How to Care for Patients — and the Planet

Modern medicine comes at a significant cost to the environment: The energy-intensive industry generates greenhouse gases that drive climate change and unrecyclable waste that packs landfills.

Efforts to reduce the environmental impact are gaining momentum in the United States, with Rutgers Health and Rutgers University as a whole working to lead such efforts. Bishr Omary, senior vice chancellor for academic affairs and research, is the co-lead organizer of a series of ten commentaries about reducing gastroenterology’s environmental impact that was just published in the December issue of the journal Gut. These commentaries from international experts are freely available online and stem from a webinar series that is also freely available.

Omary explained how health care providers can care for the planet as well as their patients.

Why should health care providers take special steps to reduce their environmental impact?
About 8.5 percent of the nation’s total carbon footprint is related to health care activities. Two-thirds of this comes from the health care supply chain that health systems can influence as the buyers. For the remaining third, providers can play a more direct role by reviewing their practices for specific efforts to undertake. One major area to address for planetary health is the mitigation of recyclable and nonrecyclable medical waste.

Why is medical waste a particular problem for gastroenterology?
Within medical specialties and subspecialties, gastroenterology is a procedure-intensive specialty that is among the highest contributors to our greenhouse gas emissions and waste production. The commentary series includes specific, actionable efforts based on the three Rs of sustainability (reduce, reuse, and recycle) while ensuring that patient care is not negatively impacted.

How difficult will it be for the health care industry to reduce its carbon footprint?
The health care industry, which includes pharma, can play a key role in this effort. Simple measures include naming a sustainability lead to help guide efforts in each organization, working with major buyers and users to focus on the three Rs and taking a pledge to measure and reduce the carbon footprint of products. The latter is particularly important since it can guide the aspects to focus on.

How can health organizations and practitioners find and implement relatively easy steps?
Many medical societies and hospitals are forming climate change and sustainability committees, developing strategic plans and designating a sustainability lead to address the challenge. However, the number of organizations undertaking these efforts needs to grow. More and more resources and specific actionable steps are available online, including the webinars available through the World Gastroenterology Organization and the Gut commentary series. Three excellent sources of information for health organizations and practitioners seeking helpful information and ways to engage are Practice Greenhealth, Healthcare without Harm and My Green Doctor. 

Are health care systems elsewhere doing more?
From a global perspective, the leader is the United Kingdom’s National Health Service (NHS). Britain has pledged nationwide carbon neutrality by 2050, and the NHS has already begun implementing concrete, systemwide steps to reduce emissions and waste. In the US, the Department of Health and Human Services offers the opportunity for health systems to take a health sector climate pledge to reduce their carbon footprint. Many have done so, including our Rutgers Health hospital affiliates, the Robert Wood Johnson Barnabas Health hospital system and the Veterans Healthcare System. In total, more than 18 percent of the 6,129 hospitals in the US have taken the pledge.

What is Rutgers doing on this issue?
The university is doing a lot. For example, there is a plan to be carbon neutral by 2040, and there is also the recent creation of the Climate and Energy Institute at Rutgers–New Brunswick that will expand on the extensive existing Rutgers University efforts. In terms of activities by faculty at Rutgers Health schools and institutes, there are many examples, including work related to vulnerable populations and food security and research into microplastics and other environmental pollutants from fossil fuels such as black carbon.