A surgeon’s pain: realizing how many have musculoskeletal issues

Posted on July 9, 2018

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(Last Updated On: July 16, 2018)

This will be a three part series:

 

Recognizing how many surgeons are in pain

Our starting point:

Prevalence of Work-Related Musculoskeletal Disorders Among Surgeons and Interventionalists: A Systematic Review and Meta-analysis

When you visit a personal trainer, dietitian, or nutritionist, you really don’t want them to be overweight. After all, if they can’t keep themselves healthy, you’re going to think how can they help you?

It’s alarming then how many surgeons are in pain! There are

“higher prevalence estimates of work-related musculoskeletal disorders among at-risk physicians compared with the general population and even labor-intensive occupations, such as coal miners, manufacturing laborers”

Who thought being a surgeon was harder on the body than being a coal miner!?

At-risk physicians means procedural doctors. Think a doctor who is routinely operating equipment.

  • Orthopedic surgeon
  • Cardiac surgeon
  • Cancer surgeon
  • Plastic surgery
  • Dentist

Those are what everyday people are most familiar with. But really, any doctor regularly working with tools falls into the at-risk group, which is 20.4% of all physicians!

For these at-risk groups, there is a

  • 17% career risk of degenerative cervical spine disease
  • 18% career risk of rotator cuff pathology
  • 19% career risk of degenerative lumbar spine disease

But we’re just getting started. When we look at pain only in the past year,

  • 60% had neck pain
  • 52% had shoulder pain
  • 49% had lower back pain

This is more pain than construction workers experience! (In some cases double the amount.) Even worse, 12% of these doctors will need time off, have to reduce their practice hours, or retire early. In health care workers, musculoskeletal problems are the number one cause of time off work.

 

Why this is an issue

 

If you’re in pain, you’re not doing your job as well

It doesn’t matter if you’re shooting a basketball, drilling an ACL tunnel or performing a root canal, if you’re in pain while doing the procedure, you’re not doing it as effectively as you could be.

Being in pain means being distracted. It means compensating your technique. It means your mind isn’t as focused on the task at hand. (Understandably!)

 

Surgeons are losing money

Initially, whenever the word surgeon is mentioned, the thought of $$$ isn’t far behind. But we know it’s more complicated than that.

You go to school for a loooong time. You can easily be well over a quarter million in debt by the time you start practicing, which for some isn’t until they are in their mid-30s. You’re deeply in debt, and have quite a few years of earnings to make up for. And you all but assuredly can’t make up those years later on. That is, you can’t work until you’re 80 instead of 65. In the United Kingdom, it is mandatory to retire by 65 (70 if in private practice). In America, orthopedic surgeons plan to retire by 62.

Missing work, not being able to practice as much, having to retire earlier than you wish, nobody wants to see that happen to a profession. Particularly when so many everyday people rely on this profession for their health. The average individual will have seven operations in their lifetime. There is already serious concern about surgeon work shortages in the years to come, which is only exacerbated by these musculoskeletal problems.

 

Patient perspective

This goes back to our overweight personal trainer. Or, if you’re a psychiatrist, your patients don’t want to see that you’re also mentally ill. If you’re a surgeon, while patient interaction is less than primary care, it helps if your patients see you’re healthy.

 

Pain contributes to burnout

  • Rate of burnout amongst general population? 28%
  • Rate of burnout amongst surgeons? 53%

 

These numbers are increasing

  • In a 1997 study, 8% of surgeons were found to have degenerative lumbar spine disease.
  • In 2004, it was up to 29%
  • In 2015, it increased even more, to 35%

 

Surgeons aren’t being helped, and don’t know how to help themselves

“85% of at-risk physicians are concerned by work-related musculoskeletal disorders and resulting disability, and more than 90% state that formal ergonomics education should be standard during training, yet only 6.9% to 17% report receiving any ergonomics education during their training, most of which is described as sporadic, informal intraoperative directives.”

These at-risk doctors have gotten to the first step: they’ve accepted there is a problem. But they haven’t gotten to solving it.

 

Why are surgeons so beat up?

In part two, we’ll look more deeply at what doing surgery entails, why it can beat you up more than being a coal miner, but also, why are the numbers increasing? Where we’ll examine how non-surgical factors have changed too.

 

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