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

Valentina Restrepo-Espinosa, MD

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% of white and 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

Valentina Restrepo-Espinosa, MD

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