back to article Explosion of DANGEROUS IT GEAR injures and CRIPPLES MEDICS

It's not MRSA, radiation leaking from equipment nor the threat of being crushed like a paper cup beneath a tumbling obese patient which is threatening doctors at work: the fastest-rising danger to medics is computers and IT, according to a Cornell University study. A federal cash injection of $20bn into digitising the US …

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  1. Ole Juul

    To whine or not to whine

    doctors, complain of neck, shoulder and upper and lower back pain on at least a weekly basis, his survey findings show.

    Welcome to the world of work. I see people who do hard physical work outside in freezing weather who don't complain because they are getting paid well. They recognize and accept the trade-off.

    1. LarsG
      Meh

      Re: To whine or not to whine

      RSI, doctors will be required to learn how to sit in the correct posture......

      The cynic in me thinks that this maybe a good way to add to the pension pot before early retirement.

    2. The BigYin

      Re: To whine or not to whine

      Physician, heal thyself.

      These are doctors - the fact they don't have the wit to sort out their own ergonomics is worrying.

    3. The BigYin

      Re: To whine or not to whine

      "I see people who do hard physical work outside in freezing weather who don't complain because they are getting paid well."

      I bet they'd grumble if they got injured whilst working!

    4. Dave 126 Silver badge

      Re: To whine or not to whine

      >I see people who do hard physical work

      Physical work is good for you, as long as you work up to it. It is what our bodies are designed for; sitting on our posteriors with our joints moving repeatedly through the same narrow range of movement, they aren't. Back pain, for example, is almost unheard of in developing countries.

      I for one would rather be treated by a doctor who wasn't distracted by their own aching neck, or suffers pain in their wrist.

      1. Ole Juul

        Re: To whine or not to whine

        Dave 126: I for one would rather be treated by a doctor who wasn't distracted by their own aching neck, or suffers pain in their wrist.

        I agree with you there, but I really expect doctors to not be suffering from stuff like that if it is self inflicted, which the computer interface misuse most certainly is. Also, my comment about whining is partly related to the fact that I wake up with what to most people, would be an intolerable amount of pain. In cases like mine where there is no medical solution we learn not to whine, because it just makes it worse. I would hope that doctors would be setting an example, both regarding avoiding damaging body stresses, and whining. Remember, they're asking for money for something which others figure out on their own.

  2. Neil Barnes Silver badge
    Boffin

    But wait!

    Was it not shown in court, no less, that RSI didn't exist?

    1. The BigYin

      Re: But wait!

      Citation, please

    2. Anonymous Coward
      Anonymous Coward

      Re: But wait!

      "Was it not shown in court, no less, that RSI didn't exist?"

      Why does it hurt so fucking much then?

  3. This post has been deleted by its author

  4. Evil Auditor Silver badge

    Homo informaticus?

    I think it's safe to say that the time I and many other of El Reg's readers spend in front of a computer is far more than the average female, young doctor. Are we all total cripples and only too anti-social to recognise it? Or was it fast lane darwinism and we already evolved into a life-form that can spend half and more of its life sitting in front of a computer without being damaged whatsoever?

    1. Doogs

      Re: Homo informaticus?

      Could be. I spend most of the time I'm awake in front of a computer screen of some sort. I find that it's when I try to use the "correct" posture that my back, shoulders and neck start to ache. A sort of semi-slouch, leaning slightly to each side alternately, seems to be my most comfortable position.

      Would be nice to think I'm evolving into something, but I suspect it's more likely I've crippled myself from a life of sedentary jobs and dedicated laziness when it comes to exercise.

    2. Admiral Duncan
      Coffee/keyboard

      Re: Homo informaticus?

      Perhaps the fact that you're working with computers for the whole day means you're more aware of how to minimise the risk of getting RSI, back/neck pains, etc. It should also mean that you get a decent adjustable chair, desk, wrist rests if necessary. OTOH doctors are running around a lot to check their patients and computers are just another tool. If it's causing pain to a significant number of users then maybe it should be seen as a design problem, in the same way that if users consistently make mistakes when using poorly written software we should blame the developers or UI designers instead of always blaming the user.

