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A Question for Dentists - Why Mediation?
A Question for Dentists - Why Mediation?
Like peer review, carefully structured and executed mediation is a beneficial tool for resolving disputes.
Shahram (Sean) Shekib, J.D., D.D.S.; Martin Applebaum, J.D., M.A.
Have you ever felt that the way we try to resolve conflict these days, with each side stuck in its hardened position while viewing the other side as nothing more than a wrongheaded adversary, isn’t the best way for people to go forward?
Our adversarial system of justice surely has its benefits in terms of protecting legal rights, but in too many situations, the system is slow, inefficient and costly—and it almost always results in winners and losers, often unnecessarily creating stress and damaging human relationships, both business and personal, in the process.
Should our first thought to resolve a dispute be protracted litigation? Should our first inclination be that we need a judge to solve a problem for us, that those in conflict cannot find a way to resolve the issue between them?
What if there were another way to approach and resolve conflict? What if there were a way to have two winners or, at the very least, a path where two people could come out of conflict understanding and respecting one another? What if there were a way that empowers those in conflict to fashion their own outcome together? What if this approach were quick, efficient and low-cost?
Well, there is such an approach. It is called mediation. In fact, mediation is already used by the American Dental Association (ADA) as part of its peer review process for resolving fee-based disputes between dentist and patient. But mediation can have a much wider application in the life of a dentist, both professionally and personally, as we will see.
Bound to Peer Review
First, let’s take a look at how mediation is used as part of the peer review process. The process can be initiated either by the patient of record or by a providing dentist who maintains an active tripartite membership in the ADA. Once the process is initiated, participation is mandatory for the member dentist. That is, the dentist cannot decline participation, though the patient can. However, once the participants begin the peer review process, both are bound to continue to its conclusion.
Peer review is a two-part process. First, comes the mediation. Once the process is initiated by dentist or patient, a member of the peer review committee will reach out to both and act as a mediator to facilitate a resolution. If the participants can come to their own agreement, that would conclude the peer review process. However, if a resolution is not reached, then a panel of dental arbitrators would decide the fate of a dispute, their decision binding upon the participants.
Mediation can also be a standalone process, where peer review has not been invoked. Let’s look at how mediation on its own works.
Voluntary Process
Mediation is an opportunity for those in conflict to safely say to one another why they have come and what they want. Unlike mediation in the peer review process, standalone mediation is voluntary throughout; participants may withdraw at any time without reaching an agreement. And there is no automatic follow-up process that results in the binding decision by a third party. There is only an agreement if the participants themselves agree on one. Where they do not, the participants are free to choose other avenues to resolve their dispute.
It is foundational to the process that the mediator, always maintaining impartiality, never makes a judgment in favor of one side and at the expense of the other; only the participants themselves are empowered to determine an outcome on their own terms.
Mediation is also a confidential process: what is said in mediation stays there, the mediator and the participants agreeing beforehand to treat the mediation session as a safe space for an honest exchange of views and grievances.
Mediation, then, is a skillful, humane, non-adversarial, cost-effective, time- and stress-saving way for people in dispute to directly address and transform conflict with one another.
Finding Resolution
There are a number of fundamental techniques that the mediator uses to encourage the participants to work together to address their problems.
First, the mediator restates to each participant what they have said. This simple technique has the effect of ensuring that each participant feels heard. It also allows each participant to hear what others have to say from a fresh voice, since very often people in conflict have difficulty listening to one another.
Next, the mediator reframes and summarizes what each participant has said, bringing the focus down to the underlying values, needs and interests that are driving the conflict. For example, in a noise complaint, what does sound mean to each participant? Well, the downstairs neighbor may want quiet enjoyment of their apartment while the upstairs neighbor may want the freedom to express themselves, perhaps by playing music.
Then, once issues are being addressed at this level (quiet vs. freedom, in our example above), the participants are encouraged to brainstorm solutions to their deeply held concerns. In our noise complaint, perhaps the time of day the music is played can be adjusted, or the location in the apartment where it is played can be changed or a carpet can be put down. Or the sound may not be the real issue at all, with something personal coming between the neighbors—and this too may be uncovered and addressed.
These techniques create openness and empathy between the parties so that they may listen past their positions to what lies below, to their values, needs and interests, since this is where resolution of the conflict will take place, with participants crafting their own viable resolution by mutually fashioning win-win responses to participant needs.
Finally, to create security between the participants, a mediated agreement may be written that memorializes the resolution and that may be used as proof of it.
Versatile Tool
Mediation can be used as a tool in virtually any area of conflict. Areas where mediation is employed to great effect include: provision of services in healthcare and other areas; civil claims; partnership; business and contract; workplace and employment; family and divorce; child custody and visitation; surrogate matters; real estate/property/neighbor disputes; and eldercare.
In addition to the fee disputes covered by the peer review process, dentists may have professional disputes revolving around their office settings. One such situation centers around partnership. It is not uncommon for a partner to leave the practice due to illness, relocation or for other reasons. Mediation is well-suited to work through the nuts and bolts of how best to go forward without creating animosity.
Similarly, one can envision everyday situations with dental staff or with the landlord of one’s office property where grievances can be addressed instead of inflamed. Dentists may also be involved in an array of personal matters, such as domestic disputes, civil claims, elder care issues, and many other possible conflicts better handled through the non-adversarial approach of mediation.
Yes, in your business life as dental professionals, in your personal relationships and in your interactions out in the world, as a matter of course, disputes of one kind or another inevitably arise. You may view conflict as an unhealthy impediment to be combated under great duress, or you may see conflict as what naturally happens when people with different values, interests and needs meet and must find ways to get along or, sometimes, to part in a skillful way.
Perhaps, when the time comes, you may choose mediation, beneficial in so many ways, as a skillful response to conflict in your life.

Shahram (Sean) Shekib, J.D., D.D.S., FAGD, FICD, FAADS, FPFA, FACD, is a certified mediator, co-founder of Attune Mediation, LLC, CEO and founder of Doctors Club Foundation, Inc. He practices in Brooklyn, NY, and is clinical assistant professor, Columbia University College of Dental Medicine, New York, NY.

Martin Applebaum, J.D., M.A., has mediated well over 300 cases in areas involving family issues, contract and business disputes, and other matters. He frequently presents seminars on mediation and mediation techniques.