Working in value-discrepant environments inhibits clinicians' ability to provide compassion and reduces well-being: A cross-sectional study

J Intern Med. 2023 Jun;293(6):704-723. doi: 10.1111/joim.13615. Epub 2023 Feb 26.


Background: The practice of compassion in healthcare leads to better patient and clinician outcomes. However, compassion in healthcare is increasingly lacking, and the rates of professional burnout are high. Most research to date has focused on individual-level predictors of compassion and burnout. Little is known regarding how organizational factors might impact clinicians' ability to express compassion and well-being. The main study objective was to describe the association between personal and organizational value discrepancies and compassion ability, burnout, job satisfaction, absenteeism and consideration of early retirement among healthcare professionals.

Methods: More than 1000 practising healthcare professionals (doctors, nurses and allied health professionals) were recruited in Aotearoa/New Zealand. The study was conducted via an online cross-sectional survey and was preregistered on AsPredicted (75407). The main outcome measures were compassionate ability and competence, burnout, job satisfaction and measures of absenteeism and consideration of early retirement.

Results: Perceived discrepancies between personal and organizational values predicted lower compassion ability (B = -0.006, 95% CI [-0.01, -0.00], p < 0.001 and f 2 = 0.05) but not competence (p = 0.24), lower job satisfaction (B = -0.20, 95% CI [-0.23, -0.17], p < 0.001 and f 2 = 0.14), higher burnout (B = 0.02, 95% CI [0.01, 0.03], p < 0.001 and f 2 = 0.06), absenteeism (B = 0.004, 95% CI [0.00, 0.01], p = 0.01 and f 2 = 0.01) and greater consideration of early retirement (B = 0.02, 95% CI [0.00, 0.03], p = 0.04 and f 2 = 0.004).

Conclusions: Working in value-discrepant environments predicts a range of poorer outcomes among healthcare professionals, including hindering the ability to be compassionate. Scalable organizational and systems-level interventions that address operational processes and practices that lead to the experience of value discrepancies are recommended to improve clinician performance and well-being outcomes.

Keywords: burnout; compassion; health personnel; professional well-being; values.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Burnout, Professional* / prevention & control
  • Cross-Sectional Studies
  • Empathy
  • Health Personnel
  • Humans
  • Physicians*
  • Quality of Life
  • Surveys and Questionnaires