Valentina Restrepo-Espinosa, MD is a postdoctoral associate at Yale School of Medicine.

Valentina Restrepo-Espinosa, MD

Valentina Restrepo-Espinosa, MD; Layla Van Doren, MD, MBA

Burnout rates were 60% among hematology-oncology physicians who treat 

compared to 43% among those who did not, despite no significant difference in grit and resilience between groups.

Findings from a cross-sectional, nationwide survey highlight disparities among providers who treat SCD, including reduced job pride and recreation time directly associated with increased burnout, and 64% of these providers earn less than $350,000 annually compared to 40% of their colleagues.

“At a high level, our study shows that sickle cell providers experience more burnout despite no meaningful differences in the personal factors that typically drive it,” said study investigator Valentina Restrepo-Espinosa, MD, a postdoctoral associate at Yale School of Medicine. “What we conclude from that is that systemic factors are likely responsible.”

Study investigators deemed burnout as an important area of investigation due to its direct association with physician attrition, medical errors, decreased productivity, and their personal experiences.

“In this role, you're often a one-person show: advocate, educator, researcher, and administrator, all while delivering the highest level of care to medically complex patients,” Layla Van Doren, MD, MBA, assistant professor of medicine at Yale School of Medicine and a classical hematologist at Smilow Cancer Hospital, said in an interview with 

“Educating colleagues and entire institutions about sickle cell disease and healthcare bias typically falls to us as well.”

The survey included responses from 159 hematology-oncology physicians, 55 of whom treated SCD. Overall, 71% identified as female and 59% as White.  Sickle cell providers were more likely to identify as Black than non-sickle cell providers (24% vs 4%).

Additionally, providers who treated SCD had more years in practice, and more often worked in academia or leadership roles (

< .05). Moreover, recreation and job pride mediated burnout in SCD physicians.

Van Doren and Restrepo-Espinosa are currently conducting a follow-up study examining the specific systemic factors driving burnout among sickle cell providers, including institutional infrastructure, compensation equity, emotional exhaustion, compassion fatigue, compassion satisfaction, and moral distress. Stay tuned for part 2 of our interview, where they discuss findings and the path forward.

For now, here’s part 1 of our Q&A with both investigators:

 What led you and your colleagues to assess burnout in hematology-oncology physicians treating sickle cell disease, and what were you expecting to see?

 The impetus came from my own experience treating sickle cell disease and recognizing that people living with this condition are medically complex, not only because of the disease process itself, but because of the significant social support needs that come with having a lifelong illness.

My own struggles with burnout were also a driving factor. In this role, you're often a one-person show: advocate, educator, researcher, and administrator, all while delivering the highest level of care to medically complex patients. Educating colleagues and entire institutions about sickle cell disease and healthcare bias typically falls to us as well.

We focused on hematology-oncology-trained sickle cell providers because we needed a control group, general hematology-oncology providers. Many non-hematology-trained clinicians also care for sickle cell patients, but a comparable control group was essential to the study design.

The results weren't unexpected to me, I live this every day. What did surprise me was the degree of burnout: 60%. I was also struck, though not surprised, that sickle cell providers showed just as much grit and resilience as their non-sickle cell counterparts.

 Can you walk us through the key findings and what they suggest about the lived experience of physicians who treat sickle cell disease?

 At a high level, our study shows that sickle cell providers experience more burnout despite no meaningful differences in the personal factors that typically drive it. What we conclude from that is that systemic factors are likely responsible.

We saw no difference in grit or resilience, key personal protective factors against burnout. We also found no significant differences in work hours, exercise, or sleep. So this does not appear to be a personal failing. It appears to be driven by the environment these providers work in. That distinction matters because it means there are actionable targets, things that can actually be improved within systems and processes to better support sickle cell providers.

 I want to emphasize that point. When people experience burnout, they often ask themselves, "What can I do differently? What do I need to change?" But when it's a systems problem, there's often very little an individual can do on their own. That's what this study reflects. The follow-up work will focus on identifying exactly which systematic and programmatic factors are driving this.

 For more context on the study design, how did you define grit, resilience, and burnout when examining individual versus systemic factors?

