Since beliefs, interests, needs and values vary among individuals, potential for conflict or dispute exists in all areas of human endeavor, including a patient-physician relationship. Conflict- or dispute-resolution requires diligent and directed negotiation, which ideally is amicable, efficient, and sustainable, if the participants acknowledge the identity, individuality, and integrity of all parties involved. In this essay a concept ofprincipled negotiation is extrapolated to a patient-physician relationship and is exemplified by a case study. In addition, the validity of a concept oftract (...) two diplomacy is discussed, relevant from the perspective of strained or fractured primary relationships. (shrink)