Study reveals high burnout among doctors treating sickle cell disease

Hematology-oncology trained physicians who treat sickle cell disease reported higher rates of burnout (60%) than their counterparts who do not provide sickle cell care (43%) despite no differences in grit and resilience between the two groups. The data were published in the American Society of Hematology's journal, Blood Advances. 

This is the first and only data on burnout, grit, and resilience in sickle cell providers. 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." 

Layla Van Doren, MD, MBA, senior author, assistant professor of medicine at Yale School of Medicine and classical hematologist at Smilow Cancer Hospital

Sickle cell disease is the most common inherited blood disorder, affecting approximately 100,000 individuals in the United States and one out of every 365 Black births. The disorder is chronic and characterized by abnormally shaped blood cells that can become lodged in the blood vessels, blocking blood flow and leading to organ damage, infection, and episodes of severe pain. Caring for individuals with sickle cell disease requires physicians to navigate ongoing demands across inpatient and outpatient settings, limited treatment options, and persistent gaps in education that contribute to disparities in timely, appropriate care for patients. 

In their cross-sectional, nationwide survey assessing burnout among hematology-oncology physicians, the researchers identified several notable differences that may explain the higher rates of burnout observed among physicians who focus on treating sickle cell disease compared with those who do not: 

• 47% of sickle cell physicians strongly agreed that they felt a sense of pride in their job (distinct from fulfillment in one's profession), compared to 65% of their colleagues 

• 81% of sickle cell physicians reported more than five years in clinical practice, compared to 65% of their colleagues 

• 40% of sickle cell physicians reported annual incomes of less than $350,000, compared to 64% of their colleagues 

• 36% of sickle cell physicians reported serving in administrative and leadership roles, compared to 16% of their colleagues 

The survey, distributed through social media platforms and email lists of sickle cell disease-focused organizations, included questions assessing burnout, grit, resilience, career satisfaction, workplace and personal social support, and demographics. 

A total of 159 hematology-oncology physicians responded to the survey, 55 of whom treat sickle cell disease. Seventy-one percent of respondents identified as female and 59% as white, though sickle cell providers were more likely to identify as Black than non-sickle cell providers (24% vs 4%). The overall median age was 43. 

"Following analysis, the data showed that both less job pride and less recreation time were directly associated with increased burnout," said first author Valentina Restrepo-Espinosa, MD, a postdoctoral associate at Yale School of Medicine. "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." 

Given the nature of the study, it has several limitations, namely self-selection and limited scope, as brevity and completion rate were prioritized over dimensional detail, such as the use of the single-item burnout questionnaire. Additionally, the method of survey distribution precluded the researchers from calculating a response rate. 

This survey is the first phase of the researchers' larger effort to understand burnout in sickle cell providers. A follow-up survey assessing individual programmatic factors that can influence or lead to burnout in sickle cell clinicians is currently underway.