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Guest Speaker Presentation

"ADR in the Health Care Profession"

Why this material is relevant.

"ADR" - the abbreviation for Alternative Dispute Resolution - involves arbitration, three types of mediation, framing negotiation, ombudsmen, and facilitation.

In your last job you probably had an employee manual that signed away your rights to go to court and committed you to arbitration. When you get out of school, there will be an arbitration clause in your employment contract.

When you signed up to go to Texas Wesleyan, you agreed to mediation procedures (do a check of the web site and read all about it). More, when you get sued (and it will happen, even if you never make a mistake), the Judge will probably send you to mediation. If you've been divorced recently and fought over it, there is a 50/50 chance you've already experienced some kind of mediation.

When there are ethics questions involving patients, more and more hospitals are using a special mediation protocol to resolve them.

Finally, if things blow up, or even if normal pressures and realignments occur, you will probably need or experience ombudsmen, complex framing negotiations or a facilitation initiative.

That is why this material is relevant to you.

What material will be covered.

What will be taught by the material.

What specific questions will be answered.

The Presentation


Body of Presentation.

  1. Terminal cancer patients
  2. Terminal premature infants
  3. Heart transplants
  4. Patient right to know questions
  5. Refusal to accept care by an adult or a child
  6. Frequent fliers.

5. What is an ombudsman (the origin of ombudsmen).

6. How do people negotiate and when is each method appropriate.


7. Case Studies


8. Answer Questions.

About the Speaker

Stephen R. Marsh is adjunct faculty in Southern Methodist University's Graduate Dispute Resolution program. He has taught Arbitration and Health Care Dispute Resolution classes there. You may find him on the web at http://adrr.com/. He is senior litigation counsel at the Zisman Law Firm. You may find his law firm at http://zislaw.com/.

Definitions (as they apply to health care setting)

Arbitration: The use of a private judge or other neutral to make a final, private and binding resolution or decision.

Arbitration is often applied to employment disputes and to malpractice claims.

Ombudsman or Ombuds: A neutral person who is designated to investigate and propose settlements of complaints and issues. Internal Ombuds deal with conflicts within a hospital, Patient Ombuds deal with patient complaints.

An Ombuds is often established when an institution has a continuing stream of problems as a prophylactic measure.

Fact-finding: The investigation of an issue by an neutral third party (often a team) who investigates the issue, determines the facts, and issues an advisory report.

Fact-finding can often be used in the place of arbitration to educate factions in conflict in order to de-escalate the problems.

Mediation: Generally mediation is a process where parties examine their dispute with the help of a third party who assists them in resolving their conflict. The mediator may make suggestions, play the devil's advocate and may (in some types of mediation) provide evaluations, but does not impose a resolution.

Transformative Mediation is the process by which parties learn to listen to each other and is often used in HR Departments. Pure Mediation is the process by which negotiation is accelerated by a human shuttle and is often used in law suits. Ethics Mediation is a variation that combines fact finding with mediation and is used to resolve ethical dilemmas. Facilitative Mediation occurs when an outsider (often a consultant) helps groups work toward resolution of their conflicts, often by educating them about how to frame and negotiate the issues and is often used in conflicts between factions (see the case study attached to this outline).

Renegotiating Healthcare  How to Disagree Without Being Disagreeable     

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Copyright 2000 by Stephen R. Marsh
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