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The Mediation Process

The first step is buy-in by the organizational leadership. Success in organizational conflict resolution requires a culture that understands the role of mediation.

The chosen mediator meets with everyone in joint session to explain the process, to gain a basic understanding of the issues and to help the parties define, generally speaking, a desired conclusion.

Then thereĀ ’ll be interviews with each party in sessions, called caucuses, to allow the mediator to better understand the issues from each person's individual standpoint, to get both parties to think outside the box about potential solutions. The mediator will ask what information, if any, may be shared with the other party and may bring potential solutions from one party to the other.

There may be a bumpy road ahead.

The trained mediator must demonstrate neutrality while attempting to understand the dynamics of the conflict, including issues of power. Everyone must respect confidentiality, and he or she will remain patient with all parties and generate a climate of cooperation. The parties alternate between caucuses and joint sessions. Some mediation sessions may take place over several days. All mediations are different.

At the end, the agreed-upon solution is usually put in writing and signed by each of the parties.

Independent arbitration

As a member of an arbitration panel, Dr. Mellman is experienced with and able to mediate or to be an arbitration panel member on matters that are two- or multi-partied, a hospital or a group. In independent arbitration, the group begins with a different understanding, that is, that members will agree to the arbitrator's solution.

The outcomes to expect

1. If everything goes well, everyone involved will meet his or her expectations: physicians, hospitals and patients. Where misunderstanding continues to block communication, sometimes:

Everyone leaves the arbitration session(s) happy.

No one leaves the arbitration session(s) happy.

2. But usually:

Each one of the disputed parties has to compromise; they have to give in order to get. Summaries of mediation were distributed to the appropriate conflicting parties.

Or, the parties understand each other and resentment is at bay. Money is saved, not wasted. Procedures are easily understood, they go smoother, egos are healed.

But, suppose the parties arrive at an impasse?

If no agreement is reached, an impasse will be declared. Despite a lack of formal resolution, the parties would have a better understanding of the strengths and weaknesses of their own position and those of the counter-party(ies). Confidentiality of the proceedings, including the caucuses, whether or not an agreement is reached, is to be maintained indefinitely.

The downside of an impasse is that the parties have now given up their control of determining an outcome. The next question would be how to settle the dispute. The answer would depend on the particular situation as to which alternative is selected.

A special case Attention must be paid to the special healthcare issue of the disclosure of errors and adverse events. The value of an early interest-based mediation intervention cannot be overemphasized. Parties in this situation are often concerned about factors beyond dollars. When adequate information is available to the parties, resolution can often be achieved.

A special case II Should informal negotiation by the parties fail to resolve a conflict, mediation is the most effective and efficient method to achieve settlement. Mediation can be facilitated by in-house persons or by outside, formally-trained mediators. If done in-house, there should be training for those who will act as neutral facilitators. Outside facilitators, however, can be better accepted as neutrals by the conflicted parties.