How internal medicine residents resolve conflicts with attending physicians

Forty-three of 49 residents in an internal medicine residency answered questionnaires in 1988 about resolving conflicts with attending physicians concerning patient care, using ten case scenarios. The residents indicated their likelihoods of using various methods of addressing the conflicts via Likert-type scales. The residents were most likely to negotiate with the attending physician and least likely to ignore the attending physician or withdraw from the case for all scenarios, though the type of procedure affected the decision. The residents planning careers in general medicine or nonmedical specialties were more likely to agree with the attending physician than were the residents planning medicine subspecialty careers (p less than .005); the graduates from osteopathic schools were more likely to withdraw from the case than were the residents from allopathic schools (p = .05). Conflicts between the residents and attending physicians were resolved by negotiation and interaction with the attending physicians, but the nature of the procedure, medical school attended, and future career plans affected the means of resolving the dilemma chosen by the individual resident.