the winner is revered as evidenced by many of the reality television shows and sports competitions. This is an effective strategy when you do not have to maintain an ongoing relationship; a quick or unpopular decision must be made, or safety is at stake. In the workplace, competition can increase motivation but it can also result in the same downward spiral seen with compromise – I’ll do whatever it takes to win next time!

Studies have shown that accommodation is a frequent choice by healthcare workers. It fits with many personalities who work in the field and who want to help others. In doing so, personal gain is forfeited and often at the expense of fulfilling important needs. The relationship is given precedence over any substantive results. The final approach is avoidance also recognized as denial. If we keep a low profile, the issue just might clear up by itself. The problem usually gets worse, a decision is made by the lesser qualified, employees become frustrated by the perceived lack of action, and reputation suffers. In reality most conflicts grow in size: the number of people involved and affected by the issue, the amount of time and effort needed to find resolution, and the costs associated with it increase too – these are often referred to the silent costs of conflict.

Every conflict resolution approach has appropriate situations when it is the best choice. However, the reasons that the majority of negotiations result in compromise are usually tied to the time and effort required to fully collaborate a successful outcome. Also, we think we are collaborating until we feel the pressure to ‘get this over’ and revert to compromise. In order to establish systems that produce optimal decision-making and resolve conflicts so that they have a minimal chance of reoccurrence, collaboration is the only viable course!