Competition for Resources Competition for scarce resources can be internal (among different units in the organization) or external (among different organizations).
Internally, competition for resources may involve assigning staff from one unit to another or purchasing high-technology equipment when another unit is desperate for staff.
Externally, health care organizations compete for finite external resources (e.g., desig- nation as an accountable care organization for Medicare). Organizations are using a variety of means, such as developing new services and advertising, to try to capture the market in health care.
Values and Beliefs Differences in values and beliefs frequently contribute to conflict in health care organizations. Values and beliefs result from the individual’s socialization experience. Conflicts between phy- sicians and nurses, between nurses and administrators, or even between nurses with associate degrees versus those with baccalaureate degrees, often occur because of differences in values, beliefs, and experiences.
Distancing mechanisms or differentiation serve to divide a group’s members into small, distinct groups, thus increasing the chance for conflict. This tends to lead to a “we–they” distinction. One of the more frequently seen examples is distancing between physicians and nurses. Opposition between intensive care nurses and nurses on medical floors, night versus day shifts, and unlicensed versus licensed personnel are also examples. Differentiation among subunits also occurs and is due to differences in structure. The administrative unit may be bu- reaucratic, the nursing unit structured on a more professional basis, and staff physicians on an even different structure. Nonstaff physicians may be relatively independent of the health care organization.
Unifying mechanisms occur when greater intimacy develops or when unity is sought. All nurses might be expected to reach consensus over an issue, but they might experience internal conflict if they are forced to accept a group position even though individually they may not be wholly committed to the decision. A nurse manager’s friendship with a staff member may also lead to this type of conflict.