Recently, I became aware of an argument over a personal matter among a group of my nursing colleagues, which has now spiralled spectacularly downwards into what has become a professional matter. Inevitably, this ended negatively, with some longstanding relationships shattered, and with no signs of resolution in sight.
For those who are spouses and parents, disagreements are familiar and allow many to become fairly adept and skilled at resolving them.
However, who would ever want to admit to arguing with a patient? Yet, we know that it happens, and the disputed matter has probably spiralled out of control before one has even recognised that the argument has escalated into a grievance, then moved up to a complaint, followed by the all too inevitable threat of legal action, at which point, we usually stop and seek intervention. By the time that insurers and lawyers get involved, the parties are often entrenched with well-established and deep-seated views on the matter, with neither party seeking mitigation.
The Oxford English Dictionary (2021) defines mediation as ‘the intervention in a dispute in order to resolve it’. The vast majority of disputes in many aesthetic clinics have been administrative in nature. In the day-to-day running of a clinic, changed appointment times, payment queries and unsatisfactory communication are not uncommon. However, these are often the triggers for escalation, so how these issues are managed at this early point is crucial. It is advisable that clinic managers recognise disputes early and are trained on how to manage them. Furthermore, ensure that an audit is kept of all disputes; a review will soon highlight the weaknesses among your processes or staff members. A complaints policy and procedure are regulatory requirements for Care Quality Commission (CQC)-registered clinics, and I continue to wonder why insurers do not make this a mandatory requirement when renewing annual schedules.
Should the dispute have reached the civil courts, the advocates and, most certainly, the judge will want to see evidence of mitigation. Mitigation is defined as ‘the action of reducing the severity, seriousness, or painfulness of something’ (Lexico, 2021). These disputed matters evoke many responses and emotions from both parties, ranging from incredulity and disbelieve to anger and fear. They can be intensely painful—trust me, they hurt, and the level of stress can be almost unbearable to tolerate, especially so when you feel alone and unsupported.
So, what can we do? First and foremost, and this is pivotal to the outcome: recognise that you are in a disputed matter and recognise it early. Try to remove personal and emotional feelings from the dispute. Secondly, get assistance, as you may be too personally invested to deal with this yourself. Many of us contact insurers when we should actually be seeking mediation and mitigation first. It is incumbent on the insurers to advise us to seek mediation and mitigation, but, in my experience, there is no advocating for this. Rather, the advice I am hearing from insurers is to ‘just settle’. In my opinion, to just settle is not the best advice for either party when mediation has not been explored. Mediation and mitigation should always be considered first, and especially so for the low monetary cost cases that are not going to be heard in any court. Mediation and mitigation of these disputed cases is the way forward.