This episode of the podcast is sponsored by Q-optics: https://q-optics.com/pages/surgicalergonomics-drlal

Disclosure:

Q-optics is a paid sponsor and the affiliate link above supports the podcast at no cost to you. It also provides you with a discount, so we hope that it is a win-win!

Paul W.M. Fedak, MD PhD, FRCS(C) is a cardiac surgeon and Director of the Libin Cardiovascular institute at the University of Calgary. He is also a scientist and physician-writer who leads at the forefront of medical innovation and academic medicine. His work explores the intersection of excellence, identity, and healing — especially the silent cost of high achievement in healthcare. Through his leadership, writing, and speaking, Paul invites a new conversation about moral injury, burnout, and the path from performance to presence, helping to reconnect medicine with its deeper purpose.

In this episode Dr. Fedak

- Shares how he started experiencing pain during the course of doing his job, ultimately leading to irreversible injury while operating

- Discusses how the culture of surgery (not showing weakness, accepting symptoms as a part of the job, lack of back up and redundancy in our medical systems) often prevents surgeons and other proceduralists getting the help they needed when they first start experiencing symptoms

- Acknowledges that fear of losing their livelihood and stigma attached to having physical limitations are huge barriers to surgeons reporting their symptoms

- Shares how the gap between his expectations regarding the results of his surgery and how his recovery actually went led to a mental spiral, clinical depression, shame and a loss of identity

- Explains how he found a new purpose and meaning in his suffering via writing and sharing his story

- Reminds us that we can take steps to reduce our risk of injury, but that workspaces within our institutions and instrument design also need to improve

You can reach Dr. Fedak via LinkedIn at: https://www.linkedin.com/in/paul-w-m-fedak-md-b833b417a/?originalSubdomain=ca

You can learn about the Society of Surgical Ergonomics here: https://www.societyofsurgicalergonomics.org/

You can learn about work-related MSK injuries among cardiothoracic surgeons in this article: https://pubmed.ncbi.nlm.nih.gov/37659461/

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Sarah Temkin, MD is a first-time filmmaker, director and producer. She was trained as a gynecologic oncologist and spent over 2 decades providing surgical and medical care for women with cancer of the female genital tract. She held leadership positions in academic medicine, served on multiple national committees and is widely published in the medical literature. She has contributed throughout her career to conversations about equity in healthcare, including gender equity within the physician workforce. She was inspired to make the award-winning short documentary film 1001cuts, informed by her lived experience, after leaving clinical practice in 2020.

In this episode, Dr. Temkin

- Shares her reasons for leaving clinical medicine and making the film 1000cuts

- Explains how working with instruments that weren't designed for them became apparent as one of the many "cuts" women surgeons face during the course of their careers

- Emphasizes that having diversity of people, thought and practice in the OR makes things better for everyone, including our patients

- Discusses how a lot of progress has been made regarding making intrumentation in the OR more inclusive but that we still have work to do

You can reach Dr. Temkin at: https://www.linkedin.com/in/sarah-temkin-214a76309/

Learn more about Dr. Temkin's film : https://www.1001cuts.org/

Watch the trailer for the film 1001cuts: https://www.videoproject.org/1001-cuts.html or alternatively you could just share the film website which has links to accessing the film through the film.

Webinar on stapler issues: https://www.societyofsurgicalergonomics.org/ and scroll down to the section Surgical Stapler Design and Usability

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Dr. Josh Mezrich is a Professor at the University of Wisconsin and holds the Mark A. Fischer Chair in Transplantation. His surgical interests include liver transplantation, kidney transplantation and laparoscopic donor nephrectomy. He is the surgical director of the living donor kidney program. He runs a translational science lab investigating the role of the microbiome and serum biomarkers on organ quality in brain dead donors. He is the inventor and co-founder of the MezLight (www.mezlight.com), a sterile surgical task light designed to provide high-definition illumination of surgical fields and ease the physical burden on surgeons.