    3. Goldmember

      Re: Homo informaticus?

      We could all be cripples, or evolved lifeforms, yes. I spend what many would deem to be an 'unhealthy' amount of time in front of computer screens, and have never had any day to day problems with neck ache, back ache or eyesight.

      I did, however, used to work in a hospital. I observed the doctors running around all the time, looking busy, and they would often use computers standing up, as if this would save them a few seconds. Worse than this, the PCs near the operating theatres were actually on high tables, and had what I would describe as bar stools in front of them; high chairs with foot rests underneath and no arm rests or back support. Using these was really the only time I have experienced aches from computer use. Perhaps a review of PC usage in hospitals and some education for the doctors might be necessary after all.

      1. Werner McGoole

        Re: Homo informaticus?

        Could it have something to do with IT people enjoying using computers and doctors hating it, perhaps?

    4. elderlybloke

      Re: Homo informaticus?

      Greetings Evil Auditor,

      I read it as the carrying around those new fangled Tablets being the cause of these girls suffering from stress and strain.

      Anyway they are much better than us at bearing pain, so it should not really be a problem.

  5. Anonymous Coward
    Anonymous Coward

    new shapes for computers and ways of interaction

    they need to finally start delivering computers in new forms with new input devices. A computer with a keyboard and a mouse is either obsolete from a usability point of view or meant for it technicians. I'm saying this because most users don't need to enter letters except for making searches - and there are other ways to do that (you could see a cloud with the most sought objects that day - for instance favourite query <<choose>>: which patient entered the hospital <<punch>> rotate arm to 9 o'clock <<hold 1 sec>> you get the list <<select person/data>>). My favourite would be virtual interaction in front of you while standing. The position of the virtual interacting device (floating keys/texts/pics/objects vertically shown via a stereoscopic screen) would slightly change to move the body stress centre constantly, just like some chair car systems shift slightly to make you adjust your position in order to save your back.

    1. Anonymous Coward
      Anonymous Coward

      Re: new shapes for computers and ways of interaction

      Just as long as a Touch screen is not your alternative. As AFAIK they are worse for RSI then a keyboard and mouse.

      Fit one of those handy sonar or laser detectors and you can gesture/type in the air. Neat! :D

      PS, even then someone will be foolish enough to bang their head on the table because they wanted to scroll down too fast.

    2. sabba
      WTF?

      Re: new shapes for computers and ways of interaction

      Having the display floating in front of you means you'll be putting more stress on your back and rotator cuff muscles since you'll be continually lifting your arm to move items.

      "Most people don't need to enter text except for searches" - how do you think your medical notes get into the computer? What about anybody working in the data capture industry (insurance agents, delivery men, secretaries)? I think you might be being a little short-sighted here. Note I'm not saying that there aren't better ways to get that data in, just that there is a significant proportion of the adult working population who need to enter text for things other than search.

      1. Anonymous Coward
        Anonymous Coward

        Re: new shapes for computers and ways of interaction

        normal people prefer to talk than to type.

        1. Ian Yates
          Facepalm

          Re: new shapes for computers and ways of interaction

          In an office environment or a busy hospital? I don't see how that could work.

        2. Graham Hawkins
          Devil

          Re: new shapes for computers and ways of interaction

          @ Ioan

          I don't know many normal people who talk to their computer. Curse it under their breath, shout at it, or possibly hit it, yes. But never talk to it...

          1. I ain't Spartacus Gold badge
            Happy

            Re: new shapes for computers and ways of interaction

            Graham,

            I don't know... I've had some success talking to my computer. A bit like with plants. A nice encouraging tone when asking it to stop hanging and open that file sometimes works. If not, harsh words and showing it the dismembered corpses of its brethren soon does the trick.

            1. Dave 126 Silver badge

              Re: new shapes for computers and ways of interaction

              @loan- points for considering alternatives, though it does sound a bit 'Minority Report'.

              Doctors need to make notes on the hoof... how about a chorded-keyboard? Held in the hand, or on a belt clip perhaps, it doesn't require your arm to be held in the same position.

