Urological Procedures and Impact on Advanced Practice Provider Burnout, Job Satisfaction, and Salary: AUA Census Analysis

Over 25% of advanced practice providers (APPs) in urology suffer from burnout. We hypothesized that procedural independence would be associated with lower burnout, higher job satisfaction, and higher salary for urologic APPs. The AUA Census data was used to conduct a retrospective cross-sectional study. The Maslach Burnout Inventory and independent procedure data was collected from the 2019 survey. Work-life balance responses were collected from 2022-2023. Salary data was collected from 2019-2020. Burnout was defined as high levels of emotional exhaustion or depersonalization, while job satisfaction was defined as responses of "satisfied" or "very satisfied." We used multiple logistic regression to test the association between performance of procedures and burnout, job satisfaction, and salary, controlling for demographic and job characteristics. Of 116 nurse practitioners and 83 physician assistants in 2019, 120 (60%) routinely performed independent outpatient procedures and 52 (26%) reported burnout. In adjusted analysis, increased work hours (aOR 1.02 per hour, P=0.02) was associated with burnout. Independent performance of outpatient procedures was not protective against burnout. Of 365 APPs in 2022-2023, 224 (61%) were satisfied with work-life balance and 216 (59%) routinely performed outpatient procedures. Performance of procedures was not associated with satisfaction. Increasing work hours was associated with lower satisfaction (aOR 0.95 per hour, P<0.01). Salary was not associated with independent performance of procedures. Independent performance of procedures was not associated with decreased burnout, increased job satisfaction, or higher salary for urology APPs. Work hours were associated with higher burnout and lower satisfaction.