When doctors disagree: Handling clinical conflict professionally

23 Jun 2026 Estimated read time: 3 min read

Dr Danny Lee, Senior Medical Adviser at Medical Protection, shares what to do when you disagree with your colleague.

Modern medical care relies on complex, multidisciplinary teamwork. However, interactions between professionals carry risks, particularly when communication is ineffective or opinions differ.

Communication gaps can evolve into threats to patient safety or disputes that damage professional relationships. Common barriers to effective communication include workload pressure, assumptions about communication protocols, and difficult prior working relationships.

Doctors are often consulted to provide second opinions on patient management. However, these consultations can sometimes lead to differences in clinical opinion or questions regarding a colleague’s competence. These situations require a professional, ethical response.

The following case study illustrates a scenario where a consultant sought advice regarding a critically ill patient whose family doubted the attending surgeon’s treatment plan.

Case study

Madam X presented with an obstructing sigmoid carcinoma and was under the care of Consultant A. Consultant A recommended endoscopic stenting to relieve the obstruction prior to definitive cancer surgery.

Madam X’s son sought a second opinion from Consultant B, a colleague in the same department but a different surgical team. The two consultants worked independently and met only at departmental meetings. Consultant B disagreed with the proposed treatment, believing a laparotomy to relieve the obstruction and remove the tumour in a single procedure was superior. He noted that endoscopic stenting carried a higher risk of colonic perforation and observed that Consultant A had only begun performing the procedure at this hospital. Consultant B sought advice from Medical Protection on how to proceed.

Underpinning principles

Differences of opinion usually arise not from incompetence or bias, but from two caring doctors honestly holding different views on the best approach for the patient. Medical Protection advises adhering to two core principles during such disagreements.

Patient Welfare: Doctors have an obligation to act in the patient’s best interest.

Professional Respect: Doctors should treat colleagues with respect and dignity.

These principles form the backbone of an ethical and professional approach to disagreement between colleagues.

Regulatory guidelines

The Medical Council of Hong Kong (MCHK) Code of Professional Conduct (2022)¹ outlines specific ethical expectations regarding disagreements between colleagues:

…Honest comment is entirely acceptable in such circumstances, provided that it is carefully considered and can be justified, offered in good faith and intended to promote the best interests of the patient. (Section 19.1)

It is unethical for a doctor to make unjustifiable comments which, whether directly or by implication, undermines trust in the professional competence or integrity of another doctor. (Section 19.3)

Practical guidance

When communicating with the patient or family

Explain that differences of opinion between doctors are not uncommon.

Reinforce that all the doctors involved are acting in the patient’s best interest.

Explain the reasoning behind your clinical opinion.

Highlight the importance of a patient’s preference in the final decision.

Offer next steps: e.g., a case conference with your colleagues or seeking an external expert opinion.

When communicating with your colleagues

Respectfully raise your opinions and concerns directly with your colleague

Frame the conversation around achieving the best outcome for the patient.

Seek a mutually agreeable resolution.

Escalation

If you have genuine concerns about a colleague’s professional conduct or competence that cannot be resolved locally, seek advice from your clinical lead or Medical Protection, or report to the MCHK (refer to Section 19.2).