We have made it to an era when even fast food restaurants stock biodegradable straws. Corn-derived utensils have been released from the confines of the Whole Foods salad bar and have made their way into a wider range of restaurants and delis.
There are pockets in this nation where composting is a city-maintained public service, where green bins enlist each and every home in the neighborhood to move one step closer to a greener lifestyle and to leave a lighter footprint on this earth. But the medical community — perhaps the one institution that has the most potential for enacting change — is lagging in the area of environmental consciousness.
During my transition between undergraduate and medical school, I worked as an operating room technician in a large hospital in the San Francisco Bay Area. I spent a significant amount of time opening cardboard boxes, stocking medications, organizing tubing and labeling syringes. Despite being the pinnacle of patient care and effective health care management, the quantities of paper products that were disposed of alongside non-recyclable material struck me as incongruous with the environmentally conscious culture beyond the hospital doors. In response to questions about why there were no recycling bins in this part of the hospital, I heard mumbles about patient information and how recycling would violate privacy protections. When an argument touches the topic of patient privacy it becomes a little trickier to discuss. Not one of us will challenge the primacy of patient welfare, the professional principle that states patient care and safety must come before all else. But there must surely be a way to expand the recycling protocol to at least include empty sterile saline bottles and the masses of packaging materials that are disposed of each and every day.
The medical community has the ability to serve as a vortex for impactful public education, translating basic science research discoveries made during sleepless nights in laboratories into common knowledge. Where health is concerned, each and every one of us has an instinctual perking up of the ears, a sense that yes, this does matter, because we all intuitively and through experience understand the importance of maintaining a state of health and wellbeing. Through health care, scientific knowledge gains irrefutable relevance. In this way medicine can become a platform for open discussion of our impact on the planet.
As physicians and physicians-to-be we have a powerful voice. We each have the ability to speak and be heard by our patients, our peers and our communities. We have struggled and sacrificed to join a profession that holds at its core a devotion to scientific truth and a love for the human race. It is time that our collective voice be used to educate the public on the health of our environment, as environmental health has monumental implications for the health of every one of our patients’ individual health.
I envision the medical practice as a place where higher learning and community engagement can come together and advance our collective decision-making. Medicine can steer us toward a more mindful way of living that will include treading lighter on this planet. Physicians sit on a wealth of knowledge and use their discernment and experience to impart knowledge to their patients. In this way, doctors can shape the world one patient at a time.
When speaking to a diabetic patient about his nutritional intake, a physician may recommend replacing juices or sodas with drinking water more regularly. This is where a physician can choose to take medical advice a step further, incorporating a nod to the sustainable use of our non-renewable resources. It takes a mere sentence to mention the favorability of utilizing a reusable water bottle and doing away with habitual purchasing of plastic water bottles. A physician can draw from her own awareness of endocrine disruptors to recommend a safe and healthy choice of reusable water bottle for her patient to purchase.
In a gynecological practice, the mindful physician can implement the same values in a context that is less publicly discussed. An estimated 12 billion pads and tampons are used and discarded annually, with the average middle class woman tossing over 300 pounds of these disposable products in her lifetime. The volume of such products that enter our landfill each year makes this industry exquisitely wasteful. But this doesn’t cross most people’s minds, because what other option is there? A growing proportion of women in North America use medical grade silicone menstrual cups. This reusable, medically safe alternative to disposable products keeps resources from entering our waste system and damaging our world. Environmentally-minded backpackers and midwives are the people who come to mind when many of us imagine who uses menstrual cups, but it does not have to be this way. Today safe, discreet and unintimidating menstrual cups are on the market and everyone deserves to know that they are a medically viable and environmentally friendly alternative. A health care professional would be an appropriate conveyor of this information.
A third convention that can easily take on a new dimension of awareness is the discussion of sunscreens or other body products that a patient may use in day-to-day life. When advising the use of sunscreen, physicians may mention products that are medically effective and minimally disruptive to both the patient and the planet’s ecological state. Not all products are created equal and a health care provider is the perfect person to impart knowledge of which products may contain harmful toxins or hazardous byproducts, and which manufacturers make efforts towards sound sustainable practices. A physician has the educational background to interpret the research, see past the advertisements and convey these truths to the people whose health he has sworn to promote.
The health care industry can impact the way we as a species relate to our planet in a systemic and perhaps more general manner. Any efforts to draw fringe products into the mainstream must begin with a widespread awareness of the product’s existence. Without knowledge of the options, there can be no choice.
A movement to ecologically sound practices in the hospital setting should not conjure up thoughts of surgeons in hand-me-down, second-hand surgical gloves. Instead, we might see a rise in the demand for biodegradable personal protective equipment such as gowns, gloves, goggles and masks. We could embrace post-consumer packaging for anything from Band-Aid wrappers to tongue depressors and push for solar powered buildings and emergency vehicles that run on electric energy instead of fossil fuels.
In practicing medicine we will continue to utilize resources for the betterment of patient health, but it is time to understand that asking questions about how to do so most resourcefully does not undermine patient care. On the contrary, it opens up the concept of health care to encompass many more avenues of wellness. It is time to take the lead and steer our field toward conscious decision-making by allowing ecological demand to translate accurately to economic demand. There are practices in this country and around the world through which such efforts are gaining momentum, such as the Healthier Hospitals Initiative, Sustainability at UCSF Medical Center and Practice Greenhealth. By spreading the word regarding current research and development and by ensuring that those in health care management are informed of the emerging systems in place, we can hope for a swift influx of scientific realism into the eco-ethical practices of the medical profession.