Understanding compassion in family medicine: a qualitative study

Background Patients and physicians have traditionally valued compassion; however, there is concern that physician compassion has declined with the increasing emphasis on science and technology in medicine. Although the literature on compassion is growing, very little is known about how family physicians experience compassion in their work. Aim To explore family physicians capacity for and experiences of compassion in practice. Design and setting This was a qualitative study designed using a phenomenological approach in rural and urban Ontario, Canada. Method In-depth interviews were audiotaped and transcribed verbatim, followed by independent and team coding. An iterative and interpretive analysis was conducted using immersion and crystallisation techniques. Purposive sampling recruited 22 participants (nine males and 13 females aged 2664 years) that included family medicine residents from Western University (n = 6), and family physicians practising <5 years (n = 7) or >10 years (n = 9) in Ontario, Canada. Results From the data, the authors derived the Compassion Trichotomy as a theoretical model to describe three interrelated areas that determine the evolution or devolution of compassion experienced by family physicians: motivation (core values), capacity (energy), and connection (relationship). Conclusion The Compassion Trichotomy highlights the importance and interdependence in physician compassion of motivation (personal reflection and values), capacity (awareness and regulation of energy, emotion, and cognition), and connection (sustained patientphysician relationship). This model may assist practising family physicians, educators, and researchers to explore how compassion development might enhance physician effectiveness and satisfaction.