Burnout in U.S. hematologists and oncologists: impact of compensation models and advanced practice provider support

Alfred I. Lee, Yale University School of Medicine, New Haven, Connecticut, United States.
Leah E. Masselink, George Washington University, Washington, District of Columbia, United States.
Laura M. De Castro, University of Pittsburg Medical Center, Pittsburgh, Pennsylvania, United States.
Ariela L. Marshall, Hospital of the University of Pennsylvania, Philadelphia, Minnesota, United States.
Nathan T. Connell, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Georgette A. Dent, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States.
Josel Fritz, American Society of Hematology, Washington, District of Columbia, United States.
Morgan Rose Homer, American Society of Hematology, Washington, District of Columbia, United States.
Tiffany L. Lucas, Kaiser Permanente Medical Group, Oakland, California, United States.
Rakhi P. Naik, Johns Hopkins University, Baltimore, Maryland, United States.
Marquita Nelson, University of Tennessee Health Science Center, Memphis, Tennessee, United States.
Casey L. O'Connell, Jane Anne Nohl Division of Hematology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, Los Angeles, California, United States.
Anita Rajasekhar, University of Florida, Gainesville, Florida, United States.
Robby James Reynolds, American Society of Hematology, Washington DC, District of Columbia, United States.
Deva Sharma, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
Melody Smith, Stanford University, Stanford, California, United States.
Lachelle D. Weeks, Dana Farber Cancer Institute, Boston, Massachusetts, United States.
Clese E. Erikson, George Washington University, Washington, District of Columbia, United States.

Document Type

Journal Article

Publication Date

4-27-2022

Journal

Blood advances

DOI

10.1182/bloodadvances.2021006140

Abstract

Burnout is prevalent in throughout medicine. Few large-scale studies have examined the impact of physician compensation or clinical support staff on burnout among hematologists and oncologists. In 2019, the American Society of Hematology conducted a practice survey of hematologists and oncologists in the American Medical Association Masterfile; burnout was measured using a validated, single-item burnout instrument from the Physician Work Life Study, while satisfaction was assessed in several domains using a 5-point Likert scale. The overall survey response rate was 25.2% (N = 631). Of 411 respondents with complete responses in the final analysis, 36.7% (N = 151) were from academic practices and 63.3% (N = 260) from community practices; 29.0% (N = 119) were female. Over one-third (36.5%; N = 150) reported burnout, while 12.0% (N = 50) had a high level of burnout. In weighted multivariate logistic regression models incorporating numerous variables, compensation plans based entirely on relative value unit (RVU) generation were significantly associated with high burnout among academic and community physicians, while the combination of RVU + salary compensation showed no significant association. Female gender was associated with high burnout among academic physicians. High advanced practice provider utilization was inversely associated with high burnout among community physicians. Distinct patterns of career dissatisfaction were observed between academic and community physicians. We propose that implementation of compensation models not based entirely on clinical productivity, increased support for women in academic medicine, and expansion of advanced practice provider support in community practices may address burnout among hematologists and oncologists.

Department

Health Policy and Management

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