What if the majority of what we call “ethical dilemmas” are really just conflicts in disguise?

In this rich, practical conversation, Dr. Haavi Morreim shares decades of experience as a philosopher-turned-mediator, attorney, and faculty member at UT Health Science Center. She explains how she moved from watching physicians get crushed by malpractice litigation to teaching clinicians the skills that prevent those wars altogether.

Key insights include:

• Why ethics committees and consults often miss the mark when the real issue is conflict
• The three non-negotiable principles of mediation (no sides, no advice, strict confidentiality)
• How “trust is the coin of the realm” and how to earn it quickly
• Why saying “you must” or “you can’t” instantly turns you into “another pair of fists in the fight”
• Simple, powerful tools every clinician can use: “Tell me more,” affect labeling, exploring the story behind the conclusion, and the anger iceberg

Dr. Morreim also recounts powerful real-world cases, including a tragic pediatric accident with divorced parents and a Jehovah’s Witness obstetrics case, to show how durable agreements are built when people feel truly heard.

Three Actionable Takeaways

• Most ethics consults are actually conflict situations. Resolve the conflict first; the “right answer” often becomes obvious.
• Trust is earned through genuine curiosity, confidentiality, and never taking sides. Never say “you must” or “you can’t” if you want people to own the solution.
• Simple micro-skills (“Tell me more,” affect labeling, “What’s the story behind that conclusion?”) create breakthrough conversations and prevent escalation in minutes.

About the Show:

Behind every procedure, every patient encounter, lies an untold story of conflict and negotiation. Scalpel and Sword, hosted by Dr. Lee Sharma—physician, mediator, and guide—invites listeners into the unseen battles and breakthroughs of modern medicine. With real conversations, human stories, and practical tools, this podcast empowers physicians to reclaim their voices, sharpen their skills, and wield their healing power with both precision and purpose.

About the Guest:

Haavi Morreim, JD, PhD, is Professor in the College of Medicine at the University of Tennessee Health Science Center and Principal of the Center for Conflict Resolution in Healthcare LLC. With a PhD in philosophy (UVA) and a law degree (University of Memphis), she has spent decades teaching, mediating, and training healthcare professionals in conflict resolution, bioethics, and mediation. She is a Tennessee Supreme Court Rule 31 Listed Mediator and regularly mediates both clinical disputes and litigated healthcare cases.

🔗 Connect with Dr. Haavi Morreim

🌐 Center for Conflict Resolution in Healthcare: healthcare-mediation.net

📘 LinkedIn: linkedin.com/in/haavi-morreim-jd-phd-4a33b974

About the Host:
Dr. Lee Sharma is a gynecologist based in Auburn, AL, with over 30 years of clinical experience. She holds a Master’s in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges and thrive through open conversations and practical tools.

• Connect with Dr. Lee Sharma:
  📧 Email: scalpelandsword@gmail.com
  🌐 Website: East Alabama Health - Dr. Sharma

The Scalpel and Sword Podcast is for informational purposes only and does not constitute medical, legal, or professional advice. Always consult a qualified professional regarding your specific situation.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What if medicine's blind spot to caregiving isn't ignorance, but a mismatch in roles and expectations?

In this thought-provoking episode of Scalpel and Sword, host Dr. Lee Sharma welcomes Dr. Kenneth Lamb, to unpack his JAMA Network Open editorial responding to a study on healthcare-caregiver teamwork post-knee replacement. Drawing from his dual lens as physician and family caregiver, Dr. Lamb questions the "team" assumption: Do doctors truly see themselves as partners in the 24/7 world of unpaid caregiving?

He spotlights the Relational Coordination Index (RCI), a metric gauging communication, shared goals, and mutual respect, and its potential to quantify collaboration, while critiquing medicine's medicalization trap. "We promise independence through expertise, yet overlook caregivers' lived mastery" Referencing sociologist Sharon Kaufman's work on aging's paradoxes, Dr. Lamb calls for evidence-based science to bridge the gap, urging the field to earn its societal mantle.

This episode is essential for physicians, caregivers, and policymakers navigating elder carie's complexities.

Three Actionable Takeaways

• Question the "Team" in Caregiving: Not all professionals buy into shared goals with caregivers. Dr. Lamb notes colleagues often defer to "case managers," creating a disconnect. Map your patient's full care network (nurses, social workers, family) using RCI-inspired questions on availability and collaboration to reveal gaps and foster true partnership.
• Measure Teamwork with RCI for Outcomes: The Relational Coordination Index assesses communication, respect, and alignment. Early data links high scores to better post-op results, but it's untested in geriatrics. In your next consult, rate RCI elements (e.g., "Do I feel the caregiver can communicate freely?") and track if it correlates with patient/caregiver satisfaction.
• Challenge Medicine's Paradox of Independence: We "medicalize" aging by itemizing details as if expertise alone restores autonomy, ignoring caregivers' intuitive skills. Dr. Lamb invokes Sharon Kaufman: Shift from "doctor knows best" to co-creation. Learn one caregiver "mastery" tip (e.g., double-gloving for hygiene) and integrate it into rounds to humanize care.

