SHM Converge Scientific Abstract ePoster Gallery-Interspecialty Othering: A Qualitative Analysis of Physician Interpersonal Conflict at the Time of Admission From the Emergency Department

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This qualitative study explored interpersonal conflict between Emergency Medicine (EM) and Internal Medicine/Hospital Medicine (IM) physicians during hospital admission discussions, a key point of interspecialty interaction. Conducted at a public/county hospital and level 1 trauma center, the study used semi-structured Zoom interviews with 18 participants: 9 IM/Hospital Medicine faculty and 9 EM providers (4 faculty, 5 residents). Using constructivist grounded theory and Social Identity Theory, the authors analyzed how clinicians perceive and navigate conflict.<br /><br />Three major themes emerged. First, “Us vs. Them” specialty identity often primes conflict. Participants described admissions conversations in battle-like terms, reflecting assumptions that the other specialty is an opponent rather than a partner. Second, “Vying for Control” showed how organizational structure and perceived power imbalances escalate tensions. Clinicians sometimes felt pressured, devalued, or forced to “argue” for admission decisions, which reinforced defensiveness and frustration. Third, some interactions became successful when physicians transformed parallel, adversarial discourse into shared problem-solving. This happened when clinicians expressed humility, asked questions, and focused on the patient as a common goal.<br /><br />The study concludes that interspecialty othering—driven by stereotypes, misaligned expectations, and pre-existing biases—can turn ordinary disagreements into perceived incompetence or work avoidance, worsening conflict and emotional strain. These conflicts can leave lasting “emotional residue” that harms communication, professional meaning, and wellbeing. The authors suggest strategies to reduce conflict, including acknowledging its emotional effects, understanding its structural and cultural roots, and reframing conversations around patient-centered teamwork, bedside collaboration, curiosity, honesty, and mutual teaching.

Asset Subtitle

Maralyssa Bann

Meta Tag

Author List Ashley Amick, Bjorn Watsjold, Caitlin Schrepel, John Ilgen, Joshua Jauregui, Maralyssa Bann, Stefanie Sebok-Syer

Category Research

Concept Interspecialty Othering

Concept Physician Interpersonal Conflict

Concept Patient

Concept Specialty Identity

Concept Us vs Them

Distinguished Non-Finalist

Presenter Organization Harborview Medical Center-University of Washington

Presenting Author Maralyssa Bann

Track Communication

Keywords

Emergency Medicine

Internal Medicine

Hospital Medicine

interspecialty conflict

hospital admission

Social Identity Theory

constructivist grounded theory

physician communication

patient-centered teamwork

organizational power imbalance

Interspecialty Othering

Physician Interpersonal Conflict

Patient

Specialty Identity

Us vs Them