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Featured on "Scalpel and Sword": The Hidden Cost of Healthcare Conflict
- Kimberly Best
- Oct 13
- 12 min read
My conversation with Dr. Lee Sharma about transforming workplace tension before it destroys your team
What I learned as an ER nurse about why good people have bad conflicts—and how mediation saves both relationships and patient outcomes
By Kimberly Best, RN, MA | Court-Listed Mediator (MO & TN) | Founder, Best Conflict Solutions
Published: October 2025
I recently joined Dr. Lee Sharma on her podcast, Scalpel and Sword: Conflict and Negotiation in Modern Medicine, to discuss something most healthcare leaders know but rarely address: unresolved conflict is quietly destroying your teams, burning out your staff, and harming patient outcomes.
The conversation revealed why traditional approaches to workplace conflict fail in healthcare settings—and what actually works when you're dealing with exhausted clinicians, high-stakes decisions, and life-or-death pressure.
This post unpacks the key insights from our conversation, the research behind them, and practical frameworks you can use starting today.
Listen to the full episode: https://scalpel-and-sword-conflict-and-negotiation-in-modern-medici.simplecast.com/episodes/ep21-sharpen-the-sword-mending-medicine-kimberly-best-on-conflict-as-a-cure-SUZq_OkS
IN THIS POST:
Estimated reading time: 15 minutes, or jump to the section you need
• The Hidden Cost of Healthcare Conflict - Why unresolved conflict affects 41% of patient care
• Why Good Teams Have Bad Conflicts - It's skills gaps, not people problems
• What Actually Works - The transformative mediation framework
• Practical Strategies - Tools healthcare teams can use immediately
• The Shame Factor - Why healthcare professionals avoid conflict
• Healthcare Is Different - Why generic approaches fail
• Getting Started - Next steps for clinicians, leaders, and organizations
THE HIDDEN COST OF HEALTHCARE CONFLICT NOBODY'S CALCULATING
If you work in healthcare, what conflicts are keeping you up at night?
Research shows that unresolved conflict contributes to 41% of perceived negative impacts on patient care. That's not a small number. That's nearly half of the problems affecting your patients—problems that could be prevented with better conflict management.
But most healthcare organizations focus on fixing the symptoms (high turnover, low morale, medical errors) rather than addressing the underlying disease: unresolved interpersonal conflict.
The Math Healthcare Leaders Miss
During our conversation, Dr. Sharma and I broke down the actual cost comparison:
• Training a new nurse: $56,000 (recruiting, onboarding, productivity loss)
• Professional mediation to resolve workplace conflict: $3,000 average
• ROI of preventing one nurse from leaving: $53,000
And that's just one person. Multiply that across your organization, add in the ripple effects on team morale, patient satisfaction scores, and clinical outcomes, and you're looking at staggering losses.
The conversations you're avoiding are costing you more than you realize.
WHY GOOD HEALTHCARE TEAMS HAVE BAD CONFLICTS
One of the core themes Dr. Sharma and I explored: conflict is not a sign of dysfunction. It's a sign of being human.
Healthcare attracts caring, intelligent, dedicated professionals. So why do these good people end up in destructive conflicts?
It's Not "People Problems"—It's Skills Gaps
In my years as an ER nurse, I watched brilliant clinicians handle medical emergencies with precision—but completely fall apart when faced with interpersonal disagreements.
The reason? We train healthcare professionals to manage medical crises, not human conflict.
Medical school doesn't teach you:
• How to address a colleague who's undermining you in front of patients
• What to do when your attending's communication style feels disrespectful
• How to navigate power dynamics when you disagree with a treatment plan
• How to repair relationships after high-stress moments damage trust
These aren't character flaws. These are teachable skills that most clinicians never learned.
The ER Taught Me About Conflict
Working in trauma and emergency medicine, I learned something crucial: people in crisis just want to be seen, heard, and understood.
The patient yelling at you? They're scared.
The family member demanding answers? They're powerless.
