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JAMS ADR Insights

JAMS Pathways Health Care & Health Systems

The Business of Health Care

Resolving Tensions Through Early Neutral Facilitation

Health care occupies a unique place in our lives. It is central to beginning life, sustaining health, promoting longevity, and managing death. It is an essential part of us individually and collectively.

But health care is a business. In fact, it is big business. In 2019, there were 22 million health care workers in the U.S., which accounted for 14% of the U.S. workforce.1 Overall employment in health care is expected to grow 13% from 2021 to 2031, resulting in about 2 million new jobs over the decade.2

It is not surprising, then, that health care generates many types of disputes. Among them are disputes born from disparities, disagreements, or differences within health systems. They may start as internal tensions or complaints. When these are not identified or addressed with purpose, they grow and eventually explode into angry disputes, which in turn may result in unresolvable conflicts with serious and far-reaching consequences.

To navigate these challenges, health systems can turn to early neutral intervention to identify and mitigate internal conflicts, disagreements, and deficiencies. One such service is JAMS Pathways, which offers a proactive approach to conflict through training and facilitation that can help clients mitigate conflict before relationships become strained, reputations tarnished, lawsuits filed, and/or employees leave or become disenchanted or disengaged. Addressing internal conflict early fosters a healthier, more harmonious work environment, ultimately benefiting health systems both operationally and financially.

For example, here are real life scenarios that health systems may encounter:

Staffing shortages. Health systems, especially hospitals, continue to suffer from serious staffing shortages. Factors contributing to this include medical professionals experiencing severe stress and burnout and systems still suffering financial losses due to the lingering impacts of COVID. Workforce shortages hit nursing staffs particularly hard. The negative financial and operational impacts of insufficient skilled staff jeopardize patient care. To deal with this, systems are forced to hire immediate and sometimes interim replacements at high pay rates and offer costly incentive packages. This has negative consequences, including diminished morale, energy, and commitment of others in the workforce. It causes anger and resentment in the long-term professionals who remain—at least for now. Also, systems experience exorbitant and unexpected increases in labor costs.

Employee group discrimination. Despite society’s focus on diversity, equity, and inclusion, ethnically and culturally diverse employees continue to experience unfair treatment within certain health systems, including in the areas of inclusion, promotion, and compensation. They feel management is indifferent to their concerns and interests. This not only threatens a collaborative and team-oriented environment essential to quality patient care, but it may spur the departure of large segments of the system’s workforce, which, among other negative implications, jeopardizes sustained health care.

Internal Staff Conflicts. Tensions also exist on a micro level and within the clinical side of health system operations. Intergroup or team conflicts over a patient’s care are common, particularly in a hospital setting, as are conflicts between experienced nursing staff on the one hand and newly qualified physicians (e.g., residents), on the other. Conflicts among health care professionals as to a patient’s care, including timing of certain procedures and substantive testing and treatment, can jeopardize the quality of care to that individual. While these conflicts are commonly handled by medical staff leadership using professional staff bylaws, Joint Commission standards, they can also be addressed through facilitative training.

JAMS Pathways Can Help

To face these challenges, health systems can enlist the services of alternative dispute resolution (ADR) professionals like JAMS Pathways, who are equipped with both the training and experience to mitigate tensions before they escalate into nightmare scenarios.

By implementing the following structure, neutral, third-party facilitators are poised to intervene to resolve tensions before they escalate into large-scale disputes that could—and likely would—jeopardize patient care.

  1. Identify the emerging conflict and its source(s), scope, and impacts on the health system.
  2. Identify the stakeholders involved in and implicated by the conflict and define the interests and objectives of each.
  3. Engage stakeholders to develop a roadmap to investigate the conflict and tackle its resolution.
  4. Implement and manage the facilitation process, including participating (and probably leading) meetings with stakeholders and/or their groups and joint meetings.
  5. Collaborate with stakeholders to craft and select a solution acceptable to all and beneficial to the system generally.
  6. Document and monitor the solution.

Finally, there is an additional service that neutral facilitators provide. Given extensive experience with health care systems, third-party professionals work with management and clinical teams to identify disputes on the horizon, including in the areas described above, and develop a “preventive care” plan to head them off at the pass before they sprout into palpable tensions and disputes. These trainings and systems designs are sequenced and layered to reflect the nuances and complexities of each organization’s unique conflict.

JAMS Pathways’ trained neutrals can identify conflicts and intervene to facilitate peace well before passive conflicts escalate into full-blown disputes. This is particularly true in the business of health care. An ADR health care toolbox is unique insofar as it contains knowledge and experience in both components integral to resolving internal conflicts—clinical care and the business of health care. Regardless of the nature or size of a dispute, we follow and apply those values that are the foundation of our services: neutrality, fairness, objectivity, and civility.


  1. S. Census Bureau. 2019. 2019 American Community Survey.
  2. S. Department of Labor Statistics. 2022. Occupational Outlook Handbook. health care Occupations. Accessed January 20, 2023 at care/home.htm.

This page is for general information purposes. JAMS makes no representations or warranties regarding its accuracy or completeness. Interested persons should conduct their own research regarding information on this website before deciding to use JAMS, including investigation and research of JAMS neutrals. See More

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