Sickle cell doctors face higher burnout than other specialists: Study
Factors included workplace pressures like feeling less pride in their job
Written by |
Hematologists-oncologists who specialize in sickle cell disease (SCD) report higher levels of burnout than those not specializing in SCD, even though no differences in grit and resilience were found between the two groups, according to a nationwide U.S. study.
The study surveyed more than 150 hematology-oncology doctors, who are trained in blood diseases and cancers. The observed differences in terms of burnout appeared to be due to workplace pressures, such as having less time for recreation and feeling less pride in their job.
The study, “Burnout in Sickle Cell Disease-Focused Hematology-Oncology Trained Physicians: A National Cross-Sectional Study,” was published in Blood Advances, a journal of the American Society of Hematology (ASH).
“This is the first and only data on burnout, grit, and resilience in sickle cell providers,” Layla Van Doren, MD, the study’s senior author, a hematologist at Smilow Cancer Hospital and assistant professor of medicine at Yale School of Medicine in New Haven, Connecticut. said in an ASH press release. “We hope this study raises awareness of the high burnout rates affecting sickle cell physicians so that institutions recognize and address the complex disparities affecting care for individuals living with sickle cell disease.”
Up to 45% of hematology-oncology doctors in US report burnout
SCD is the most common inherited blood disease in the U.S., where it affects about 100,000 people and occurs in about one in every 365 Black births. The disease changes the shape of red blood cells, which normally carry oxygen through the body. Instead of being round and flexible, the red blood cells become rigid and crescent-shaped, causing a range of symptoms.
Because SCD is lifelong and unpredictable, patients often need frequent medical care in both hospitals and outpatient clinics. Treatment options remain limited, and many patients face barriers to timely care. These barriers include gaps in medical training about the disease and healthcare inequalities, which can lead to delays or differences in treatment.
Burnout is a state of emotional and professional exhaustion caused by long-term work stress. In the U.S., up to 45% of hematology-oncology doctors report experiencing burnout. Too few doctors specialize in SCD, placing heavy demands on a small workforce and risking burnout and staff shortages.
To better understand this scenario, the researchers conducted a nationwide U.S. survey of 159 hematology-oncology doctors. The survey asked about burnout, grit, resilience, career satisfaction, and work conditions. Grit refers to persistence toward long-term goals, while resilience describes the ability to recover from stress.
SCD specialists participated much less often in recreational activities
About one-third (35%) of the doctors reported that they specialized in SCD. This group was significantly older than the non-SCD group (median age 45 years versus 43 years) and was significantly more likely to identify as Black (24% vs. 4%). Most respondents in both groups were women and white.
A significantly greater proportion of SCD-focused physicians reported burnout compared with those who did not specialize in the disease (60% vs. 43%). Still, both groups showed similar levels of grit and resilience, suggesting that personal coping abilities alone do not explain the difference.
While “measures of self-care such as hours of sleep per night and frequency of physical activity were similar between groups,” the researchers wrote, doctors specialized in SCD participated significantly less often in recreational activities.
SCD-focused physicians were significantly more likely to engage in such activities only once a week (51% vs. 27%) than two or more times a week (45% vs. 59%) relative to non-SCD physicians. Also, the SCD group was significantly less likely to agree with the sentence “I feel a sense of pride in doing my job” (47% vs. 65%).
Following analysis, the data showed that both less job pride and less recreation time were directly associated with increased burnout. Identifying the underlying reasons for these trends can give us a tangible plan to mitigate the frequency of burnout in sickle cell providers and reduce the associated risks posed to patients
These factors appeared to act as “mediators of burnout,” the researchers wrote, meaning they partly explain why burnout rates were higher in the SCD group.
“Following analysis, the data showed that both less job pride and less recreation time were directly associated with increased burnout,” said Valentina Restrepo-Espinosa, MD, the study’s first author and a postdoctoral associate at Yale. “Identifying the underlying reasons for these trends can give us a tangible plan to mitigate the frequency of burnout in sickle cell providers and reduce the associated risks posed to patients.”
Other differences were also observed. Doctors specializing in SCD were significantly more likely to have been practicing for more than five years, to care for children, to work in academic medicine, and to hold administrative or leadership roles. They were also more likely to report lower annual income, on average, compared with non-SCD physicians.
Among the study limitations, the team noted that survey participation was voluntary, which may introduce self-selection bias, meaning people with strong opinions might be more likely to respond. The survey also used a single-question measure for burnout and was distributed online, so the researchers could not calculate an exact response rate.
This research represents the “first phase of a larger effort,” wrote the researchers, who are now conducting a follow-up survey to examine specific workplace and program-level factors that may contribute to burnout among doctors who care for SCD patients. Understanding these factors may help improve working conditions and patient care.
