CHEST Foundation
Web Site

CCFAP Replication Toolkit
Now Available

Support The CHEST
Foundation

Patient Education Guides

Speakers Kit

The Ambassadors Group

TOC | Previous | Next

Section Five
Running a Coalition

"The world is full of willing people, some willing to work, the rest willing to let them."
Robert Frost

Overview of Section

This section discusses several factors that are critical to the day-to day running of a coalition. It deals with the people of the coalition, the leaders, the members, the committees and its community allies, and the roles they need to play for a healthy coalition. The section also deals with communication and some of the obstacles to effective communication. Finally, it talks about conflict, inevitable when capable people come together to do something significant, and ways of handling that conflict.

C. Conflict in Coalitions

Handling Conflict

A coalition like any active force holds the potential for conflict. Internal conflicts are inevitable given the makeup of most coalitions. Health coalitions are composed typically of health-care providers, community organizers, individual medical professionals, national or state associations, and, in some cases, for-profit companies allied to the health field.

While these and other organizations can agree on the necessity of joining together to conquer asthma or to deal jointly with some significant public health issue, there is no reason to suppose that they will always agree on priorities or on methodology. In addition, we recognize that personality issues arise anytime people work together. What is clear is that the distinguishing feature of a successful coalition is not that the members are able to avoid conflict but that they have learned how to deal openly with these conflicts and to profit from them.²⁴

Origins of Conflict

Conflicts as might be expected arose as the different organizations attempted to draw up and execute their operational plans. Conflicts emerge usually from one of three conditions:

The members agree on the facts but have varied perspectives on the situation and on the practical steps that need to be taken.
The members agree on the coalition's goals but have differing belief systems and values emerging from their life experience or their professional education.
The members agree on the goals of the coalition but have incompatible interests and objectives as they go forward toward achieving the goals.

Surveys report conflicts between the following:

Between state coalitions and local coalitions;
Between national associations and state or local coalitions;
Between local coalitions and school districts;
Between state or local coalitions and a state agency;
Between coalitions and physicians;
Between specialists in asthma and family practitioners;
Between research physicians and practitioners.

Sources of Harmony

To accompany these differences in coalition members, some commonly shared fundamental interests form the basis for resolving the conflict. The following three factors that stimulate conflict resolution usually exist in coalitions:

Leaders and members have overlapping interests; typically they know one another from other activities and consider other members of the coalition their colleagues. They normally have a high interest in resolving the conflict quickly.
No coalition member usually has the ability to impose a solution on the group.
Despite the differences, the coalition participants have more in common than they may realize. In facing the conflict, these similarities of viewpoint usually emerge.

Approaches to Conflict Resolution

There are five commonly accepted ways of dealing with conflict. The nature of the survey and interviews did not permit an analysis of those most frequently used by coalitions today. It is suspected that in most organizations and groups, all five or some combination of the five are used.

Five Ways of Dealing With Conflict

Denial. Get rid of the conflict by pretending it does not exist. With issues of little consequence, it can be a time saver, but with anything else, the issue becomes unmanageable.
Suppression. Recognize that there is unfortunately conflict but indicate that "Nice people don’t fight." Again, the conflict does not go away but underground.
Power. The conflict is acknowledged. To prevent a full venting of the issue, an individual or organization with power to do so resolves the issue and declares one side "the winner" and the other "the loser."
Compromise. Each side is urged to give up something so the sides can be moved closer together and the coalition can proceed with business. While compromise does deal with the issue, the resultant solution may not be as effective as either of the two opposing solutions.
Collaboration. The conflict is acknowledged and the participants are urged to work jointly on presenting the best possible solution which may be an enhancement of both original proposals.