Josh’s first book, When Death Becomes Life, was published by HarperCollins on January 15, 2019, and has sold in 12 countries outside the United States. His second book, Every Living Creature: How Xenotransplantation Will Change Our Lives, will be published in spring of 2026.

In this episode, Dr. Mezrich

- Discusses the issues with current lighting options in the OR and how they prompted his interest in inventing a new one

- Provides us with a list of attributes the wanted the new light to have, including not needing to be placed on the surgeon's head

- Describes his journey from the initial prototype of Mezlight to the currently available model

- Explains the challenges and opportunities faced by clinicians on an entrepreneurial journey

- Elaborates on his best practices for improved ergonomics in the OR including emphasizing the importance of microbreaks

Dr. Mezrich can be reached at: https://www.linkedin.com/in/josh-mezrich-555498190/

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Dr. Kris Chrouser is an Associate Professor in Urology and the S. Matthew Berge Research Professor at the University of Michigan and the VA Ann Arbor Healthcare System. Her research aims to maximize surgical outcomes by optimizing surgeon performance, intraoperative teamwork, and surgeon wellbeing. In addition to teaching operative urology, she also educates trainees in surgical ergonomics, non-technical skills, and improving workplace wellbeing by utilizing quality improvement techniques. She serves as site director for the VA surgery CRQS program and is the High Reliability Organizational (HRO) Clinician Champion at the Ann Arbor VA.

In this episode, Dr. Chrouser

- Familiarizes us with the Surgical Stress Effects model that she developed to study the impact of various factors (including intangibles) that can influence surgical and procedural outcomes

- Discusses how surgeon/proceduralist discomfort can affect non-technical (and sometimes technical) performance and many safety events can be traced to issues with communication and other non-technical skills

- Explains why we don't have quantitative data regarding how physician work-related musculoskeletal (MSK) injury can affect patient outcomes i.e. lack of reporting

- Reviews the prevalence of work-related MSK injuries among urologists and shares tips and trick to help mitigate the risks

- Highlights the importance of an "Occupational time-out" after the pre-incision time-out in order to help optimize the environmental factors

- Shares the (unpublished) data from her study implementing ergonomic best practices among OR teams

You can reach Dr. Chrouser via email at chrouser@med.umich.edu

You can access the OR stretch app at https://orstretch.mayoclinic.org/

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Shari Stevens is a licensed massage therapist in Iowa City, IA and is the owner and operator of A Healing Touch Massage. She received massage training at the Carlson College of massage therapy in 1999. She also has additional training in trigger point massage, myofascial massage, assisted stretching techniques such as Active Isolated Stretching and Stuart Taws' Soft Tissue Release. Before learning massage, Shari worked as a lawyer for 10 years.

In this episode Ms. Stevens

- Shares her journey of her career transition from attorney to massage therapists

- Helps us understand what is meant by myofascial pain

- Reminds us about the different types of massage therapy available including Swedish massage, Myofascial release, Shiatsu (accupressure point-based) etc.

- Shares tips on how to find an appropriate massage therapist and what typical treatment programs might look like

- Gives us some tips on how we can work on trigger points by ourselves at home

You can reach Shari at icmassage.net

The Trigger Point Therapy workbook: https://www.newharbinger.com/9781608824960/the-trigger-point-therapy-workbook/

Theracane: https://theracane.com/

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Dr. Ian S. Soriano is a general, gastrointestinal and bariatric surgeon and serves as Director of robotic surgery for the UCSF Department of Surgery. Dr. Soriano's research focuses on using laparoscopic and robotic techniques to reduce surgical complications and improve patient outcomes. He also studies ways to support the longevity of surgical careers through robotics and ergonomics.

