Prioritizing Patient Wellness—and Our Own

The doctors, researchers and staff at Kellogg put patients’ health and safety first. But as Amy Zhang, M.D., is quick to remind us, it’s just as important to look out for our own well-being.

“To give patients our very best, we have to be at our best,” says Dr. Zhang. A glaucoma and cataract surgeon, she is one of seven Faculty Associates appointed to the Michigan Medicine Wellness Office. The office is dedicated to improving well-being and reducing professional burnout among faculty, staff and learners. Faculty Associates like Dr. Zhang undertake scholarly projects that inform wellness policies across the health system.

Since joining the office in 2022, Dr. Zhang’s projects have included collecting and analyzing data on how physicians manage their in-baskets—the mailbox function within the electronic health records database. “Keeping current on correspondence and scheduling is one way to lessen daily stress,” she explains. She also analyzed health system-wide data on vacation utilization and presented her findings at the 2023 meeting of the AMA’s American Conference on Physician Health.

Now Dr. Zhang is addressing a specific workplace risk for ophthalmic clinicians: musculoskeletal pain and injury related to poor ergonomic design in equipment and instruments.

“It’s a bigger problem than we tend to acknowledge,” Dr. Zhang says. “It’s well documented that, as a result of our examination and operating room equipment, ophthalmologists are twice as likely as primary care doctors to suffer work-related neck or upper back pain.”

For example, the ophthalmologist’s go-to examination tool, the slit lamp, has remained essentially the same since its invention in 1911. Its design limits one’s ability to sit as close as needed, requiring overextension of the neck to compensate.

Ophthalmic surgeons, too, risk developing musculoskeletal pain from maintaining static positions and improper ergonomic positioning throughout procedures. And eye clinicians are also prone to repetitive motion injuries to hands and arms, such as carpal tunnel syndrome and cubital tunnel syndrome.

Over time, what starts out as discomfort can lead to serious upper extremity, cervical and spinal issues.

With grant support from Michigan Medicine, input from experts in ergonomics, biomedical engineering and physical therapy, and guidance on logistics and promotion from Kellogg’s cultural committee, Dr. Zhang is designing a pilot intervention for her fellow clinicians targeted for early 2024.

“The plan is to evaluate the effectiveness of offering ‘drop in’ instruction and support on-site to help clinicians learn simple exercises—micro-stretches—to counteract the postures we’re forced to maintain,” Dr. Zhang explains. “The intervention needs to be quick, easy and accessible, not just another item for an already jammed to-do list.”

In addition to the pilot intervention, Dr. Zhang is working with the AUPO to field a national survey of residents to gauge how early musculoskeletal issues arise.

“I didn’t realize how fit you need to be for a career in ophthalmology,” she acknowledges. “As physicians, we need to take the advice we give our patients about stress reduction, exercise and conditioning. It’s never too early or too late to prioritize habits that promote wellness.”

Header image caption: Amy Zhang, M.D.