July 18, 1990

Resolving Conflicts in Practice Policies

Author Affiliations

Duke University Durham. NC

Duke University Durham. NC

JAMA. 1990;264(3):389-391. doi:10.1001/jama.1990.03450030113044

AS MORE and more organizations begin to develop practice policies, some are bound to be in conflict, recommending different things for the same patients. It is important to resolve conflicts in policies for several reasons. First, the differences in recommended actions can lead to differences in health outcomes; the existence of conflicting policies implies that at least some patients will be mistreated (unless neither recommendation has any effect on health outcomes). Second, differences in policies cause confusion. Practitioners will be advised to do different things, and will not know the standdards to which they will be held. Patients will get conflicting messages, third-party payers will get the sense that decisions are arbitrary, and quality assurance programs will use different criteria. A third reason to resolve conflicts is that they harm the credibility not only of the policies in question but also of the organizations that issued them. In general, conflicts