The colleague snapping at you? They're overwhelmed.
Understanding what's underneath behavior changes how you respond. And in healthcare, that understanding can mean the difference between escalation and de-escalation, between a team that functions and one that fractures.
"Like health, conflict can heal or harm depending on how we handle it."
— Kimberly Best, from Scalpel and Sword podcast
WHAT ACTUALLY WORKS: THE TRANSFORMATIVE CONFLICT MANAGEMENT APPROACH
Dr. Sharma asked me to explain the mediation model I use with healthcare teams. Here's what makes it different from traditional HR interventions:
Traditional HR Approach vs. CONFLICT MANAGEMENT
TRADITIONAL HR CONFLICT MANAGEMENT:
• Focuses on compliance and liability
• Determines who's right and who's wrong
• Imposes solutions from the top down
• Treats conflict as a problem to eliminate
• Result: Resentment, surface compliance, unresolved tensions
TRANSFORMATIVE CONFLICT MANAGEMENT:
• Focuses on restoring communication and relationships
• Helps people understand each other's perspectives
• Empowers parties to create their own solutions
• Treats conflict as an opportunity for growth
• Result: Sustainable resolution, strengthened relationships, conflict skills that last
The Framework That Changes Everything
Here's what I told Dr. Sharma about how I approach healthcare conflict:
1. CREATE PSYCHOLOGICAL SAFETY FIRST- AKA TRUST
People need to feel seen, heard, validated, and valued before they can move to problem-solving. This isn't "soft skills" work—it's the foundation for real solutions.
In healthcare settings where hierarchy is embedded in every interaction, creating genuine safety requires intentional structure. Everyone in the room—regardless of title—must know their perspective matters.
2. SURFACE THE REAL ISSUES (NOT JUST THE PRESENTING PROBLEM)
The complaint about scheduling? It's really about respect.
The disagreement about patient care? It's really about being heard.
The tension with a colleague? It's really about trust that was broken six months ago.
My job as a mediator is to help people identify and address what's actually driving the conflict—not just the surface symptoms.
3. TEACH CONFLICT SKILLS WHILE RESOLVING CONFLICT
This is where transformative conflict management differs from other approaches. I don't just resolve today's conflict—I teach people how to handle tomorrow's disagreements.
When the mediation ends, participants leave with:
• Better understanding of what triggers them and why
• Language for difficult conversations
• Tools for de-escalation
• Frameworks for addressing future issues directly
They're not dependent on HR or a mediator to intervene every time tension arises. They have the capacity to manage conflict themselves.
PRACTICAL STRATEGIES HEALTHCARE TEAMS CAN USE RIGHT NOW
During the podcast, Dr. Sharma asked for concrete tools clinicians could implement immediately. Here's what I shared:
Build Conflict Management Systems, Not Just Fix Conflicts
This was a key point Dr. Sharma and I explored: reactive conflict resolution keeps you in crisis mode. Proactive conflict management systems prevent crises.
WHAT HEALTHCARE ORGANIZATIONS NEED:
• Clear escalation pathways for interpersonal conflict (not just clinical concerns)
• Training in de-escalation and difficult conversations (for everyone, not just leaders)
• Regular team communication check-ins (before problems become entrenched)
• Access to mediation services (making it as normal as Employee Assistance Programs)
• Culture that normalizes disagreement as part of excellent care (not as failure or weakness)
Organizations that build these systems see measurable improvements in retention, patient satisfaction, and clinical outcomes.
WHY DO HEALTHCARE WORKERS AVOIDE CONFLICT? THE SHAME AND BLAME FACTORS
One of the most powerful parts of my conversation with Dr. Sharma centered on shame—specifically, why healthcare professionals feel shame about having conflict at all.
The Expectation of Perfection
Healthcare culture teaches clinicians:
• You should be able to handle anything
• Emotions are unprofessional
• Asking for help is weakness
• Conflict means you're not cut out for this work
These messages create a toxic cycle: conflict arises → you feel ashamed → you avoid addressing it → conflict escalates → shame deepens → you burn out or leave.
