Dr Michael Patkin AM

FRCS FRCSEd FRACS

Dr Michael Patkin was a pioneer in the field of surgical ergonomics. He earned the status of being a member of the Order of Australia in 2011 for ‘service as a surgeon and to the study and practice of ergonomics’. It was a worthy reward for a lifetime of dedication to his profession and his patients.

Michael was born in Melbourne in 1933. His first love was mathematics – he was fascinated by numbers, codes and measurement. He memorised the Dewey decimal system of book numbering and was never happier than in a library or bookshop. He taught himself shorthand and to touchtype, learned FORTRAN, studied semiotics and joined a pistol club to learn about tremor control. He loved chemistry and destroyed his parents’ bathroom while testing his knowledge at home.

The young Michael studied medicine at Melbourne University and the (now demolished) Prince Henry Hospital. His later work in ergonomics ran alongside his professional career as a surgeon but was largely voluntary – an expenditure of energy and imagination, rather than a source of income. He won a Prince Philip Design Award for his design of a needle-holder in 1970.

Along the way, he spent almost 30 years in solo surgical practice in Whyalla, on South Australia’s Eyre Peninsula. It is notable that this success was achieved in a regional city rather than a teaching hospital or formal academic institution.

Ergonomics – a branch of the engineering discipline of human factors dealing with people at work and the design and use of tools and equipment – was not a feature of surgical or medical training in the late 1950s when Dr Patkin began his career. However, eager to overcome what he felt were his own inadequacies as a newly qualified surgeon, he began what was to become a life-long study in hand function, visual acuity, instrument design, dexterity, seating, and the many skills necessary for safe and successful work in the operating theatre.

Dr Patkin recognised that existing study and international research in the field of ‘human engineering’ by Murrell (Australia), Tichauer (America) and Granjean (Switzerland) had much to offer surgeons looking for improved operating outcomes. He knew that smoother, quicker and more efficient operating skills would help patient outcomes and offer financial and other advantages to the health system and its workforce.

His first paper on the topic, ‘The Hand Has Two Grips’ appeared in The Lancet in 1965 while he studied in London. Returning to Australia with his family later that year he began work in the Hunter Valley and continued to research and write on a wide range of topics, producing his article ‘Ergonomic Aspects of Surgical Dexterity’ in 1967.

In 1974, after a brief period as Fellow in Surgery at the Royal Newcastle Hospital, Dr Patkin moved with his family to Whyalla to set up in surgical practice. There followed a hectic period of research, writing and lectures to health colleagues.

This was the era of the new ‘micro-surgery’ and Patkin provided input and expertise on ergonomics and the operating microscope to surgical leaders in the field.

In 1985 Dr Patkin was elected President of the then Ergonomics Society of Australia and New Zealand. This appointment led to him travelling across Australia and overseas, bringing together the rich experiences of engineers, psychologists, medicos, architects, physiotherapists, human factors experts, and industry chiefs in the search for improved quality in workplaces, especially hospitals and operating theatres. The Ergonomics Society’s reach and importance expanded hugely during his Presidency, so the Society was well positioned when industry turned to it for advice and help when the repetitive strain injury (RSI) and workplace stress problems hit industrialised nations in the 1980s.

In 1986, in recognition of his long-time interest and involvement in computers and their relation to ergonomics, he was appointed Lecturer of the Year by the Australian Computer Society.

Increasingly, Dr Patkin was asked to consider solutions to the emerging workplace problems related to the ‘Information Age’ and the changing roles of people in offices and other work environments.

During the 1990’s Patkin directed his research towards keyhole surgery, which proved technically challenging for many surgeons practising it for the first time. Dr Patkin was familiar with the associated problems of tremor, confined spaces, poor lighting and bulky hardware, and sought ergonomic solutions that could be passed on through surgical training. These all came together in the paper “Ergonomics, Engineering and Surgery of Endosurgical Dissection Surgery” in 1995. He undertook research into the problems through videotaping narratives with operators across the world, during procedures, and conducted training sessions for surgeons in Adelaide.

These studies resulted in his major break-through work on ‘heuristics’, rules of thumb or mental shortcuts adopted subconsciously by skilled workers. Publications included ‘Fundamental Skills for Surgery’, a chapter in the training manual for the Royal Australasian College of Surgeons, and articles on surgical heuristics in the December 2008 issue of the ANZ Journal of Surgery which the Editor described as ‘priceless information which should be required reading for surgical trainees’.

Dr Patkin was a Fellow of the Royal Australasian College of Surgeons, the Royal College of Surgeons of England, the Royal College of Surgeons of Edinburgh, Fellow and Past-President of the Ergonomics Society of Australia and New Zealand, and a member of the AMA. Following retirement in 1999 he was appointed to an Honorary position in the Department of Surgery, at the University of Adelaide, The Queen Elizabeth Hospital,

Adelaide, and the Department of Surgery, Flinders University, Adelaide. He was appointed Adjunct Professor of Ergonomics in Surgery at Macquarie University, a Fellow of the Ergonomics Society of Australia, and a member of the Board of Governors, Communication Research Institute of Australia.

After retirement to Adelaide, Dr Patkin gave a series of lectures on ‘successful ageing’ to Fellows of the Royal Australasian College of Surgeons who were contemplating retirement, to help in self-assessment of their surgical skills and contribute to decisions about whether to retire or to remain effectively and safely operating where there was a community need. Other work included workshops on operating room and hospital design.

Dr Patkin undoubtedly gained personal fulfillment and satisfaction through his lifetime association with ergonomics. Surgery, and the patients and operators involved with it now and in the future, have also gained immeasurably through his inventiveness, determination, original thought, and his readiness to share his rich body of work with others.

Dr Patkin met and married Margaret in the Channel Islands in 1961. He was the father of four children and the grandfather of six. He died in Adelaide on 4 April 2023.

More information about Dr Patkin’s work can be found at mpatkin.org