The TKI and Conflict Agility: Why Physician Leaders Need More Than One Mode
Your Default Conflict Mode Got You This Far. It Won't Get You Further.
I was working with a physician leader last year who described herself as "the person who always finds the middle ground." She meant it as a strength. And for a long time, it was. Compromising kept committee meetings on track and prevented blowups with her department chair.
But then she became a division chief, and the stakes changed. She compromised on a faculty hire she should have fought for. She compromised on protected research time that her team needed intact, not halved. By the time she called me, she was frustrated and her faculty were losing trust.
Her problem wasn't that compromising is bad. She only had one gear.
What the TKI Actually Reveals
The Thomas-Kilmann Conflict Mode Instrument maps your tendencies across five conflict-handling modes: competing, collaborating, compromising, avoiding, and accommodating. Kenneth Thomas and Ralph Kilmann built the framework on two dimensions -- assertiveness and cooperativeness -- and the resulting profile shows not just your dominant mode but also the modes you underuse.
That second part is where the real coaching work lives. Most physician leaders I work with aren't surprised by their top mode. They already know they tend to avoid or compete or accommodate. What catches them off guard is seeing, in black and white, which modes they've essentially abandoned.
A 2015 article in Physician Leadership Journal made the case that effective physician leaders demonstrate "conflict versatility" -- the capacity to draw on multiple modes depending on context rather than defaulting to one style. The TKI is the clearest tool I've found for measuring that versatility.
Five Modes, Five Different Situations
Here is the part that changes how physician leaders think about conflict. Each TKI mode has a situation where it's the right call.
Competing works when patient safety is on the line and you need a fast, non-negotiable decision. If a resident's judgment is putting someone at risk, this is not the time for consensus.
Collaborating is right when the outcome matters to both parties and the relationship does too. Designing a new curriculum with a colleague who has different pedagogical views is worth the investment.
Compromising fits when you need a workable answer quickly and both sides can give something up. Scheduling and resource-sharing arrangements often land here.
Avoiding is appropriate when the issue is trivial or emotions are too hot for productive conversation. Sometimes the wisest move is to revisit tomorrow.
Accommodating makes sense when the relationship outweighs the specific issue, or when the other person's position is simply better than yours. Yielding intentionally takes more confidence than yielding reflexively.
Thomas and Kilmann emphasized this point themselves. No single mode is universally effective. The goal is reading the context and choosing the mode that fits rather than reaching for the one that feels comfortable.
The Sports Analogy That Keeps Coming Back
I think about this like a basketball player who has an incredible three-point shot but never drives to the basket. At the college level, the outside shot might be enough. In the pros, defenders close out faster and the game demands a full repertoire. The same thing happens when physicians move into leadership. The conflict mode that worked when your job was clinical excellence becomes insufficient when you're managing people, budgets, and politics.
How to Build Conflict Agility
After a physician leader takes the TKI, I focus the coaching conversation on three questions.
First, what's your dominant mode and when does it serve you well? This validates the strength rather than pathologizing the default.
Second, what's your lowest-scored mode and what would it look like to use it once this month? If you never compete, try holding firm on one decision that matters. If you never accommodate, try genuinely deferring to a colleague's expertise.
Third, what recurring conflict situation do you keep handling the same way with diminishing returns? That's the place to try a different mode and see what happens.
The TKI doesn't tell you who you are. It tells you what you tend to do -- and more importantly, what you tend not to do. That gap between your dominant mode and your dormant modes is where the growth lives.
The Assessment Is Just the Starting Point
Taking the TKI takes about fifteen minutes. Understanding your results takes a conversation. Building actual conflict agility takes practice over months. But physician leaders I've coached through this process consistently tell me it changed how they show up in hard conversations -- not because they stopped being themselves, but because they gave themselves more options.
If you keep running into the same interpersonal walls, a conflict style assessment might be the most efficient way to figure out why. Check out our individual coaching options.