Breaking the Shame Cycle
Here's what I told Dr. Sharma: Conflict is not a character flaw. It's a natural part of working in high-stakes, high-stress environments with other humans.
The goal isn't to eliminate conflict. The goal is to develop the capacity to handle it well.
When healthcare organizations normalize conflict as something that happens to everyone—and provide real support for managing it—shame decreases and problem-solving increases.
"The conversations you're avoiding are costing you more than you realize."
— Kimberly Best
HOW THIS APPLIES TO DIFFERENT HEALTHCARE ROLES
For Physicians
You're trained to make split-second decisions under pressure. But conflict with colleagues, staff, or administration requires different skills than clinical decision-making. Learning to navigate power dynamics, communicate across hierarchies, and address tension directly protects your wellbeing and your ability to provide excellent care.
For Nurses
You're caught between patients, families, physicians, and administration—often bearing the brunt of everyone's stress. Developing conflict skills helps you advocate for yourself and your patients, set boundaries without guilt, and build collaborative relationships even in difficult environments.
For Healthcare Administrators
You're responsible for culture, retention, and outcomes—all of which are directly impacted by unresolved conflict. Investing in conflict management systems isn't "soft skills" training—it's infrastructure that protects your bottom line and your organization's reputation.
For Healthcare Teams
You work together under extreme pressure. Small tensions become major rifts when left unaddressed. Learning to handle disagreements constructively strengthens trust, improves communication, and makes the high-stress work sustainable.
WHY I MOVED FROM ER NURSING TO MEDIATION
Dr. Sharma asked about my own journey—why I transitioned from clinical practice to conflict resolution work.
The honest answer? A painful personal divorce forced me to learn what I wish someone had taught me decades earlier.
Going through my own conflict—one where I didn't have the tools I needed—made me realize how many people are suffering through difficult situations without support or skills.
I saw the parallels between healthcare and mediation:
• Both require staying calm under pressure
• Both involve meeting people in crisis
• Both demand empathy without judgment
• Both focus on helping people find their way through
But in healthcare, we intervene in physical crises. In mediation, we intervene in relational crises—with the same potential to save lives, preserve families, and strengthen communities.
The Skills Transfer from Nursing to Mediation
Everything I learned as an ER nurse prepared me for conflict work:
• TRIAGE: Identifying what needs immediate attention versus what can wait
• ASSESSMENT: Observing not just what people say, but how they say it—body language, tone, what's not being said
• DE-ESCALATION: Staying calm when everyone else is dysregulated
• SYSTEMS THINKING: Understanding that problems rarely have single causes—there are always interconnected factors
• EMPATHY UNDER PRESSURE: Connecting with people even when time is limited and stakes are high
The difference? In the ER, I was responding to crises. As a mediator and conflict coach, I'm preventing them.
WHY HEALTHCARE CONFLICT IS DIFFERENT (AND WHY GENERIC APPROACHES FAIL)
During our conversation, Dr. Sharma and I discussed why healthcare environments create unique conflict challenges:
1. Life-and-Death Stakes
Unlike most workplace conflicts where the worst outcome is hurt feelings or lost productivity, healthcare conflicts can directly impact patient safety. This raises the emotional intensity of every disagreement.
2. Embedded Hierarchy
Healthcare has clear power structures: physicians, nurses, techs, administrators. These hierarchies are necessary for clinical decision-making but can make interpersonal conflict harder to address. Speaking up to someone "above" you feels risky—even when patient care is at stake.
3. Chronic Understaffing and Overwork
When everyone is exhausted and under-resourced, minor irritations become major conflicts. The issue isn't personalities—it's systems that demand more than humans can sustainably give.
4. Regulatory and Legal Pressures
Healthcare operates under intense scrutiny. The fear of lawsuits, licensing board complaints, and regulatory violations makes people defensive and conflict-avoidant.
