Are you ready to start taking climate action in your healthcare office or clinic? Are you wondering where to start? Here are 7 climate actions you can take in your practice today to be kinder to the environment and less climate-change-inducing to the climate.
1. Use nonsterile plastic (nitrile) gloves only when appropriate
That is, when you come into contact with body fluids, mucous membranes and open wounds. These gloves offer no protection to patients – they are often in an open box in patient rooms, where anyone can touch them and they have likely already been on the ground or touched by the last person getting gloves from the box.
And yet there is decreased handwashing because of them – we often don’t even wash our hands after taking these off, mistakenly thinking that we are protected because we wear these gloves!
And if that is not enough of a reason to eschew these gloves, how about the human rights abuses that have occurred in the manufacturing of them?
To be clear: these gloves are ONLY indicated if we will come into contact with body fluids, mucous membranes or open wounds. Have a look at all the money and plastic waste saved by these pioneers at the Great Ormond Street Hospital.
2. Switch to SMART therapy for asthma
SMART stands for Single Maintenance and Reliever Therapy, and it’s basically the appropriate replacement of two hydrofluorocarbon-emitting MDIs for Symbicort, a dry-powdered steroid and long-acting-beta-agonist inhaler.
This is medically brilliant for mild to moderate asthma patients, leading to increased compliance and better control of asthma. But it’s also pretty awesome for the environment (and so, our futures). The propelled MDIs, including all of the different brands of salbutamol we have in New Zealand, are propelled by hydrofluorocarbons (HFCs), which are potent greenhouse gases (GHGs).
The MDIs no longer contain the ozone-destroying chlorofluorocarbons (CFCs), but they are still propelled by gases that are the CO2-equivalent of a 225km car ride. If you are prescribing MDIs consider switching to dry powder inhalers (DPIs).
3. Curb your consumption
At work, this means challenging the “just in case” culture. And turning off lights and computers at the end of the day. Less consumption leads to less use of fossil fuels, less manufacturing, less transportation and less waste. Less consumption is always a right answer. Be mindful about how the environmental cost of something may tip the scales in your decision-making.
4. Practice good medication stewardship
-Only prescribe medications that are needed, for the shortest amount of time needed.
-Talk to patients about how they will dispose of unused medications.
-Consider the “hedge” prescription for new medications
Why is this important? Not only is there a tremendous amount of energy that goes in to the production of pharmaceuticals, but there is also a risk to the environment with appropriate as well as inappropriate use of them.
This study from 2022 looked at pharmaceuticals present in rivers across the world. Drugs enter our wastewater via manufacturing, inappropriate disposal and also after the meds have been appropriately prescribed to and taken by patients and then excreted. This study found drugs in most of the rivers that were surveyed, with caffeine, carbamazepine, metformin and paracetamol found the most. Drugs are not generally filtered out during wastewater treatment, or even drinking water treatment. And the effects of these drugs and their breakdown products on ecosystems within rivers can be devastating.
We need to be judicious about all medications that we prescribe. They cannot be reused and often are completely wasted. When that happens, the best-case scenario is that they are returned to pharmacies. In the worst cases they are disposed of in the sink or toilet (It happens – I’ve asked!) All NZ pharmacies can take back unused medications.
5. Recycle what you can, and put things into the right bins.
If you put your waste in the wrong bin, the whole bin gets contaminated and goes into landfill instead of whatever recycling channel it would have otherwise been destined for.
Some areas for disposal are particularly important. Put ONLY sharps in the sharps bin, and ONLY BIOHAZARDS in the biohazard bins. This waste is processed differently than the rest, and much more energy-consumingly. We must keep to a minimum what goes into these bins.
6. Travel actively and/or smartly. When that’s not possible, offset.
It’s not realistic that we won’t travel. But we must make more mindful choices about this. We must be mindful of the environmental cost of travel, and reduce it when possible. Use public transportation, walk or ride your bike to work, carpool. When it’s not possible, offset your carbon.
When you carbon offset something, you pay for a mechanism to take the CO2 out of the air that you have put in with the activity. This can be by planting a forest or forest maintenance. Or it can be investments in projects in clean energy. You can offset travel, running a business or your home, or even a conference. Putting money towards carbon offsets will also inevitably help you curb your own consumption, as this is another expense.
7. Set a good example and talk about why you’re doing it.
You have a perspective on what climate change will mean for us; you know that consumption cannot continue at this rate. So, demonstrate how we should be living now to prepare. Mend your clothes – it can be very fashionably done. Buy secondhand clothes and wear your amazing finds at work. Bring in your reusable water bottle, and your reusable coffee cup. Bring your lunch in jars or other reusable containers. The sustainable action needs to be the thing we all do, so make it fashionable. And talk about why you’re doing these things. You will make ripples!
Go out there and shine, sustainable doctor!
