QS104 - Trends of Physical Injury Amongst Colorectal Surgeons – An ASCRS Survey on Surgeon Wellbeing

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Purpose/Background: Physical injury remains understudied among healthcare providers, particularly colorectal surgeons who may be at increased risk. The high ergonomic demand of the operating room not only contributes to injury, but also limits surgeon capacity for patient care when physical injuries do occur. There is a paucity of literature describing surgeon perceptions on strategies to mitigate physical injury and downstream effects. We thus sought to identify patterns of injury among colorectal surgeons, the effects on surgeon practice, and possible solutions.

Methods/Interventions: This cross-sectional survey captured surgeon demographics, practice pattern and setting, as well as the cumulative incidence, type, and treatment of physical injury. The survey was distributed to all members of the ASCRS via email, and responses were anonymously collected in REDCap between February and May 2024. Univariate analyses were performed of demographic and practice variables comparing surgeons who had experienced physical injury against those who had not.

Results/Outcomes: A total of 325 surgeons completed the physical wellbeing survey, out of whom 188 (58%) were male. The mean age of respondents was 49 years (SD 10.5 years). Surgeons most commonly practiced in an academic setting, 141 (43%), and most commonly operated 10-20 hours weekly, 157 (48%). One hundred and fifty-five surgeons (48%) performed >75% of cases minimally invasively (MIS).
One hundred and eight-five surgeons (57%) experienced at least one physical injury over their careers. Of these, 93 (50%) sustained injuries at work and 46 (25%) during sports. Seventy-four (40%) surgeons sustained injuries mid-career at 5-15 years of practice, and 38 (21%) late-career after 15 years. Of all injuries ever sustained, hand/wrist (31%), lower back (29%), neck (27%) and shoulder (26%) were the most common. Ninety-one surgeons (49%) reported requiring physical therapy, 44 (24%) required surgery, and 23 (12%) required extended leave from work. As a result of physical injury, 78 surgeons (42%) changed operative positioning or equipment, 22 (12%) changed their typical surgical approach, 26 (14%) changed retirement plans, and 21 (11%) changed clinical focus.
Surgeons who suffered an injury were more likely to mid-career aged 45-55 (44% vs 23%, p< 0.001), operate >20 hours weekly (42% vs 32%, p=0.047), and take call >3 nights weekly (18% vs 6%, p=0.008) compared to those who did not suffer an injury. There were no differences across gender, practice setting, presence of trainees or percent of MIS cases between surgeons who had suffered injuries and those who did not.
Eighty-four surgeons (45%) reported education about optimizing ergonomics in the operating room would have helped make injuries easier to deal with, while 80 (43%) reported having a less busy schedule.

Conclusion/Discussion: Physical injury commonly occurs among colorectal surgeons, particularly among those mid-career, those who operated greater than 20 hours weekly, and those who took more than 3 nights of call weekly. Injuries commonly occurred at work, affecting body parts that reflected the ergonomic challenges of operating. Physical injury may lead to significant consequences to surgeons’ careers, as those who experience injury often require invasive treatment or extended time of work, and changes practice patterns or career plans. Surgeons may benefit from better education on operating room ergonomics and less strenuous work schedules to prevent or mitigate physical injury.