5. Vicarious Trauma and Compassion Fatigue
Healthcare professionals absorb others' pain daily. This cumulative stress lowers conflict tolerance and makes emotional regulation harder.
Generic workplace conflict training doesn't account for these realities. That's why healthcare needs specialized approaches—and why my background as a nurse matters when I work with medical teams.
THE TOOL I CREATED TO MAKE CONFLICT SKILLS ACCESSIBLE
Dr. Sharma asked about the Best Conflict Conversation Cards—why I created them and how healthcare teams use them.
The Problem They Solve
Most conflict training is either:
• Too theoretical: Great concepts, no practical application
• Too time-intensive: Full-day workshops people can't attend
• Too expensive: Out of reach for smaller organizations or individuals
I wanted to create something that was:
• Evidence-based but immediately usable
• Affordable enough for anyone to access
• Practical enough to use in real-time
• Flexible enough for both personal development and team training
How Healthcare Teams Use Them
DAILY PRACTICE: Keep a card visible, practice that skill for a week
TEAM MEETINGS: Draw a Story Card, share experiences, build understanding
PRE-CONVERSATION PREP: Review relevant Skills Cards before difficult conversations
TRAINING SESSIONS: Use for role-play scenarios and skill development
LEADERSHIP DEVELOPMENT: Integrate into management training
The goal isn't memorization—it's internalization. When you practice these skills regularly, they become your natural response.
Learn more: Best Conflict Conversation Cards (available at bestconflictsolutions.com)
THE RESEARCH BEHIND TRANSFORMATIVE APPROACHES
Dr. Sharma asked about the evidence base for the approaches I use. Here are key studies and statistics that inform my work:
Conflict's Impact on Patient Care
• 41% of healthcare professionals report that unresolved conflict negatively impacts patient care (American Journal of Medical Quality)
• Medical errors increase in environments with high interpersonal conflict
• Patient satisfaction scores correlate with staff communication quality
Financial Impact
• Turnover costs: $56,000 average to replace one nurse (NSI Nursing Solutions)
• Mediation costs: $3,000 average for professional workplace mediation
• Burnout costs: Estimated $4.6 billion annually in healthcare
Mediation Effectiveness
• 80-90% resolution rate for workplace mediation
• Faster than litigation: Average 6-8 hours versus months/years in court
• Relationship preservation: Parties work together afterward, unlike adversarial processes
Conflict Skills Training Outcomes
• Reduced turnover in organizations with conflict management systems
• Improved team communication and psychological safety
• Decreased use of formal grievance processes
WHERE TO START: PRACTICAL NEXT STEPS FOR HEALTHCARE PROFESSIONALS
If you're reading this thinking, "My workplace needs this," here's where to begin:
For Individual Clinicians
1. ASSESS YOUR OWN CONFLICT PATTERNS: Where do you get triggered? What situations do you avoid?
2. PICK ONE SKILL TO PRACTICE: Choose from the frameworks above and commit to trying it for two weeks
3. FIND SUPPORT: Consider conflict coaching to build your personal skills
4. USE TOOLS: Get the Best Conflict Conversation Cards for daily practice
For Healthcare Leaders
1. ASSESS YOUR ORGANIZATION'S CONFLICT CULTURE: How are disagreements currently handled? What's the cost of turnover?
2. CREATE CLEAR PATHWAYS: Make mediation as accessible as EAP services
3. PROVIDE TRAINING: Invest in conflict skills development for all staff levels
4. MODEL THE BEHAVIOR: Leaders who handle conflict well set the tone for entire teams
For Healthcare Organizations
1. CONDUCT A CONFLICT AUDIT: Where are tensions highest? What patterns exist?
2. BUILD SYSTEMS: Establish protocols for addressing interpersonal conflict before it escalates
3. OFFER MULTIPLE ENTRY POINTS: Mediation for specific disputes, coaching for skill development, training for teams
4. TRACK OUTCOMES: Measure retention, satisfaction, and error rates before and after implementation
RESOURCES MENTIONED IN THE PODCAST
Listen to the Full Episode
SCALPEL AND SWORD: CONFLICT AND NEGOTIATION IN MODERN MEDICINE
Episode 21: "Mending Medicine: Kimberly Best on Conflict as a Cure"
Host: Dr. Lee Sharma
About the Podcast
Scalpel and Sword explores the untold stories of conflict and negotiation in modern medicine. Hosted by Dr. Lee Sharma—physician, mediator, and guide—each episode offers real conversations, human stories, and practical tools to help physicians reclaim their voices and wield their healing power with both precision and purpose.
