Workplace social capital, workplace loneliness, and compassion among physicians: A nationwide cross-sectional moderation analysis

OBJECTIVE: Although compassion is a cornerstone of medicine and a key outcome of medical education, a compassion crisis in contemporary healthcare has been described. While previous studies have primarily focused on individual-level determinants of compassion, environmental factors have been overlooked. Here, we examined the association between workplace social capital (WSC; briefly, employee perceptions of trust, reciprocity, and network interactions both among peers and among individuals of different hierarchical levels or organizations) and compassion and determined whether it was moderated by workplace loneliness. METHODS: the Nikkei Medical Online website. WSC, workplace loneliness, and compassion were assessed using validated scales. We first performed multivariable linear regression analyses to examine associations between WSC, workplace loneliness, and compassion, followed by moderation analysis to examine whether workplace loneliness modified the association between WSC and compassion. RESULTS: Data from 7,447 physicians were analyzed. Higher WSC was consistently and positively associated with greater compassion. Contrary to expectations, workplace loneliness exhibited a weak but statistically significant positive association with compassion. The interaction between WSC and workplace loneliness was statistically significant. In the simple slope analysis, WSC was positively associated with compassion at all levels of workplace loneliness, albeit with decreasing strength as workplace loneliness increased. CONCLUSIONS: Although WSC exhibited a positive association with compassion, its magnitude was not uniform and diminished with higher workplace loneliness. The unexpected positive association between workplace loneliness and compassion may suggest that compassion arises not only in favorable social environments but also in the context of personal or relational difficulties, potentially reflecting how clinicians' own experiences of vulnerability shape compassionate responses. The design of continuing professional development initiatives to sustain compassion may need to consider both organizational conditions and physicians' subjective relational experiences.