Antonio (Tony) Fernando is a medical doctor and
Senior Lecturer at the School of Medicine in the University of
Auckland located in
Auckland, New Zealand. His research interests include diagnosis
and treatment of insomnia and other sleep disorders. He is currently
working on a PhD on compassion in healthcare.
suggested that the scientific study
of compassion in medicine may be enhanced
when conducted within a transactional framework...
"We have suggested
that the scientific study of compassion in medicine may be enhanced when
conducted within a transactional framework in which compassion is viewed
as stemming from the dynamic interactions between physician, patient,
clinical, and institution/environment factors. The Transactional Model of
Physician Compassion offers a framework within which to identify and
organize the barriers and facilitators of physician compassion and thus
better inform future interventions aimed at enhancing physician
Transactional Model of Physician Compassion
"Physician compassion is expected by both patients and the medical
profession and is central to effective clinical practice. Yet, despite
the centrality of compassion to medical practice, most
compassion-related research has focused on compassion fatigue, a
specific type of burnout among health providers.
Although such research has highlighted the phenomenon among clinicians,
the focus on compassion fatigue has neglected the study of compassion
itself. In this article, we present the Transactional Model of Physician
Compassion. After briefly critiquing the utility of the compassion
fatigue concept, we offer a view in which physician compassion stems
from the dynamic but interrelated influences of physician, patient and
family, clinical situation, and environmental factors.
Illuminating the specific aspects of physicians’ intrapersonal,
interpersonal, clinical, and professional functioning that may
interfere with or enhance compassion allows for targeted interventions
to promote compassion in both education and practice as well as to
reduce the barriers that impede it.
Potential areas for physician intervention include;
on the nature of compassion "
education on " the benefits the
doctor, the patient, and their families can derive from compassionate
"training doctors how to
manage their expectations of patient behavior and outcomes"
"eight-week program on mindfulness meditation, self-awareness, and
communication found sustained improvements in physician
patients to see situations from the perspective of the medical
unnecessary interruptions during the consultation and providing
environments should encourage togetherness, collegiality, and mutual
support among different disciplines and within the medical hierarchy "