MOVE YOUR FEET, LOSE YOUR SEAT

At the onset of the COVID-19 pandemic, a “remote by default” strategy¹ was advocated for general practice consultations, which resulted in a seismic, and a likely long-lasting shift towards telemedicine in primary care.² This led to some doctors working in general practice to lament, “I didn’t become a GP to work in a call centre!” The effect on the clinician-patient relationship has been discussed in detail,^1,3 however less attention has been paid to the impact this is having on the health and wellbeing of GP staff. Given that computer-work, paperwork, telephone and video consultations are all traditionally performed while sitting down, the reduction in face-to-face consultations has made general practice even more sedentary. Due to evidence linking excessive sedentary behaviour to many health problems, with a cumulative dose-response relationship with mortality risk,⁴ the World Health Organisation advises individuals to minimise and break up periods of sedentary behaviour where possible.⁵

One way of minimising sedentary behaviour is by using an “active workstation,” such as a height-adjustable sit-stand desk. In the general practice setting, active workstations allow clinicians to stand and/or move while undertaking computer-work, paperwork, telephone and video consultations (Figure 1). We researched the uptake of active workstations among GPs and GP Specialty Trainees in Northern Ireland, as well as exploring the opinions of GPs to their sedentary behaviour and physical activity. Among 320 participants, 18 (5.6%) reported having access to an active workstation in their practice, potentially allowing them to significantly reduce sedentary time. In subsequent interviews with GPs, multiple participants stated that they “hate sitting down all day long.” This shows that not all GPs are happy with the current sedentary status quo, and some are now actively taking steps to reduce this.

Figure 1.

A height-adjustable sit-stand desk in the primary care consulting room.

We hope these findings will encourage other clinicians working in desk-based specialties to consider how their sedentary behaviour is affecting their health and to contemplate ways to reduce this where possible. The colloquial expression “Move your feet, lose your seat” is used as a justification when a person steals another’s seat if they stand up or walk away from it. Is it time to reframe this statement for those working in General Practice as “Lose the seat, move your feet”? We plan to explore ways to help staff in primary care to be less sedentary and more physically active throughout the working day.