Professional Compromise and Its Association with Burnout, Job Satisfaction, and Patient Satisfaction Among Physicians in a Chinese Tertiary Hospital.

Abstract

Background: Physician burnout poses a global challenge to healthcare systems. Professional compromise-pressure on physicians to deviate from clinical judgment or professional standards due to systemic constraints-may contribute to burnout, yet evidence from non-Western settings remains limited. This study examined the prevalence of professional compromise among physicians at a Chinese tertiary hospital and its associations with burnout, job satisfaction, turnover intention, and departmental patient satisfaction.

Methods: A cross-sectional survey was conducted between January and March 2025 at a tertiary hospital in Zhejiang Province, China (n=120 physicians; 10 clinical departments; response rate 80.0%). Professional compromise was measured with a validated five-item instrument adapted from the Measure of Moral Distress for Healthcare Professionals; burnout was assessed using the Emotional Exhaustion subscale of the Maslach Burnout Inventory (licensed from Mind Garden, Inc). Pearson correlations, independent t-tests, and chi-square tests examined associations; effect sizes were quantified using Cohen's d and odds ratios.

Results: The mean professional compromise score was 3.85 (SD 0.55) on a 1-5 scale, with 50.0% of physicians reporting frequent compromise (score ≥4). Obstetrics and Gynaecology and Emergency Medicine departments exhibited the highest compromise rates. Professional compromise correlated positively with burnout (r=0.587, p<0.001) and negatively with job satisfaction (r=-0.347, p<0.001). High-compromise physicians had substantially higher burnout (Cohen's d=0.97), lower job satisfaction (Cohen's d=0.57), and greater turnover intention (55.0% vs. 28.3%; OR=3.09, 95% CI 1.41-6.77). At the department level (n=10), professional compromise correlated negatively with patient satisfaction (r=-0.929, p<0.001).

Conclusion: Professional compromise was prevalent and robustly associated with adverse clinician outcomes. These findings suggest that systemic contributors to professional compromise warrant attention in strategies to improve clinician well-being and healthcare quality. Longitudinal multi-site research is needed to confirm these associations and evaluate targeted interventions.