Nicolette G. Payne, MD, discusses the rise in burnout among pediatric urologists

In this interview, Nicolette G. Payne, MD, discusses a recent study pointing to an increase in burnout among pediatric urologists since the 2016 American Urological Association Census, emphasizing that although the study itself wasn't designed to pinpoint the causes, several speculative factors can be considered.¹

One prominent theory suggests that younger generations of graduating urologists face increased financial pressures due to higher student loan debt. This debt can lead to greater pressure in their practice and a perceived need to work longer hours, a factor directly associated with higher burnout rates in the study. Changes to billing and reimbursement practices also contribute to these financial strains, intensifying the feeling of burnout.

Another significant contributing factor is the broader workforce shortage across all urology fields, not just pediatrics. This shortage may force existing providers to manage heavier patient loads and undertake more surgeries to compensate for the lack of available urologists, further exacerbating burnout.

An intriguing counter-theory, proposed by a reviewer of the paper, posits that previous generations of urologists might have developed greater resilience against burnout. This resilience could stem from their experiences with more demanding residency programs and fewer work-hour restrictions, leading to lower expectations and a higher tolerance for challenging work conditions as attending physicians. Essentially, their residency experiences might have created a "protective factor," making their attending lives seem less burdensome by comparison.

Payne concludes by stating that although their paper doesn't delve into the underlying causes, identifying these factors and exploring them further would be the crucial next step in understanding and addressing the rise in burnout among pediatric urologists.

REFERENCE

1. Payne NG, Salevitz D, Dvorak N, North A, Grimsby GM. Prevalence, risk factors, and coping strategies for burnout among pediatric urologists. Urology. 2025 Jun 13:S0090-4295(25)00592-8. doi:10.1016/j.urology.2025.06.025