        3. rory dobson
          FAIL

          Re: normal people prefer to talk than to type.

          Only for your experience of normal.

          I would rather *not* talk to MOST people... if I could possibly avoid them.

    3. Ole Juul

      Re: new shapes for computers and ways of interaction

      they need to finally start delivering computers in new forms with new input devices. A computer with a keyboard and a mouse is either obsolete from a usability point of view or meant for it technicians.

      It really bugs me that people comment on keyboards who are young and vigorous and ignorant of the needs of a worn and tired body. What you describe requires looking and choosing, which in itself means it cannot be done without a lot of small physiological steps. With a keyboard, one knows what and where the choices are without looking or using other stressful techniques. I think you'll find that newer setups for making input choices require movement of the arms and wrists. Likely also elevated stresses on neck and upper body muscles if the input mechanism is raised to eye level.

      As a post polio sufferer, I can tell you that the newer input methods I've seen produce a lot of stress on the body. The keyboard is an extremely low friction input method for many reasons. One which is often ignored, is that it does not require the use of the eyes to see and search. Unfortunately, some people don't learn how to type without creating unnecessary stresses, which is what this article is about. It's not hard to figure out if you're sensitive to small muscles or have taken classical piano lessons. If not, drop by here and I'll give you lessons based on a lifetime of dealing with these sorts of problems. What I have learnt is applicable to healthy people as well. Yes, I understand how a healthy young person might feel no need to consider small stresses, but please take the time to think this through and perhaps even study it a little. That way you may eventually be able to help people like me, instead of making our lives miserable.

    4. Gordon 11

      Re: new shapes for computers and ways of interaction

      A computer with a keyboard and a mouse is either obsolete from a usability point of view or meant for it technicians.

      No, it is not!

      The problem with menu-driven things is that you are then limited to what is on the menu (i.e. what the original developer could think of). Hence GUI applications are extremely limited. They need keyboard input for flexibility. (Although a virtual keyboard would do).

  6. sabba
    Happy

    Wireless keyboard, trackball and a good desk-chair combination...

    ...along with decent lighting will make all of the difference.

    Use of a mouse and fixed keyboard use to cause me all kinds of problems with my shoulders. Then I moved to a trackball, wireless mouse and things improved considerably.

    Not saying it'll work for everyone but...

    1. LaeMing

      Re: Wireless keyboard, trackball and a good desk-chair combination...

      I use a trackball at home - one of those logitech ones with the ball under the thumb. It took a few weeks to get used to but I am now very fluid on it. I still use a mouse at work still but I think the trackball is generally better

      At work I am not in front of the computer constantly - more often moving boxes of stuff about or climbing. about under the ceiling setting lights or data projectors for exhibitions, or or soldering or welding, etc., so plenty of varied movement away-from-desk. At home I am sitting in front of the computer for longer periods much more and I doubt I could stand a mouse there now.

      1. PC Paul

        Re: Wireless keyboard, trackball and a good desk-chair combination...

        I tried a trackball, and loved it.

        But within a few days I started to get a tingling feeling at the base of my thumb whenever I used it. I took that as a warning about RSI/Tendonitis and went back to a mouse. No problems since, but I still get the tingle whenever I try that trackball again.

        I guess I'm of the generation just before texting came in, so I didn't grow up typing with my thumbs...

        1. pepper

          Re: Wireless keyboard, trackball and a good desk-chair combination...

          I'm lefthanded so I use the Logitech Marble Mouse(trackball). Which uses the finger next to the thumb(no idea what the english word is) to control the trackball. Its also symetrical. Its quite nice. My father has a right handed trackball mouse where you need to use the thumb and I find it not as comfortable.

        2. sabba
          Happy

          Re: Wireless keyboard, trackball and a good desk-chair combination...

          Like anything it is important to find a device that fits your hand. Not all trackballs are equal and a trackball that works for one person might not work for another. Conversely, trackballs won't necessarily suit everybody. I do know however that of the people I know who have reported shoulder or wrist issues once I have persuaded them to move to a trackball instead of a mouse or trackpad their problems have lessened. Hardly scientific proof I know.

