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Study Examines the Ergonomics of Surgery and its Adverse Effects on Physicians

A JAMA analysis of 21 studies shows that surgeons are at risk of developing musculoskeletal disorders due to the way they stand and equipment they use.

Published: January 3, 2018

STANCE The way procedural surgeons stand, as well as the tools they use, contribute to such MSDs as carpal tunnel syndrome and rotator cuff pathology.

A study has confirmed what your achy laparoscopic surgeons could have told you: Minimally invasive surgery can be a grueling total body workout for physicians. An analysis of 21 studies found that surgeons and medical interventionalists are at risk of developing work-related musculoskeletal disorders (MSDs), largely due to they way they're forced to stand during procedures and the design of their equipment.

The meta-analysis in the Journal of the American Medical Association (JAMA) looked at 21 studies completed through 2016 regarding MSDs, including their prevalence among procedural physicians. A total of 5,828 physicians with an average of 12 years of practice were discussed in the studies that researchers analyzed.

Many of the doctors in those studies had similar MSDs; 19% had degenerative lumbar spine disease, 18% had rotator cuff pathology, 17% had degenerative cervical spine disease and 9% had carpal tunnel syndrome.

Researchers in the JAMA article said that procedural physicians were most at risk of developing MSDs, "due to long work hours involving repetitive movements, static and awkward postures and challenges with instrument design." The work of procedural physicians has been described by ergonomists as equal to some industrial work, according to the article.

Beyond causing pain for surgeons, the risk of MSDs can have negative aspects on a facility's finances and a surgeon's career. According to the article, 12% of physicians with work-related MSDs needed to take a leave of absence, restrict or modify their practice, or even go into early retirement.

"Little attention has been paid to the growing body of literature describing the work-related MSDs forcing these physicians to undergo surgery, reduce positivity and at times lose their careers," the article said.

While researchers couldn't offer up a solution, saying instead that more research needs to be done to determine how to effectively reduce the prevalence of MSDs, they did note several other recent analyses, which have examined the prevalence of burnout, depression and attrition in physicians.

"When considered together, these data suggest that some aspects of medical culture may be detrimental to the mental, emotional and physical health and career longevity of physicians and subsequently, may be detrimental to the volume and quality of patient care," the article said.

Anna Merriman

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