Qualitative phenomenological exploration of lived experiences and perspectives of Chinese hospital administrators engaged in medical dispute management

Medical disputes are a significant challenge in healthcare settings worldwide, with hospital administrators playing a pivotal role in managing the conflicts. In China, despite a reported decline, medical disputes continue to raise public and governmental concerns due to factors such as medical accessibility, patient expectations, and staff competency. This study aimed to explore the lived experiences and perspectives of Chinese hospital administrators directly engaged in medical dispute management, to understand the challenges they face and inform the development of targeted training and support systems. Using a qualitative phenomenological approach, we conducted semi-structured, in-depth interviews with 13 hospital administrators from two major regional comprehensive hospitals in Beijing. Participants were selected through purposive sampling and met criteria including active engagement in managing medical disputes and adequate communication skills. Data were analyzed using Colaizzi's thematic analysis method to extract significant themes from the participants' experiences. Administrators reported four interconnected challenges: how gender shapes authority and perceived safety in disputes; the struggle to maintain an impartial, 'outsider' stance; wide variability in the emotional toll of conflict; and a pronounced need for structured, ongoing dispute-management training. The key themes revealed included (1) Gender Dynamics in Conflict Management: female administrators faced challenges in authority recognition and preferred having male colleagues present during intense disputes for perceived safety and effectiveness; (2) Outsider Perspective in Conflict Management: maintaining an impartial and detached stance was crucial for effective mediation, but administrators varied in their ability to achieve this mindset; (3) Variability in Psychological Experiences: administrators reported diverse emotional reactions and psychological impacts. Some struggled to detach emotionally and lacked formal support systems; (4) Need for Specific Training: there was a clear demand for structured, ongoing training programs tailored to the unique challenges of medical dispute management. Chinese hospital administrators face complex challenges including emotional strain, mixed-gender preference in intense encounters, and insufficient training and support. Addressing the issues is essential for enhancing administrators' effectiveness in conflict resolution, improving patient care outcomes, and promoting organizational efficiency. Medical institutions should develop comprehensive training programs and establish support systems for administrators' well-being.