        3. Pookietoo

          Re: tingling feeling at the base of my thumb

          More likely the way you were resting your arm than the way you were moving your thumb, I think. I'm old and knackered and don't do txtng but I'd be more knackered without my Logitech trackballs.

    2. Anonymous Coward
      Anonymous Coward

      Re: Wireless keyboard, trackball and a good desk-chair combination...

      ... and a refrigerator full of beers, a snack cabinet, office with a window, these would help me forget the pain and suffering.

      Also, a raise.

  7. AndrueC Silver badge
    Stop

    I've had those problems for several years now. I find that a combination of stretching, taking a proper lunch break (out for an hour's walk) and a decent chair are keeping it at bay.

  8. Corinne

    Health & Safety at Work Act

    By law employers are (in theory) obliged to carry out workstation assessments and train staff in best practice in using them, which would include positioning of mouse/keyboard/screen & posture. However I've rarely had a workstation assessment (not since I worked in the Civil Service) though most bigger companies do have some on-line "training" in workstation use.

    I actually trained as a sports injury therapist many years ago so many family, workmates & friends ask advice on bad backs, necks & shoulders; the majority of their problems can be resolved by changing their desk seating habits along with mouse/keyboard & screen positioning (well over 50%) or their driving position. A big issue recently has been people using laptops rather than the traditional desktop with separate screen, keyboard & mouse as it's virually impossible to position a laptop so both the screen is at the right height AND the keyboard. Add into that people slouching over coffee tables rather than sitting upright at a desk or table & laptops are a recipe for back & neck issues.

    1. I ain't Spartacus Gold badge

      Re: Health & Safety at Work Act

      Please have an upvote, and my wholehearted agreement. Laptops are the scourge of decent posture. As someone with such poor eyesight that it's impossible to get a proper ergonomic computer position, I deal with it by changing position a lot, only using the top half of the screen (to keep my head/neck at the best angle), having my monitor on a weird looking stand, and using a tablet when I can. Laptops are horrible for me.

      But the effort it takes to get people in the office to do it properly, and not hunch up over their laptops, like Gollum gloating over The Precious... I had one guy stretching and making ouch noises every ten minutes for a month before I could persuade him to get a mouse, keyboard and laptop stand. Problem instantly solved.

      Also, if your chair's wobbling and falling apart, don't be a cheapskate. Fix it or get a new one. It may cost money, but it's cheaper than getting a new back.

      1. Dave 126 Silver badge

        Re: Health & Safety at Work Act

        @I ain't Spartacus

        Yep. Which is why I like the look of the Lenovo Yoga - that 'Ultrabook' that can be used a 'tent' position, or inverse 'L' position. This would make it easier to arrange on the desk for use with a separate keyboard, because its own keyboard can be rotated out of the way of where you would want to put a separate keyboard. i.e, you wouldn't need a fancy stand, just a pile of books and separate keyboard and mouse. It can also work as a tablet, allowing you to mix up the way you interact with it (by the touchscreen, or using the webcam to detect hand movements); as my old design lecturer was fond of saying: 'The best position is the next position'- don't stay in one position for too long.

        http://shop.lenovo.com/gbweb/gb/en/learn/products/laptops/ideapad/yoga/yoga-13/index.html

        If one is choosing a conventional laptop to be used in a stand, models that don't have audio ports or card readers on the front face work better.

    2. Dave 126 Silver badge

      Re: Health & Safety at Work Act

      >it's virtually impossible to position a laptop so both the screen is at the right height AND the keyboard.

      Which is why tablets* could prove to be a blessing- the screen can be placed in the correct position, independently of the separate keyboard.

      *I'm including any device, ARM, x86, without an integrated keyboard as a 'tablet'.

      This issue of the screen being mounted too low on laptops is even worse on 16:9 screens than it is on 4:3 or 16:10 displays, since it is the pixels at the top of the screen, not the bottom, that are lost.

  9. ukgnome

    Sloppy posturing

    This sort of report make me just a little mental (more so than usual)

    If a mechanic tried lifting cars so that he can service them it would be seen as a bad idea, so why don't people listen when it comes to working at a computer. I can only guess it's because of the facebook slave generation that thinks a computer is just an entertainment device.