In this episode, Dr. Soriano

- Provides tips for setting oneself up for ergonomic success in laparoscopic surgery with proper table height, anti-fatigue mats and placement of monitors

- Discusses the history and ergonomic challenges of laparoscopy and specifically laparoscopic retractors and staplers

- Explores the differences between manual and powered staplers with respect to patient outcomes, surgeon ergonomics and costs

- Provides tips for setting oneself up for ergonomic success in robot-assisted surgery, including choice of chair to sit on

- Describes the importance of breaks and stretches in both types of surgery

- Reminds us to pay attention to the ergonomic concerns of the assistant at the bedside in robot-assistant surgery

- Shares that using hand-activated cautery and other energy devices also helps us to reduce ergonomic strain

You can reach Dr. Soriano here: https://www.linkedin.com/in/ian-s-soriano-md-67996a83/

Watch the webinar on Staplers at the Society of Surgical Ergonomics website: https://www.societyofsurgicalergonomics.org/

Explore the OR stretch app at: https://orstretch.mayoclinic.org/

Review the ACS Ergonomics taskforce recommendations at: https://www.facs.org/for-medical-professionals/education/programs/surgical-ergonomics/recommendations/

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Dr. Amy D. Zhang is an associate clinical professor of the glaucoma service at the University of Michigan Kellogg Eye Center. She was previously at Case Western University where she was the glaucoma fellowship director. Her clinical interests are her work in minimally invasive glaucoma surgery and home tonometry. She is the well-being director for the Department of Ophthalmology and most recently a faculty associate of the Office of Well-Being at Michigan Medicine. She has an interest in improving ophthalmic ergonomics and looking into addressing drivers of burnout across the health system. She has collaborated with the School of Kinesiology and has current collaborations with Industrial Engineering examining the role of human factors engineering in healthcare.

In this episode, Dr. Zhang:

- Emphasizes that ophthalmologists have very high rates of work-related MSK symptoms

- Describes best practices for ophthalmology trainees and practitioners to set themselves up for ergonomic success in the OR (especially with the microscope) and in the clinic (at the slit lamp)

- Shares tips and tricks for working ergonomically in clinic workrooms with computer workstations

- Discusses the ergonomic challenges faced by proceduralists with the onset of presbyopia and provides us with key points to discuss with our eyecare providers when getting fitted with eyewear

Use this article and included toolkit published by Dr. Zhang to describe your work to your eyecare provider

Dr. Zhang can be reached here

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Marc S. Rubin,MD is a colon and rectal surgeon who has been practicing on Boston’s North Shore for 30 years. He is Chair of the department of surgery at Mass General Brigham – Salem hospital, previously served as Division Chief of Community Surgery at Massachusetts General Hospital and is an Assistant Professor of surgery at Harvard Medical School. Nationally, he is a past Governor of the American College of Surgeons and has served as an Associate Editor of the journal Diseases of the Colon and Rectum.
In this episode, Dr. Rubin:

- Tells us about his own journey with musculoskeletal symptoms pertaining to his neck, which ultimately led to a career-altering injury

- Emphasizes that surgical leaders need to take an active role in not only shining a light on the problem of work-related repetitive strain injuries among surgeons but also work to help remedy the current situation

- Shares how he advocated for ergonomics coaching and equipment with administration at his institution by making both a wellness and financial case

- Stresses the importance of including all the stakeholders when advocating for ergonomic changes in procedural areas (which might have helped reduce some of the pushback and barriers to implementation) i

- Points out that education may not be effective on its own and it is therefore important to hardwire changes in the environment so that good ergonomics is the default situation

- Shares his own experience with my video-based ergonomics coaching (using AI based proprietary software developed by my partner Linda Miller) and how it helped improve his ergonomics both inside and outside the OR

- Suggests that we need to work with our hospitals and specialty societies to develop ergonomics guidelines that can implemented without being burdensome

- Recommends that we work to make safe spaces for early reporting of symptoms so that employees can get the help they need before injuries become chronic or permanent

You can reach Dr. Rubin here.

You can learn more about Sugical Ergonomics coaching I offer here.

Follow us on LinkedIn, X, Instagram and Facebook and please reach out to us if you have any suggestions regarding episode ideas and guests or if you'd like to be a guest on the show