Within all groups there are different ideas, behaviors, and interests among members that can be used very constructively, or can create problems.  

Broadly speaking, the BCMA mem­bership is comprised of a group of physicians who are dedicated to improving the health and well-being of their patients. Within that larger group are other groups comprised of 39 different specialty sections including family physicians, groups of rural and urban physicians, medical, surgical, and diagnostic groups, and groups of students, residents, practising phy­sicians and retired physicians. That’s a lot of groups, with a lot of personalities. Since human nature fascinates me, I thought I would talk about the broad topic of human interaction, but narrow it down to how we deal with problems.

Certain factors impact the effectiveness of a group. For instance, the cohesiveness of the group members, the degree of reliance of and among members, the composition and size of the group, the resources available, member abilities, and norms (i.e., expected behaviors and attitudes of members) will each contribute.  

When problems arise, they can sometimes grow, resulting in conflict. Conflict will arise when people are dependent on others in order to complete a task, when there is misunderstanding or ambiguity, when there are communication barriers in place, or when personalities clash. This is not necessarily a bad thing, as long as it is resolved effectively and can lead to professional or personal growth.  

There are a number of approaches that groups and individuals use to manage conflict, and they run the gamut between cooperativeness and aggressiveness. Over the years, the different groups of the BCMA have likely employed many of these ap­proaches as they deal with issues and problems along the way.

•    Avoiding the issue is a common response to conflict. This style is typified by delegating controversial decisions, accepting default positions, and not wanting to hurt anyone’s feelings.
•    Accommodating is when individuals are willing to meet the needs of others at the expense of their own by backing down from their stand. Preserving the relationship is seen as most important.  
•    Collaborating is the merging of individual needs and goals towards a common goal. Usually referred to as a “win-win” solution, collaboration requires open communications and cooperation in order to achieve a better solution than either side could have achieved alone.  
•    Competing is a style where individual needs are advocated over the needs of others. People who tend toward this style take a firm stand, know what they want, and seek control, fearing that the loss of it will result in solutions that fail to meet their needs.
•    Compromising is an approach in which people give and receive by trading off in an effort to at least partially satisfy everyone. This style is useful when the cost of conflict is higher than the cost of losing ground, when equal strengths are at a standstill, or when a deadline is looming.

Although conflict can be a negative, stressful experience, it can also be looked at as a positive experience. Without it, people would not be challenged to think beyond their everyday routine boundaries. When a variety of people with different perspectives, values, experiences, education, life­styles, and interests come together, differences abound. That diversity can enrich the discussion, the ideas, and the goals if the conflict and tensions that emerge are resolved and the group uses the learning to improve its work.

Different approaches to managing conflict like those mentioned above have been used with and among the many BCMA groups for decades, each resulting in its own degree of success.  Taking a step back and looking at our group dynamic, in the end, we all want the same relative goals—a health care system that works for our patients and for the physicians who deliver their care. 
—Nasir Jetha, MD
President