I do both development and DBA activities, so I get to design it end-to-end. I don't have the conflict of developer versus DBA, as I pick the best tool for the job, and that tool is never an ORM because of the uber-inefficient code they produce.

I find the most conflict occurs when determining user requirements. The business side doesn't know what they want because the client doesn't know what they want. So, naturally, they want me to write something. Then they change it 45 times until they like it. Now it's in production and everyone's happy, up to the point where they want it to do something in a different way that was never even thought of. This continues in perpetuity for several years and then there's a large meeting of the minds where the business side actually takes the time to sit down and really think things through. Then a redesign happens with lots of hours (and therefore cost) being sunk into something. Voila! It now does exactly what everyone wants.

I think the trick is to get people to think it through before design starts. Everyone's in such a rush that they don't want to take the time to think it through the first time, but it sure does save a pile of time and money when it happens.