Caplan Jason P, Epstein Lucy A, Stern Theodore A
Dept. of Psychiatry, Univ. of Arizona, Tucson, AZ, USA.
Psychosomatics. 2008 Jan-Feb;49(1):8-13. doi: 10.1176/appi.psy.49.1.8.
Conflicts among consultants are frequent in general hospitals. Unfortunately, such disputes are rarely resolved to the satisfaction of all concerned. The authors discuss the conflicts that may arise among consultants and review techniques that can lead to more effective collaboration. Authors review the literature on consultants' conflicts and discuss strategies for their resolution. They present the case of a man with neuropsychiatric symptoms and discuss how practitioners of psychiatry and neurology often approach differential diagnosis, work-up, and treatment of challenging cases. The consultants were able to find several points of agreement and generated a workable plan that led to improvement in the patient's symptoms. Conflict among medical consultants is poorly described in the literature. However, an understanding of conflict and strategies for its resolution can lead to improved patient care. Conflict is a common and virtually unavoidable aspect of multidisciplinary care. However, effective tools exist that can help physicians embrace, rather than avoid, conflict, and lead to more effective collaboration. Effective management of interdisciplinary conflict improves communication, assists in medical decision-making, and, most importantly, improves the delivery of patient care.
综合医院中会诊医生之间的冲突很常见。不幸的是,此类纠纷很少能令所有相关方都满意地得到解决。作者们讨论了会诊医生之间可能出现的冲突,并回顾了能够促成更有效协作的技巧。作者们回顾了关于会诊医生冲突的文献,并讨论了解决冲突的策略。他们介绍了一名有神经精神症状男子的病例,并讨论了精神科和神经科医生在面对具有挑战性的病例时,通常如何进行鉴别诊断、检查和治疗。会诊医生们找到了几个共识点,并制定了一个可行的方案,使患者的症状得到了改善。医学会诊医生之间的冲突在文献中鲜有描述。然而,了解冲突及其解决策略有助于改善患者护理。冲突是多学科护理中常见且几乎不可避免 的一个方面。然而,现有的有效工具可以帮助医生接受而非回避冲突,并促成更有效的协作。跨学科冲突的有效管理能改善沟通,辅助医疗决策,最重要的是,能改善患者护理的提供。