    When I left school, before the world of computing I worked in a typing pool. The very very scary girls in the pool would often bark at me if I dared to slouch. And after 20 years sat down typing I don't have a bad back, or carpal tunnel or RSI, and it's all thanks to the very very scary pool mistress that used to bark orders at me. (she also used to touch me under the desk, but that's another rant.

  10. Pete 2 Silver badge

    Too much golf?

    So why to medics have more problems than IT professionals?

    It can't be due to the amount of time spent in front of a work 'puter - my local surgery only offers appointments for 3½ hours in the morning and 3 in the afternoon, with a 2½ hour break for lunch. And none of the GPs work all those shifts (and none of them work at all at weekends).

    Now, it's true that their offices are dingy little rooms with trailing cables and childrens' toys scattered around (is this how they drum up business? by booby-trapping their own work spaces. H&S would have a fit, as would any IT unionised company) and poorly sited desks - but that's no worse than a lot of the IT shops I've seen.

    Maybe the clue is in the "tennis elbow" remark? I may be tarring every IT worker with the same brush, but it does seem to me that in general IT people are less likely to spend time taking exercise than your average doctor. Apart from the fitness aspect, we just don't get such cushy shift opportunities with long breaks that need filling.

    1. Corinne

      Re: Too much golf?

      There's a difference between staff in GPs surgeries and hospital workers, I get the impression that the report is more related to hospital workers.

      When it comes to GP surgeries, the vast majority are either converted from other buildings (3 out of the 4 GP surgeries I've attended were large converted houses) or were built before IT became ubiquitous. As more & more IT was required, they just shuffled round what they had to try to accommodate it and rarely bothered to change existing desks, chairs & layouts. They also won't be of a size to have ergonomics or health & safety experts in house. On the other hand, nearly all IT workers are in buildings that have been built to allow for IT or have been converted specifically to allow for it. Due to the H&S laws around working with IT they have to supply appropriate furniture.

      Oh regarding your local GP surgery? I agree that the availability is pants (my curent one is just as bad), but please bear in mind that surgery appointment hours aren't the only work they do. There's a big chunk of other paperwork that goes into their job, and half the time they aren't working a "shift" of appointments they could be doing home visits or be part time at a different surgery.

  11. Anonymous Coward
    Anonymous Coward

    As a medical professional

    I do suffer from aches and pains in my right wrist....

    "the fastest-rising danger to medics is computers and IT, according to a Cornell University study."

    ...yeah, let's go with that. *cough*

    1. Anonymous Coward
      Anonymous Coward

      Re: As a medical professional

      Nudge nudge

      Wink wink

      How is it?

      1. Dave 126 Silver badge

        Re: As a medical professional

        Was it in El Reg that I read of an epidemic of RSI amongst men of a certain age? What was puzzling medics about it was that it was symmetrical- present in both wrists- so IT use didn't appear to be the culprit. The leading theory was that use of Viagra was causing these older gentlemen to engage in an activity in which their wrists would be supporting a large fraction of their body weight.

        Was it El Reg? If not, it was probably New Scientist. Sex-obsessed, that rag...

  12. geoffbeaumont

    If you'd seen the sort of user interfaces most medical software has you'd understand why the RSI... Efficient and intuitive they aren't... Even relatively light use of most of them involves a lot of repetitive actions.

    Of course there are other side effects to these dreadful UIs. They are slow to use, which means more time spent data processing (compared to paper forms) and therefore either fewer patients seen or less time spent with each patient (or a bit of both). In some cases they increase errors, usually because it's not obvious that after entering something you then have remember to go into a different bit of the system and approve what you've just done, or because a crucial bit of information about past decisions is hidden.

  13. disgruntled yank

    Not fair!

    You shouldn't lure us in with a headline promising explosions and then tell us about doctors with stiff necks and RSI.

    1. Robert Carnegie Silver badge

      Yes. Confusing.

      Not about actual computers actually exploding.

