ABSTRACT
Although it can be difficult to sustain, compassion is central to healthcare, offering benefits to patients, providers, and systems. So why is our care challenged in health? In considering this question, this chapter first critiques the view offered by compassion fatigue—that compassion is costly and resource depleting—arguing, instead, that many of the challenges in healthcare come from “misfits” between the contexts compassion evolved in versus those in which we try to use it. Noting that compassion in health is differentiated by expectation, remuneration, repetition, inverted carer to caree ratios, and, finally, context, we use the framework of the Transactional Model of Physician Compassion to organize the factors thought to influence compassion that can be amenable to interventions. Although data remain scarce, we suggest that understanding compassion in healthcare requires a systemic perspective, an understanding of the subjectivity of personal experiences, and a recognition of the discrepancies between historical contexts and modern-day healthcare.
