Hematologists and oncologists are more likely to experience burnout if their compensation model is based solely on clinical productivity and less likely to experience burnout if they work with advanced practice providers (APPs), according to results of a survey published in Blood Advances.

This survey was conducted in 631 hematologists and oncologists in 2019 using a validated, single-item burnout instrument. There were 411 complete responses included in the final analysis. More of the cohort worked in community-based practices (63.3%) than in academic practices (36.7%), and the vast majority of respondents were men (71.0%).

Compensation models differed between academic and community practices. In the academic setting, 8.0% of respondents had a relative value unit (RVU) model, 32.5% had a RVU plus salary model, 51.0% had a salary-only model, and 8.6% had a different model. In the community setting, 30.4% had RVU only, 35.7% had salary only, 19.6% had RVU plus salary, and 14.2% had a different model.

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Most respondents in the academic setting (74.2%) and about half of respondents in the community setting (50.8%) said they often worked with APPs. In both groups, physicians reported working with APPs across multiple areas, with the most common being hospital rounds and when performing invasive procedures.

Burnout was reported by 36.5% of the entire cohort, and 12.0% of respondents reported a high level of burnout.

Several factors were significantly associated with increased risk of burnout in a multivariate analysis. There were significantly higher odds of burnout with an RVU-only compensation model (odds ratio [OR], 4.37; 95% CI, 2.00-9.58). This association was sustained when stratified by practice type.

Female physicians had a greater likelihood of burnout overall (OR, 2.56; 95% CI, 1.24-5.28). This was more pronounced in the academic setting (OR, 6.84; 95% CI, 1.79-26.15) than in the community setting (OR, 2.07; 95% CI, 0.84-5.10).

Working with APPs decreased the odds of burnout (OR, 0.40; 95% CI, 0.20-0.80), which was driven primarily by physicians in the community setting (OR, 0.28; 95% CI, 0.12-0.65) rather than the academic setting (OR, 1.21; 95% CI, 0.18-8.12).

“Our findings raise a concern about the state of wellness of the hematology/oncology workforce and suggest that compensation systems focused exclusively on clinical productivity in either academic or community practices may be exacerbating physician burnout,” the researchers concluded. They added that “increased utilization of APPs in clinical practice may mitigate high burnout, specifically among community hematologist and oncologists.”


Ian Lee A, Masselink LE, De Castro LM, et al. Burnout in US hematologists and oncologists: impact of compensation models and advanced practice provider support. Blood Adv. 2023;7:3058-3068. doi: 10.1182/bloodadvances.2021006140

This article originally appeared on Hematology Advisor