How to Address Interprofessional Conflicts Involving Female Surgeons

New research shows interprofessional conflicts between female surgeons and nonphysician staff can be addressed at the individual and institutional levels.

There are strategies to address workplace conflicts between female surgeons and nonphysician medical staff members, a recent research article says.

Earlier research has shown female surgeons experience less achievement, more dissatisfaction, and higher levels of burnout compared to male surgeons. Interprofessional conflict has been associated with workplace dissatisfaction and stress, and earlier research indicates women are more likely than men to experience interprofessional conflict.

The recent research article, which was published by JAMA Network Open, is based on data collected in interviews of 30 U.S. female surgeons who were selected to reflect the age range and surgical experience level of female surgeons nationwide. The data generated several key findings.

• The primary causes of interprofessional conflicts involving female surgeons were communication breakdowns, performance-related disputes such as staff members failing to provide proper equipment for a surgery, and breaches of institutional policies and protocols such as wearing nail polish.
   
• The female surgeons felt there was a double-standard in interprofessional conflicts favoring male surgeons, an expectation that they should comply with gender norms rather than professional norms, and negative impacts on their well-being and professional reputation.
   
• The female surgeons felt there was the potential for compromised patient safety because of decreased communication following an interprofessional conflict.
   
• Most of the interprofessional conflicts involving female surgeons were with female staff members. In the study's interviews, many female surgeons said these interprofessional conflicts were likely related to actions violating gender stereotypes such as assertive direction from another woman.

"These data support the need for systematic changes to prevent interprofessional workplace conflict and to ensure more equitable adjudication when conflicts arise," the study's coauthors wrote.

Addressing interprofessional conflicts involving female surgeons

At the individual level, female surgeons reported pursuing three primary strategies to address interprofessional conflicts.

1. Relationship management: "Participants discussed aspects such as personal accountability, gauging the emotional responses of others, and recalibrating their actions based on those responses," the study's co-authors wrote. Many of the female surgeons reported that relationship management contributed to the emotional burden of interprofessional conflicts because it was viewed as additional labor.

2. Rapport building: Many of the female surgeons reported participating in events for nonphysician staff such as baby showers to forge friendships. "For some, this process was natural and in line with how they would communicate with colleagues, but for others it felt contrived and was viewed as a form of performance needed to make things run smoother," the study's co-authors wrote.

3. Social support: "In the absence of having leadership effectively manage these situations, women surgeons would find other forms of support to alleviate the burden. This support was found in both formal and informal spaces and most often involved commiserating over shared experiences," the co-authors wrote.

Institutional strategies to address interprofessional conflicts involving female surgeons include three approaches, according to the research article.

1. Behavioral standards: Bullying, hostility, incivility, and sarcasm should not be tolerated from any medical staff member, particularly in training programs.

2. Interprofessional team building and training: "Despite the critical nature of teamwork in the operating room, surgeons rarely have significant input in choosing their team members, regular opportunities for performance evaluation, or regular opportunities for team-based training. In this way, the traditional nature of physician and nursing leadership silos may create obstacles to optimal teamwork and accountability," the study's co-authors wrote.

3. Staffing consideration: "Many conflicts reported by the participants occurred early in the tenure of the women surgeons, and relationships often improved after several years, after the staff became more familiar with the women surgeons. Given that many conflicts were related to perceived performance gaps, strategies such as assigning high-performing staff members to new surgeons may reduce interprofessional conflict by reducing the performance-based gaps surgeons may encounter when in a new system," the co-authors wrote.

Related: Expert Shares Strategies to Address Bullying and Incivility in Healthcare