  14. John H Woods Silver badge

    I'll get downvoted, but...

    ... ban Qwerty already!

    1. Dave 126 Silver badge

      Re: I'll get downvoted, but...

      I won't downvote you. I will suggest that Dvorak users have been able to match their Qwerty speeds, but not surpass them. http://www.mit.edu/~jcb/Dvorak/

      That's not to say I think QWERTY is the last word in Human Text Input, though.

    2. harmjschoonhoven

      Re: I'll get downvoted, but...

      The problem is, if you use Dvorak over the weekend, you 'll have to adjust to Qwerty on Monday morning.

      As far as I remember the Dvorak keyboard was successfully tested on a US battleship.

      1. John H Woods Silver badge

        Re: I'll get downvoted, but...

        Thanks for your replies, guys.

        I would agree that Dvorak doesn't necessarily make you any faster, but it does make typing a lot easier for many of us. Because of my job I tend to have enough access to most of the machines on which I am required to work to remap the keyboard. I don't need to move the keys because I touch type (it's a great way to stop casual farting around at your terminal, because colleagues cannot commandeer your keyboard). Also nearly all HR will support your right to take your own keyboard in for health reasons (with the added bonus of better hygiene!) and you can quickly plug it in.

        But whatever happened to chording? A long time ago I had a colleague who could take dictation at conversational speed on a Microwriter with his hand in his pocket. There's got to be a better way of entering text, especially for mobile devices.

  15. lukewarmdog
    Coffee/keyboard

    Tennis Elbow

    "Doctors also complained of suffering from tennis elbow after carrying around a tablet computer."

    Erm tennis elbow according to my quick glance at wiki is caused by elbow movement. Carrying something around would not cause this.

    I'd also maybe point out that some kind of bag or satchel to put the (obviously extremely heavy) tablet in might help the (obviously extremely weak) doctors alleviate this condition.

    Did Alan Hedge hurt himself in any way during the creation of this report?

    New ergonomic keyboard icon. Obviously.

    1. Dave 126 Silver badge

      Re: Tennis Elbow

      You tend to move your arms as you walk, to keep the body in balance. This is also why sprinters have well-developed upper bodies, when at first thought one would assume they only need muscles in their legs.

  16. Steve Davies 3 Silver badge

    The medics just don't have a clue

    I saw my doctor last week and knew immediately that she was suffering from using the computer.

    Pretty well everything was wrong with her posiiton, screen height, mouse position and even chair height.

    She admitted that she was suffering from shoulder pains.

    Yet we go and get health advice this lot? Pah.

    The only ones who seem to be on the ball are the Army medics at Frimley Park.

  17. Magani

    Someone we know?

    "...the fastest-rising danger to medics is computers and IT..."

    The BOFH is moving to a medical centre?

  18. TheRealRoland

    Is this what is called...

    Making them eat their own dog food?

  19. b166er

    Perhaps a good use for Kinect?

    Good gesture and speech recognition could make some of these problems disappear.

  20. Flugal
    Joke

    '...rather than traditional methods such as dictation.'

    "Do you use a dictaphone".

    "No, I use my finger like everybody else"

    1. Blitheringeejit

      @Flugal

      I fear that modern mobile technology has finally put this lovely old gag out to grass - would anyone under 25 get it? IIRC it originates in the rotary-dial telephones of my youth, and was lucky to survive the transition to push-button dialling 30-odd years ago.

      Where do old jokes go when they die?

  21. This post has been deleted by its author

  22. Johnmae
    Facepalm

    Speaking of horrible postures, pretty much every doctor I've been to lately has had a miraculously bad position in front of the computer, usually with the screen in one corner of the desk, and the keyboard in front of the screen, meaning that they usually have to turn sideways to be able to type and/or see their screens.

    On top of that most have the height of the monitor and keyboard way of, and on top of that typing hunt and peck with high lifts of the hands.

    And what really annoys me is that it would be easily solveable by using an L shaped desk, one side towards the visitor, and the computer on the other side of the L, and with some typing training.

  23. hold2ransom
    Big Brother

    Sick note!

    Physician heal thy self!

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