By Dr. Talar Tejirian
The medical field is considered to be intellectually challenging and demanding of time. Physicians are expected to be available for patient care with little consideration of their personal time. As surgeons, we chose our specialty knowing that we would be dedicating a large portion of our time to our career. However, we rarely consider the high physical demands of our job. Surgery is a mentally, emotionally, and physically demanding career. Unfortunately, the physical demands of operating have long been ignored both by individual surgeons and surgical societies at-large.
Finally, we are now discussing the health of us surgeons. A surgeon’s physical health is an important part of our overall well being and career longevity. Ergonomics is a key factor in our success, as is physical preparedness, training, and recovery.
Studies show that almost three quarters of surgeons report some form of physical pain, most commonly with the back, neck and arm/shoulder. These reports of pain are universal, span all surgical specialties, and are equally prevalent between traditional and minimally invasive surgeons. Meanwhile, the “surgeon culture” seems not to encourage us to admit that such a problem exists. Surgeons and their team are typically not proactive in preventive measures towards physical health. Surgeons often ignore their signs and symptoms until it is pathologic. The physical toll from the act of operating can result in numerous consequences for surgeons, including the abrupt and unwelcomed end of one’s career.
I learned the true reality of these consequences when my career was cut short 20 years too soon. It took the need for cervical spine surgery and subsequent permanent nerve damage to my arm to realize that we surgeons must prioritize our physical health. Ideally, surgeons should manage their career to minimize risks of physical injury.
We can maximize and improve the health of us surgeons by focusing on improving ergonomics in the operating room and protecting non-negotiable time for physical training and recovery.
Prevention is key. Improving ergonomics in the operating room involves many facets. First, dedicated ergonomics training is needed starting in medical school and continuing through residency and among seasoned surgeons. The training should be both general and individualized. As the ergonomic challenges to each surgeon are unique, training programs and hospital systems should invest resources to maximize the ergonomic benefits to each individual surgeon’s height, body habitus, and other physically unique aspects. In addition, simple practices, such as micro-breaks, can be incorporated with universal benefit.
However, ergonomics alone is not enough; it is only one piece of the puzzle. If we are to really maximize surgeon physical health, we must consider the physical training and recovery needed for this very physically demanding profession. Just as athletes train their bodies to maximally perform their jobs, we as surgeons must routinely do that as well. The physical training must start from day one, and just like clinic time or meetings, it needs to be regularly scheduled. Professionals such as occupational and physical therapists who understand the physical demands of operating should be used to assure the highest level of training and recovery.
Focusing on the physical health of the surgeon is a new, but salient concept. It requires a significant culture change which includes recognizing the problem and finding permanent solutions to minimize harm to surgeons. Surgical ergonomics and surgeon physical training are key components. Surgeons need to recognize that physically suffering and living with pain is not an acceptable part of our job. We can and hopefully will improve this for the good of our colleagues and our profession as a whole.
Please join us on Monday, February 21, 2022, from 8-9 pm EST for an AWS Tweetchat about Surgical Ergonomics! This chat is being hosted in partnership with SAGES and will focus on all aspects of our surgical career that affect our body mechanics and, thus, physical well being. The chat will be moderated by Dr. Talar Tejirian and other guests from SAGES (@SAGES_Updates). We will also be welcoming non-surgeon experts in the field that can help answer your questions regarding appropriate posture, exercises, stretching, and so on. The questions will be posted directly from the @WomenSurgeons Twitter account. You can also find them by following the hashtag #AWSchat. If you have not participated in a tweet chat with us before, check out this tutorial written by Dr. Heather Yeo (@heatheryeomd) to know more. We will be discussing the following topics during our tweet chat:
Q1: Why is surgeon physical health important? What are the consequences of not paying attention to the physical health of the surgeon?
Q2: How can we surgeons change the collective mentality of the ideal physically super-human surgeon?
Q3: What are the components of surgeon physical health? Which parts of the body are most at risk?
Q4: Why is ergonomics important both in and out of the operating room? How can we improve open, laparoscopic, and robotic surgery to reduce injury? Are there products available that can help maximize ergonomics?
Q5: What are the limitations to surgical ergonomics? How can residents and medical students also maintain appropriate physical health while training under the rigors of their attending surgeons?
Q6: Why do surgeons need physical training? How can we best obtain that training? What are sample exercise routines that can help surgeons?
Q7: Is physical recovery needed? What is the best way to allow our bodies to heal?
Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.