As a family-medicine physician, I am accustomed to patients with anxiety. Some, like Michelle, toil in the anxiety of acute settings, like the claustrophobia of being in the middle seat of a trans-Atlantic flight. Others, like William, suffer from the persistent anxiety that occupies everyday life. While this is common in primary care, recently, one source of anxiety has become eerily too familiar in my clinic — climate change. More and more often, patients are coming to me worried about their future and asking what can be done.
At first, I responded to their questions clinically — I treated their symptoms of anxiety. But it didn’t feel sufficient, knowing the World Health Organization expects climate change to “threaten the essential ingredients of good health.” The more I threw away single-use plastic gloves after each patient encounter, the more I pondered my role as a physician in combating climate change.
I joined the Washington State Medical Association’s commitment to “support policies that both reduce pollution and address the issue of climate change.” But with the U.S. initiating its withdrawal from the Paris Climate Agreement, I wondered what it really meant to turn this organizational pledge into a practiced, institutional value that meaningfully addressed the concerns of patients.
I began exploring how varying sectors contribute to greenhouse-gas emissions. I discovered that nearly 10% of all U.S. carbon emissions are from health care. In fact, the U.S. health-care system, were it to be a country of its own, would be the world’s 7th largest producer of carbon dioxide. How could the health-care sector, so concerned in its calls to action, remain conspicuously absent from conversations regarding climate action?
It is time for the medical community to go beyond talking about the harms of climate change and start restructuring its own systems to address the active harm it is causing. We must look in the mirror and hold ourselves accountable.
There are numerous opportunities for health care to lead in climate action. For example, anesthetic gas-capturing systems could be used to limit the effects of anesthetic gases often used in operating rooms that warm the atmosphere at rates hundreds of times that of CO2. Health systems could model what the University of Washington Medical Center has done with “Meatless Mondays,” a practice that has helped the facility cut food consumption-related greenhouse gas emissions by 11.8%. Using renewable-energy sources, like Gundersen Health has done with dairy digesters, turbines and biomass boilers, can improve energy efficiency by 40%.
Perhaps most important, health-care systems can leverage their purchasing power in supply-chain procurement, as supply-chain procurement can account for 65% of all health-care carbon emissions. Health systems can ask suppliers to estimate their carbon footprint and that of their products. Even further, suppliers could be pressured to reduce plastic packaging and, when available, use nonplastic materials in order to limit the 7,000 tons of medical waste generated per day, nearly a quarter of which can be attributed to plastic packaging and plastic products.
These examples remind us that change is possible but requires concerted effort. Health-care leaders must move beyond financial metrics and include environmental impact in their planning, assessments and decision-making.
Moreover, we all must use the power we have within our own professions and institutions to demand climate action; the health-care sector is only one piece of this puzzle. It remains imperative to push for policies limiting fossil-fuel emissions. Additionally, if we are to address climate change, and prevent the projected 250,000 climate-associated deaths in upcoming years from malnutrition, malaria, diarrhea and heat stress alone, we need all industries to self-examine their practices. Each sector must consider the ways in which it can practice accountability. As world leaders met for the COP25 Climate Change Conference earlier this month , we need to take responsibility in our own professions and work toward a greener future.