 I'll let Valentina speak to the specifics, but I'll note that adding grit and resilience to the study was her idea, and I loved it. Around the time we were designing the study, I had read Angela Duckworth's 

, and I was struck by how she described the concept and developed a validated tool to measure it. I'll hand it over to Valentina to explain how these measures have been validated in the physician workforce.

 We wanted objective, validated instruments, nothing subjective. For grit, we used Angela Duckworth's Short Grit Scale, an 8-item instrument that has been extensively validated across healthcare workers, including physicians and nurses. For resilience, we used the Connor-Davidson Resilience Scale, or CD-RISC.

The CD-RISC has three versions: 25-item, 10-item, and 2-item, all by the same author. To avoid survey fatigue, we used the 2-item version, which has also been extensively validated in physicians. That version focuses specifically on the ability to bounce back after hardship, which was the dimension most relevant to our questions.

 We used the single-item burnout instrument from the Physician Work Life Study, which is widely used in physician surveys precisely because it's a single item, minimizing survey fatigue, and has been extensively validated in physicians and healthcare workers.

The more commonly known alternative is the Maslach Burnout Inventory, which measures burnout across three domains. But we weren't interested in parsing which domain was most affected. We wanted a clear yes-or-no answer: are these providers burned out? From there, we could focus on understanding why, which meant casting a wide net around contributing factors rather than drilling into burnout subtypes.

Editor’s Note: Van Doren and Restrepo report no relevant disclosures.

Restrepo-Espinosa V, Van Doren L. Burnout in Sickle Cell Physicians Linked to Systemic Barriers. 

https://doi.org/10.1182/bloodadvances.2025018338/567099

Higher burnout rates among physicians who treat sickle cell disease. EurekAlert! Published March 12, 2026. Accessed March 30, 2026. 

https://www.eurekalert.org/news-releases/1119293

Articles

Burnout affected 60% of hematology-oncology physicians treating sickle cell disease versus 43% of peers, despite comparable grit and resilience and no differences in work hours, sleep, or exercise. Survey data from 159 physicians suggest system-level drivers, with reduced job pride and limited recreation time mediating burnout. Sickle cell clinicians more often held academic or leadership roles, had more years in practice, and were more likely to identify as Black. Compensation disparities were notable: 64% earned under $350,000 annually.

Burnout in Sickle Cell Physicians Hits 60% While Grit and Resilience Stand Strong

Increased burnout rates among clinicians who treat 

 point to systemic barriers rather than personal-level factors.

A recent study found burnout rates of 60% among hematology-oncology physicians who treat SCD, compared to 43% in those who did not, with no significant difference in grit and resilience reported between groups (

“This is the first study ever conducted specifically on sickle cell providers, and I hope it starts a conversation because burnout can be uncomfortable to talk about, and admitting to it can feel like an admission of weakness or lack of commitment,” Layla Van Doren, MD, MBA, assistant professor of medicine at Yale School of Medicine and a classical hematologist at Smilow Cancer Hospital, said in an interview with 

It's neither. This is a systemic problem, and that's what this work is helping us understand.”

The cross-sectional, nationwide survey was the first study on burnout, grit, and resilience in sickle cell providers, likewise highlighting disparities among providers who treat SCD, including reduced job pride, distinct from job fulfilment, and decreased recreation time. Study investigators identified that these factors were directly associated with increased burnout, while increased levels mitigated burnout. Additionally, 64% of these providers reported annual earnings of < $350,000 compared to 40% of their colleagues (

= .005). Meanwhile, SCD providers had more years in practice and more often worked in academia or leadership roles (all 

Van Doren and Restrepo-Espinosa are currently conducting a follow-up study examining the specific systemic factors driving burnout among sickle cell providers, including institutional infrastructure, compensation equity, emotional exhaustion, compassion fatigue, compassion satisfaction, and moral distress.

HCPLive spoke with investigators Van Doren and Valentina Restrepo-Espinosa, MD, a postdoctoral associate at Yale School of Medicine, about what the findings reveal, and what the field needs to do next. 

, where they discuss background, study design, and key findings.

