Eye Docs Have More Aches and Pains Than Family Docs

Fran Lowry

October 25, 2011

October 25, 2011 (Orlando, Florida) — Eye care physicians have a higher prevalence of neck, hand, wrist, and lower back pain than family medicine physicians, according to a study presented during a poster session here at American Academy of Ophthalmology 2011 Annual Meeting.

It's because of the nature of the work they do, lead author Anna S. Kitzmann, from the University of Iowa, Iowa City, told Medscape Medical News.

"Anecdotally, ophthalmologists have a high rate of musculoskeletal problems," she said in an interview. "There have been a handful of studies on this topic, but they have only looked at ophthalmologists. There has never been a control group to see how we fare in comparison," she said.

In this case–control study, Dr. Kitzmann and her team emailed an electronic survey to ophthalmologists and optometrists at the University of Iowa and the Mayo Clinic, in Rochester, Minnesota, and to family medicine physicians at these institutions (who served as the control group).

As enticement to participate in the anonymous survey, the physicians were offered a gift card for Starbucks.

Of the 186 surveys completed, 94 were from eye care doctors and 92 from family physicians, for a response rate of 99% and 80%, respectively. The 2 physician groups were matched for age, sex, body mass index, years in practice, and other demographic characteristics.

Eye care providers reported a higher prevalence of neck pain (46% vs 21%; P < .01), hand and wrist pain (17% vs 7%; P = .03), and lower back pain (26% vs 9%; P < .01) than family physicians.

More eye doctors reported that their work was very stressful than did family doctors. Thirty-one percent of them reported high demand and low control in their jobs, compared with 20% of family physicians.

Additionally, fewer eye care doctors than family doctors classified their job as an active job (high demand, high control; 24% vs 47%; P = .01).

Industry Should Take Note

"A lot of us think the reason for this high rate of musculoskeletal pain is just from the equipment we use, which has never really been ergonomically updated," Dr. Kitzmann said.

"Bending over, working in awkward positions for a long time, grasping small instruments, being in a static position, bending and twisting — these are all things that contribute to musculoskeletal disorders. We would like the industry to take note and start to improve the design of their equipment," she said.

"I'm very glad to see this study," said Michael Kass, MD, from Washington University, St. Louis, Missouri. "A lot of ophthalmologists wind up with cervical spine problems and it affects their career longevity," he told Medscape Medical News.

John C. Hagan, III, MD, an ophthalmologist from Kansas City, Missouri, who was a general practitioner before specializing, told Medscape Medical News that he had to quit doing eye surgery at age 57 because of orthopedic problems, mainly involving the lower back.

"The disability insurance company contested my claim, but through research we were able to easily document the higher rate of orthopedic problems in surgeons vs nonsurgeons," he said. "My golf 3-some is now a 2-some as my 61-year-old ophthalmology friend is disabled from lower back problems. It is an epidemic."

There is no question that surgeons, especially eye surgeons, experience a higher rate of complications from musculoskeletal problems than general practitioners. There is also, in my experience, a much higher level of stress associated with being an eye surgeon than with being a general practitioner."

Dr. Kitzmann, Dr. Kass, and Dr. Hagan have disclosed no relevant financial relationships.

American Academy of Ophthalmology (AAO) 2011 Annual Meeting: Abstract PO095. Presented October 23, 2011.


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