70. A National Survey of Occupational Musculoskeletal Injuries in Cardiothoracic Surgeons
University of Minnesota
Minneapolis, MN
United States - Contact Me
Dr. Maddaus has had three careers during his 68 years of living:
The first was as a dedicated, and very successful, juvenile delinquent. He grew up as an only child with a violent alcoholic step-father and an alcoholic, suicidal mother living in cockroach infested apartments. From age 13 he spent most of his time on the streets stealing cars, breaking into places, and getting high. After the 25th arrest and 5 reform school stints, he joined the Navy to avoid going to prison.
After, he decided to switch careers, so he obtained his GED and with a monumental effort ended up being accepted to the University of Minnesota Medical School. He graduated in 1982 with honors and then went on to the general surgery residency at the University of Minnesota from 1982 -1990, and then to thoracic surgery training at the University of Toronto from 1990-1992. He joined the faculty of the Department of Surgery at the University of Minnesota in 1992 where he remained until his retirement in 2012. During that time he rose to full professor and head of the Division of Thoracic Surgery, and he held the Garamella endowed chair in thoracic surgery and was the director of the general surgical residency training program.
His third career is in the field of personal resilience born of his first career and of his experience with burnout and prescription narcotic addiction following major back and hip surgeries. Since his retirement, he has studied resilience and trained at meditation retreats, self-compassion retreats, and trained as a teacher of self-compassion. He has encapsulated his experience into a concept he calls The Resilience Bank Account, which is a set of 9 habits that are backed by strong science, that lead to physical and mental wellbeing and foster the reserves to manage the inevitable vicissitudes and challenges of all of our lives. His academic paper – The Resilience Bank Account, Skills for Optimal Performance – was published in January of 2020 in the Annals of Thoracic Surgery.
Massachusetts General Hospital
Boston, MA
United States - Contact Me
Camille Mathey-Andrews is a second year research resident at Massachusetts General Hospital interested in general thoracic surgery and thoracic oncology.
Description
Over the past several years, there has been growing concern that surgeons are at increased risk for work-related orthopedic injuries due to poor ergonomics. We sought to conduct a survey of cardiothoracic surgeons in the U.S. and Canada to evaluate the incidence of occupational injury among cardiothoracic surgeons, as well as cardiothoracic surgeons' perceptions of and use of ergonomic techniques in the operating room (OR) and office.
Methods:
Cardiothoracic surgeons identified through the Cardiothoracic Surgery Network were asked to complete a 33-question survey assessing their musculoskeletal health, as well as their perceptions and use of ergonomic techniques in the OR and office. Results were analyzed using Wilcoxon rank sum and Pearson's chi square tests. Multivariable logistic regression was used to identify characteristics of surgeons associated with an increased odds of experiencing a work-related injury.
Results:
Of the 602 surgeon respondents, the majority were male (92%) and between 56-65 years of age. With regards to specialization, 40% practiced thoracic surgery, 48% cardiac surgery, and 12% reported having mixed practices. The overall incidence of work-related musculoskeletal injuries was 64%, with 30% of injured surgeons requiring time off from work and 20% requiring surgery or the use of narcotics. Cervical spine injury (n=216) was the most common orthopedic injury attributed to operating, followed by lumbar spine injury (n=180) and neck tension (n=171). In multivariable-adjusted analysis, surgeons who predominately practiced cardiac surgery were significantly more likely to experience work-related orthopedic injury than thoracic surgeons (aOR: 3.4, p<0.01). Notably, 90% of surgeons reported that they felt that their institution did not provide sufficient ergonomics education and support for cardiothoracic surgeons and only 35% felt that the cardiothoracic surgical community is supportive of implementing ergonomics techniques in the OR and office.
Conclusions:
In this survey, North American cardiothoracic surgeons reported experiencing work-related orthopedic injuries at an alarmingly high rate, leading to significant time away from work and for many to retire from over a decade early from surgical practice. These findings illustrate a critical need for institutions to prioritize ergonomics education and implement ergonomics-directed techniques in the OR and office.