About Dr. Lee Sharma
Dr. Lee Sharma is a gynecologist based in Auburn, Alabama, with over 30 years of clinical experience. She holds a Master's in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges through open conversations and practical tools.
Connect with Dr. Sharma:
Email: scalpelandsword@gmail.com
Website: eamc.org
THE CONVERSATIONS WE'RE NOT HAVING ARE COSTING LIVES
Here's what I want every healthcare professional to understand:
Conflict is not a failure. Avoiding conflict is.
The tension with your colleague that you're not addressing? It's affecting patient care.
The communication breakdown in your team? It's contributing to errors.
The workplace culture that punishes disagreement? It's driving away your best people.
But here's the good news: conflict skills are teachable. Relationships are repairable. Systems can change.
You don't have to figure this out alone. Whether you're navigating a specific conflict, want to build your personal skills, or need to transform your organization's approach to conflict, support exists.
Because at the end of the day, healthcare is about healing. And sometimes, the healing that matters most is the kind that happens between colleagues—the kind that allows everyone to do their best work caring for patients.
"Like health, conflict can heal or harm depending on how we handle it."
Let's choose healing.
WORK WITH ME
Healthcare Mediation
Resolve workplace conflicts quickly and confidentially—before they escalate to formal grievances or turnover.
Conflict Coaching for Clinicians
Build your personal conflict management skills in 1:1 sessions tailored to your specific challenges.
Team Training Programs
Equip your healthcare teams with practical conflict skills through interactive workshops and ongoing support.
Organizational Consulting
Build conflict management systems that reduce turnover, improve culture, and enhance patient outcomes.
Speaking Engagements
Bring practical, evidence-based conflict training to your conference, leadership summit, or staff development day.
Contact: Visit bestconflictsolutions.com or email kim@bestconflictsolutions.com
ABOUT KIMBERLY BEST, RN, MA
Kimberly Best is a registered nurse, mediator, and founder of Best Conflict Solutions. With a Master's in Conflict Management from Lipscomb University and certifications from institutions including Pepperdine, Harvard Law School, and Hofstra, she brings 30 years of combined clinical and mediation experience to healthcare conflict resolution.
As a former ER and trauma nurse, Kim understands the unique pressures of healthcare environments. She designs conflict management systems and trains teams to transform workplace disputes into opportunities for growth and strengthened relationships.
CREDENTIALS:
• RN with 30+ years clinical experience (ER, trauma, hospice)
• MA in Conflict Management, Lipscomb University
• Graduate Studies in Clinical/Community Psychology, UNC Charlotte
• Court-listed mediator in Missouri and Tennessee
• FINRA Arbitrator
• Immediate Past President, Tennessee Association of Professional Mediators
• Senior Mediator, Los Angeles Community/Police Unification Program
• Specialized training: Transformative Mediation (Hofstra), Healthcare Mediation (USF), Restorative Practices (IIRP)
CONNECT WITH KIM:
Website: bestconflictsolutions.com
LinkedIn: linkedin.com/in/kimberlybestmediator
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DISCLAIMER: This blog post is for informational and educational purposes only. It does not constitute medical, legal, or professional advice. Always consult qualified professionals regarding your specific situation.
KEYWORDS: healthcare conflict resolution, workplace mediation, nurse burnout prevention, physician conflict management, healthcare team communication, transformative mediation, patient care quality, healthcare turnover reduction, conflict management training, healthcare leadership development
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