 What does it tell us that sickle cell providers had comparable grit, resilience, and work hours to the control group, but reported lower annual salary, job pride, and recreation time?

 The job pride finding was something we discussed at length. I think job pride is distinct from personal fulfillment. Caring for people with sickle cell disease is deeply fulfilling for those of us in this field — it's what keeps us going and why we do it. But job pride is tied to something different: feeling supported at your institution, having the program resources your patients need, feeling that opportunities for career development exist.

The recreation finding was equally striking. Sickle cell providers recreated less per week despite logging the same work hours as the control group. That raises the question of cognitive and emotional load — providers may be going home too mentally and emotionally exhausted to engage in activities outside of work, even when hours on paper look equivalent.

 These three findings — lower salary, lower job pride, and less recreation — all point to the environment these physicians are working in. On salary: sickle cell providers in our study had significantly more years of experience than the control group. You'd expect more senior physicians to earn more, especially with equivalent work hours. Instead, they earned less. That speaks directly to how institutions assign value to this work.

If the people and institutions around you don't recognize the value of what you're doing, that filters into how you see yourself professionally. We believe that's part of what's driving lower job pride — not a lack of meaning or commitment, but a lack of institutional recognition.

On recreation: equal work hours should translate roughly to equal time for personal activities. The fact that it doesn't suggests sickle cell providers are leaving work carrying something heavier — mentally and emotionally — that limits their ability to recover. That kind of exhaustion can reinforce and deepen burnout over time.

The broader picture is that sickle cell providers are doing work of tremendous importance — comparable in many ways to oncology, which was our control group — but are not working in an environment that reflects that. They're not feeling valued, and they're not receiving the institutional support they need to sustain themselves professionally or drive the changes they want to see for their patients.

 Many physicians treating sickle cell disease reported burnout, and your study points to job pride and recreation as potential mitigating factors. How should the hematology field interpret these findings to improve the culture for these physicians and help address systemic barriers?

 I don't think our study, as it stands, produces something immediately actionable — because we still don't have a precise picture of which systemic factors are most responsible. Identifying those is the necessary next step, which is why we're conducting a follow-up study.

 We're going very granular into the systemic factors in the follow-up, since this study identified those as likely key. We're examining the institutional infrastructure in which providers work — dedicated nursing, dedicated infusion center space, access to mental health providers, and similar elements. We're also asking providers directly what they find most challenging, whether that's the advocacy burden, fighting insurance, or other specific pressures.

We're asking sickle cell providers whether they feel their institution regards them with appropriate respect, and whether their compensation reflects the work they actually put in, to better understand the job pride and salary findings from this study.

To further examine the recreation finding, we'll be assessing emotional exhaustion using a dedicated validated instrument, as well as compassion fatigue — sometimes referred to as secondary PTSD — which can occur when providers work closely with patients experiencing significant trauma. We'll also assess compassion satisfaction, the sense of reward that comes from helping people through difficult circumstances, and moral distress, which arises when a provider knows the right course of action but is prevented from taking it by external factors such as structural bias, insurance barriers, or lack of institutional resources and support.

 This is the first study ever conducted specifically on sickle cell providers, and I hope it starts a conversation because burnout can be uncomfortable to talk about, and admitting to it can feel like an admission of weakness or lack of commitment. It's neither. This is a systemic problem, and that's what this work is helping us understand.

Burnout prevalence among hematology-oncology physicians caring for sickle cell disease is markedly higher than among peers not treating SCD, despite comparable work hours and similar grit and resilience. Lower job pride, reduced recreation time, and lower compensation—paradoxical given greater seniority—cluster with higher burnout and suggest institutional undervaluation and insufficient programmatic support. The pattern implies disproportionate cognitive and emotional load, limiting recovery outside work. Ongoing work is targeting granular systemic drivers, including infrastructure gaps, compensation equity, advocacy burden, emotional exhaustion, compassion fatigue/satisfaction, and moral distress.

In the first study of its kind, researchers found that physicians treating sickle cell disease experience burnout at a rate of 60% — driven not by personal factors, but by systemic ones. 
