Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Learning Objective: The goal of this study was to gain a deeper understanding of the personal and professional impact inter-physician conflict has on physicians’ well-being.

Background: Despite the recognized importance of collaboration and communication, interpersonal conflict amongst healthcare providers in different specialties remains a pervasive issue. Recent work elucidated some of the social conditions and processes that contribute to conflict between EM and IM physicians at the time of admission. However, little is known about the consequences that inter-physician conflict has on providers’ well-being.

Objective: The goal of this study was to gain a deeper understanding of the personal and professional impact inter-physician conflict has on physicians’ well-being.

Methods: In this study, the authors used constructivist grounded theory to explore themes related to the impact of conflict on individual providers. A purposive sampling approach was used to recruit participants (n=18), which included EM residents and attending physicians as well as IM attending physicians. Two authors conducted hour-long, semi-structured interviews and then coded the transcripts following Charmaz’s three stages of coding. The authors used constant comparative analysis until thematic sufficiency was reached.

Results: Participants described personal impacts of inter-physician conflict including emotional and moral distress which occurs in the context of feeling demoralized by colleagues. Conflict further impacted participants professionally by promoting cynicism, job dissatisfaction, and a negative view of their professional identity and professional accomplishments. Finally, participants described the ‘emotional residue’ that remained after conflict, which tended to perpetuate future conflict.

Conclusions: Physicians attributed emotional exhaustion, cynicism, and reduced sense of personal accomplishment to conflicts arising during conversations around admission. In this way, inter-physician conflict is an under-recognized contributor to physician burnout that should be explored to support the well-being of trainees and attending physicians.