Ergonomics, physician wellness plays big role in endoscopists’ health

CHICAGO — A survey intended to delve into the health of women endoscopists revealed a need for greater physician training as a whole to prevent injury and improve physician wellness, according to one presenter at Digestive Disease Week.

“Provider wellness is important. There’s a conflict between productivity, efficiency and vitality of our workforce. Provider wellness is considered the opposite of burnout and, ultimately, ensuring provider wellness allows for ongoing high-quality care,” Katherine S. Garman, MD, assistant professor at Duke University, said during her presentation.

Overall findings

Both men and women in the endoscopy field reported high rates of injury. Prior to entering the field, 46% reported injury, while afterward, 86% reported “some sort of strain or injury.”

Of those surveyed, 36% reported neck injuries, with 3.7% being debilitating. This was predicted by inability to move one’s screen and 15.8% reported a practice alteration to alleviate the injury.

Additionally, 34% reported injury in the left thumb and 21.2% resulted in a practice alteration. Lower back injury was reported in 35%, with 4.4% described as debilitating and 25.7% reporting a practice alteration.

After performing logistic regression analysis, Garman and colleagues linked injury since starting endoscopy to any prior injury (OR 2.5; 95% CI, 1.43-4.33), number of half days scoping (OR 2.45; 95% CI, 1.41-4.28), a request to increase production volume (OR 2.45; 95% CI, 1.41-4.28) and screen height (OR 0.823; 95% CI, 0.68-0.99).

In an effort to respond to their injuries, the following actions were taken: microbreaks were implemented by 15% of women and 13% of men; ergonomic time-out was implemented by 9% of women and 7% of men; 19% of women and 11% of men incorporated special clothing or equipment (P = .006); and 7% of women and 8% of men tried staying seated during endoscopy, though Garman reported this increased the risk of neck strain (50% vs. 34%, P = .026).

“In general, responses to injury reported by survey participants indicated a general lack of awareness of such strategies as taking microbreaks,” which Garman defined as a “small, biologically meaningful movement.”

Overall, 37% of respondents attempted changes to reduce the pain related to endoscopy. Most often, they adjusted the table height (76%), which was rated as the most effective change. Additionally, some adjusted screen height (53%), employed a gel mat (41%), reduced the hours of endoscopy (22%), bought support clothing (20%) and used microbreaks (20%).

Another interesting finding Garman reported was that “Vigorous exercise was associated with a decreased risk of injury after starting endoscopy.”

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