Interprofessional conflict linked to communication, hierarchy and resources in Indian hospitals

Interprofessional conflict was associated with communication failure, hierarchical power dynamics and resource constraints in a qualitative study of healthcare workers in public and private hospitals across four Indian states. Researchers conducted 19 semi-structured in-depth interviews with hospital staff in Arunachal Pradesh, Gujarat, Rajasthan and Telangana between December 2025 and February 2026. Communication failure was endorsed as a source of conflict by all 19 participants, followed by hierarchical power dynamics, reported by 18 participants, and resource constraints, reported by 17. Every participant reported deterioration in team dynamics, while 74% reported adverse effects on patient care. Formal conflict-resolution infrastructure was absent across the four states in the accounts of 18 participants.

The study was the second phase of a programmatic mixed-methods investigation. Its preceding quantitative phase, conducted from January to December 2024, had established the prevalence and correlates of conflict at the same sites. For the qualitative phase, participants were recruited through purposive sampling from government teaching hospitals, private tertiary teaching hospitals, private medical college hospitals and government hospitals. The sample included junior resident doctors, senior residents, consultants, professors, staff nurses, and nursing in-charges or superintendents. The analysis used a constructivist reflexive thematic approach, with six phases, independent coding by two analysts and systematic negative case analysis. Thematic saturation was reached at the fifteenth interview. Reporting followed COREQ guidelines.

Six overarching themes and 20 sub-themes were generated from the interviews. Communication failure was the most universally endorsed source of conflict, appearing in all 19 interviews. Hierarchical power dynamics and resource constraints were also identified by large majorities of participants. The findings indicate that conflict in the studied hospitals was linked to organisational and structural features of work, rather than being described solely as isolated interpersonal disagreement. The analysis also identified differences in how staff responded: junior staff were reported to rely more heavily on avoidance, while some participants described conflict as a catalyst for systemic improvement. These patterns reflect the experiences and interpretations of the sampled workers and do not establish that the same proportions apply to all healthcare settings in India.

Gender-based discrimination emerged as a context-specific sub-theme reported exclusively by female participants, three of whom identified it in the interviews. Because this finding was based on a small number of accounts, it should not be treated as a prevalence estimate. Participants most consistently favoured mandatory, curriculum-integrated conflict-resolution training and the development of systemic communication infrastructure. The authors framed these priorities as possible inputs to curriculum reform under the National Medical Commission’s AETCOM framework and to health-system strengthening in comparable low- and middle-income country settings. The findings may inform local policy and institutional planning, but the transferability of specific priorities beyond the four studied states requires local assessment. As a qualitative study based on purposively sampled interviews, the research does not measure national prevalence, establish causal effects or demonstrate that the proposed interventions improve patient safety, teamwork or workforce retention.

Subject of Research: Interprofessional conflict among healthcare workers in selected public and private hospitals across four Indian states

Article Title: The normalisation of dysfunction: a multi-site reflexive thematic analysis of interprofessional conflict in Indian public and private hospitals

Article References: Sarkar, A., Gehlawat, M., Roy, D., Mathur, M., Dayama, S., Chauhan, M., & Dillu, S. (2026). The normalisation of dysfunction: a multi-site reflexive thematic analysis of interprofessional conflict in Indian public and private hospitals. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15532-9

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15532-9

Keywords: interprofessional conflict, healthcare teams, communication failure, hierarchical power, resource constraints, patient safety, gender discrimination, qualitative research, Indian hospitals, conflict resolution, normalisation, dysfunction