About the Show:

Behind every procedure, every patient encounter, lies an untold story of conflict and negotiation. Scalpel and Sword, hosted by Dr. Lee Sharma—physician, mediator, and guide—invites listeners into the unseen battles and breakthroughs of modern medicine. With real conversations, human stories, and practical tools, this podcast empowers physicians to reclaim their voices, sharpen their skills, and wield their healing power with both precision and purpose.

About the Guest:

Dr. Kenneth Lamb, MD, MAS, is a geriatrician and Assistant Professor at the University of Colorado Anschutz Medical Campus. Trained at Stanford, UCSF, Western Ontario, and Toronto, he researches caregiver-physician teamwork and the paradoxes of elder care. His recent JAMA editorial questions whether doctors truly belong on the caregiving “team,” using the Relational Coordination Index, while advocating evidence-based collaboration. As both physician and family caregiver, he champions practical skills and systemic support for unpaid caregivers.

About the Host:
Dr. Lee Sharma is a gynecologist based in Auburn, AL, with over 30 years of clinical experience. She holds a Master’s in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges and thrive through open conversations and practical tools.

• Connect with Dr. Lee Sharma:
  📧 Email: scalpelandsword@gmail.com
  🌐 Website: East Alabama Health - Dr. Sharma

The Scalpel and Sword Podcast is for informational purposes only and does not constitute medical, legal, or professional advice. Always consult a qualified professional regarding your specific situation.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What does conflict really look like in modern medical training, and how can it be handled in a way that supports both learners and patients?

In this episode of Scalpel and Sword, host Dr. Lee Sharma welcomes Dr. Michael Miley. Having trained through every stage of academic medicine—medical student, resident, chief resident, and now attending—Dr. Miley offers a rare, longitudinal perspective on conflict, wellness, and leadership in healthcare.

Together, they explore how conflict shows up on medical teams: through assumptions, hierarchy, workload distribution, communication breakdowns, and mismatched expectations of learners at different stages. Dr. Miley reflects on witnessing toxic behaviors early in training, the cultural shift toward wellness and work-life balance, and how systems—not individuals—often drive burnout.

A central theme of the conversation is autonomy and clinical maturity. Dr. Miley discusses how asking “why” rather than making assumptions helps assess learners’ reasoning, diffuses conflict, and improves patient care. He shares lessons from serving as a chief resident in a large program—mediating disputes, holding peers accountable, and separating behavior from identity during difficult conversations.

This episode highlights how curiosity, transparency, and professionalism can transform conflict into an opportunity for growth—and why efficient, humane training environments matter not just for physicians, but for patients.

Three Actionable Takeaways

• Curiosity Diffuses Conflict: Asking “why” instead of making assumptions helps uncover gaps in reasoning, reduces defensiveness, and creates psychological safety for learners and teams.
• Autonomy Should Be Earned, Not Assumed: Progressive responsibility, tailored supervision, and clear expectations allow trainees to grow without being overwhelmed—supporting both education and patient safety.
• Address Behavior, Not Identity: Effective leaders separate actions from personal worth. Framing conflict around professionalism, impact on the team, and patient care leads to accountability without personal attack.

About the Show:

Behind every procedure, every patient encounter, lies an untold story of conflict and negotiation. Scalpel and Sword, hosted by Dr. Lee Sharma—physician, mediator, and guide—invites listeners into the unseen battles and breakthroughs of modern medicine. With real conversations, human stories, and practical tools, this podcast empowers physicians to reclaim their voices, sharpen their skills, and wield their healing power with both precision and purpose.

About the Guest:

Dr. Michael Miley is a board-certified internal medicine physician and faculty member at the UAB Heersink School of Medicine regional campus in Montgomery, Alabama. A graduate of Auburn University and the Alabama College of Osteopathic Medicine, he completed his residency and chief resident year at HCA Florida Blake.

Dr. Miley is passionate about medical education, clinical maturity, autonomy assessment, and creating training environments that support wellness, efficiency, and effective communication.

LinkedIn: https://www.linkedin.com/in/michael-c-miley-do-76163ab3

About the Host:
Dr. Lee Sharma is a gynecologist based in Auburn, AL, with over 30 years of clinical experience. She holds a Master’s in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges and thrive through open conversations and practical tools.

• Connect with Dr. Lee Sharma:
  📧 Email: scalpelandsword@gmail.com
  🌐 Website: East Alabama Health - Dr. Sharma

Tags

medical training, conflict in medicine, residency culture, physician burnout, clinical maturity, autonomy in medical education, healthcare leadership, communication in healthcare, internal medicine residency

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#ScalpelAndSword #ConflictInMedicine #MedicalEducation
#ResidencyLife #PhysicianLeadership #ClinicalMaturity
#HealthcareCommunication #PhysicianWellbeing

The Scalpel and Sword Podcast is for informational purposes only and does not constitute medical, legal, or professional advice. Always consult a qualified professional regarding your specific situation.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.