Dr. Robert Marema: It’s Time to Prioritize Surgeons’ Quality of Life

Dr. Robert Marema: It’s Time to Prioritize Surgeons’ Quality of Life

July 22, 2019

Let’s not kid ourselves: The surgical workforce is in a crisis.

For starters, the Association of American Medical Colleges forecasts a deficit of between 33,500 and 61,800 surgeons and specialists by 2030.[1]

This projected shortage is especially troubling given an increase in the number of older Americans who need specialty care and services. Retirement decisions of practicing doctors will also have an effect on future physician supply, with more than one-third of all active physicians 65 or older in the next 10 years.

Compounding an impending shortage of surgeons in the U.S. are a number of workforce challenges like burnout and performance-related symptoms.

A report found that more than 90% of hospital executives said they expect their organizations to face a serious talent shortage in the next 10 years.[2]

That said, now is the time for hospital administrators to address the serious issues impacting surgeons so we can help maintain acceptable access to surgical care and improve patient outcomes.

At the heart of these issues are difficult working conditions that result in physical ailments due to repetitive tasks of the job. Physician comfort in surgery must be greatly improved.

Although the patient benefits of minimally invasive surgery are evident, research shows there is a need to improve the ergonomic conditions.

A study by the American College of Surgeons revealed that 87 percent of laparoscopic surgeons suffer from performance-related symptoms.[3] Laparoscopy often requires surgeons to hold a static position of the neck and back for a long period, and frequently uncomfortable position of arms and shoulders to optimize hand held camera and instrument positions and minimize movements within the operative field.[4],[5] Holding of the static posture for prolonged periods of time is the source of increased muscle fatigue and musculoskeletal disorders.

In addition to being physically demanding, being a surgeon in today’s environment brings unique mental and time stressors that are negatively impacting the surgeon and surgical staff workforce.

We have to constantly conduct complex procedures under time pressures within a setting plagued with distractions and interruptions while learning new technologies.[6] There is sufficient evidence that excessive stress can impair a surgeon’s hand-eye coordination while affecting their non-technical skills of teamwork and decision-making, highlighting the important effects of stress within the human factor in surgery.

And burnout among physicians is a pervasive problem that can lead to major medical errors.[7]

It’s astonishing that 40 percent of surgeons suffer from burnout according to an American College of Surgeons study.3 The number of cases performed per year is a stronger predictor of symptomatology than either age or years in practice. This is likely the reason why general surgeons nearly top the list of burnout rates (49 percent) among specialties in the 2018 Medscape Physician Lifestyle Report.[8]

We ultimately must manage our workload and take much needed time off to curb physician burnout, improve our well-being, keep up morale and focus our time and attention on caring for patients. This is a clarion call that we need to take better care of the surgeon so they can take better care of the growing patient caseload.

Perhaps technology advances will also be a solution rather than an added complexity in surgeons’ lives.

The original robotic surgical platform (the da Vinci System) was designed to improve surgeon ergonomics, but also added per-procedure cost that limited the full value robotics can play in today’s value-based healthcare environment. As such, less than 10% of surgery was performed with surgeons in a more ergonomic setting. Today, a new robotic surgical platform referred by some as digital laparoscopy (the Senhance Surgical System) can offer many of the ergonomic and control benefits needed by surgeons at per-procedure costs similar to traditional laparoscopy. That’s a promising, and frankly novel, direction for surgical tools to keep costs low while considering value to the surgeon experience.

The issues that surgeons face today aren’t going away tomorrow or next month. That’s why hospital leadership needs to come together to create a tactical, actionable plan that tackles surgeon burnout, improves ergonomic conditions and makes sensible investments in new technology to help surgeons do their job more efficiently and effectively.

Robert Marema, M.D., is Director of Bariatric Surgery, Flagler Hospital Bariatric Center, Saint Augustine, Florida


[1] https://news.aamc.org/medical-education/article/new-aamc-research-reaffirms-looming-physician-shor/

[2] The Economist Intelligent Unit. Beyond the tipping point: hospital resilience revisited. http://healthcare.prudentialretirement.com/_assets/documents_pdfs/hcflre5_eiusurveyhighlights2017_wcag.pdf

[3] Park A, Lee G, Seagull FJ, Meenaghan N, Dexter D. Patients benefit while surgeons suffer: an impending epidemic. J Am Coll Surg. 2010;210(3):306-313.

[4] Berguer R, Forkey DL, Smith WD (1999) Ergonomic problems associated with laparoscopic surgery. Surg Endosc 13:466–468.

[5] Esposito C, Najmaldin A, Schier F, Yamataka A, Ferro M, Riccipetitoni G, Czauderna P, Ponsky T, Till H, Escolino M, Iaquinto M, Marte A, Saxena A, Settimi A, Rothenberg S (2014) Work-related upper limb musculoskeletal disorders in pediatric minimally invasive surgery: a multicentric survey comparing laparoscopic and sils ergonomy. Pediatr Surg Int 30:395–399.

[6] Edgar M, Mansfield A, Thomson J. Surgeons under stress (II). Update following the college seminar/workshop on pastoral care. Ann R Coll Surg Engl. 2000;82:87–88.

[7] Blendon RJ, DesRoches CM, Brodie M, et al. Views of practicing physicians and the public on medical errors. N Engl J Med. 2002;347(24):1933-1940.

[8] Peckham C. [Accessed October 15, 2015];Medscape Physician Lifestyle Report 2015. http://www.medscape.com/features/slideshow/lifestyle/2015/public/overview

Medical Device News Magazinehttps://infomeddnews.com
Our publication is dedicated to bringing our readers the latest medical device news. We are proud to boast that our subscribers include medical specialists, device industry executives, investors, and other allied health professionals, as well as patients who are interested in researching various medical devices. We hope you find value in our easy-to-read publication and its overall purpose and objectives! Medical Device News Magazine is a division of PTM Healthcare Marketing, Inc. Pauline T. Mayer is the managing editor.

Experts Views and Opinions

The creation of CAR T cell therapy begins with collection of the patient’s blood and separation of the lymphocytes. These include T cells, B cells, and innate lymphoid cells, all of which are separated through apheresis (leukapheresis). It is this separation process which, if optimized, has the potential to revolutionize immunotherapy treatments for cancer patients.
The latest results from a clinical trial presented today at the VEITHsymposium in New York City demonstrate how new living blood vessels created through restorative medical devices have become reality and can open unthinkable treatment avenues for patients. Xeltis is developing cardiovascular devices, namely artificial vessels and valves, that gradually create living and long-lasting vessels made of patients’ own, new healthy tissue.
In the dynamic realm of entrepreneurship, where seasoned professionals often take center stage, the story of Sai Mattapalli and Rohan Kalahasty — both 17-year-old high school seniors — emerges as a beacon of inspiration. 
Within two years, the U.S. will have a shortage of 98,700 medical and lab technologists and more than 80% of health systems are currently reporting shortages in their radiology departments. More than half of the radiologists in the U.S. are 55 and older, and the flow of residents to fill the gap isn’t nearly big enough. The staffing shortage is even more acute among radiation technologists and in the U.K., 97% of radiology departments cannot meet diagnostic reporting requirements.
Dr. Litwin advises, "Approximately 60 study sites worldwide are participating in RESPONDER-HF, a randomized clinical trial of the Corvia Atrial Shunt." What to know more about this life-saving device? Read what this expert has to say.

By using this website you agree to accept Medical Device News Magazine Privacy Policy