Dr Richard Mayne, a general practice academic clinical fellow at Queen's University Belfast, who led the research, said that during his training posts in general practice he found he was spending a lot of time sitting down and wondered what impact this was having on his health.
The idea for the research came from a study in the 1950s when epidemiologist Professor Jeremy Morris looked at health outcomes and cardiovascular disease among bus conductors and bus drivers in London after the Second World War.
'What he found was that bus conductors lived longer and the bus drivers, unfortunately, died younger from cardiovascular disease than their colleagues,' Dr Mayne explained. 'And the main difference between the two jobs was the amount of time they were spending sitting down at work.
'So I was thinking, are GPs potentially the bus drivers of the medical world – at our desk all day with patients coming in and out and us just sitting down the whole time?'
Working in general practice
In hospital posts most doctors will be on their feet and moving around for much of the day, almost the complete opposite of general practice, Dr Mayne said.
The study aimed to quantify this by looking at how much time GPs and GP trainees spent sitting during the course of a working day.
Participants completed a questionnaire and also took part in an accelerometer study, which involved wearing a device on their thigh that could detect whether they were sitting, standing or moving.
'What we found was that most doctors working in general practice were averaging around 10 and a half hours of sitting or sedentary time over the course of every working day, which is very high,' said Dr Mayne. 'Among the GP trainees that were working in hospital settings, they were averaging less than eight hours of daily sedentary time, so it was a very significant difference in the two groups.
'And it does make you wonder whether this is having an effect on the health of GPs given that the more time you spend sitting, the higher your mortality risk.'
Harms of sedentary behaviour
Dr Mayne said that while the importance and benefits of physical activity is widely understood there is much less awareness of the harms of sedentary behaviour.
'The main issue is prolonged periods of sedentary time – sitting down or lying down – because basically your body goes into shutdown mode and you burn very little energy. You don't use any of the muscles in your legs, which are the main muscles for burning energy and for improving blood flow throughout the body as well,' he explained.
'Chronically, over time, it does lead to adverse cardiovascular outcomes, heart disease, as well as metabolic health problems like diabetes. A range of mental health conditions and things like dementia are all also associated with excessive sedentary time.'
Dr Mayne's session at the RCGP annual conference will be exploring what can be done to reduce sedentary behaviour and increase physical activity in practices. 'I hope we will get some good engagement with that and good suggestions,' he said.
He suggested that part of the problem is that people associate working behind a computer as being a job that has to be done sitting down. However, he said alternating between sitting and standing using height adjustable desks might be part of the solution.
'It's really trying to minimise the amount of time you're spending sitting down, especially for prolonged periods,' Dr Mayne said. 'And trying to move more through the working day.'
Dr Mayne said he is now involved in research looking at whether encouraging doctors to become less sedentary and more physically active throughout the day could help to reduce burnout, fatigue and other issues associated with working long hours in general practice.
- This session at the RCGP annual conference is A3: Are we sitting too comfortably? Exploring sedentary behaviour in practice staff. 11.15am-12noon, Thursday 14 October.
