Greening the White Coats

Elyas Bakhtiari, for HealthLeaders Media, April 30, 2008

When the president of the AMA issues a call to action to physicians, it usually is related to reimbursement cuts, malpractice litigation, or another familiar advocacy issue tied to the business of medicine. But when AMA President Ronald M. Davis, MD, addressed physicians in an AMA eVoice column last week, he asked for physician commitment to a different cause—making healthcare “green.”

“I urge you to make your practice greener in ways that are ecologically sustainable, are safe for public health and the environment, and promote good patient care,” he wrote, going on to suggest that environmental awareness should be a part of medical school courses and continuing physician education.

Will physicians heed his call? Some have already gone green. New Orleans ophthalmologist Eric Griener, MD, decided to emphasize environmentally-friendly building principles when designing and constructing a new eye clinic. Alan Greene, MD, (yes, that’s his real name) has found a nice marketing niche for himself as a prominent “green pediatrician.”

The benefits of going green in healthcare construction and marketing have already been demonstrated for hospitals—technology editor Gary Baldwin has covered eco-friendly technological innovations for HealthLeaders Magazine and marketing editor Gienna Shaw has written about the benefits of waving the green flag. The same basic principles hold true for physician practices, though there are limitations.

The reimbursement and cost woes that seem to permeate every aspect of physician practice management also limit the amount of time and resources physicians can dedicate to environmentally friendly medical practices, at least for now. Given the challenges physicians are facing in implementing EMR systems—which provide significant ancillary environmental benefits by reducing paper usage—asking for more extensive facility redesign or green marketing efforts may be too ambitious, particularly for small and medium-sized practices that are struggling financially. When given the choice between purchasing carbon offsets and investing in medical equipment, I think we know what most doctors will have to choose.

But, as Davis points out, health and the environment are inextricably linked, and many physicians are naturally inclined toward environmentalism. For now, most of these physicians will take incremental steps, focusing on simple practice improvements that don’t require heavy investment (energy efficient light bulbs, to use a basic example, can actually save practices money).

For an idea of where healthcare environmentalism might be headed, however, look to the North. Last fall, the Canadian Medical Association (CMA) voted overwhelmingly to encourage physicians to discuss environmental issues with patients, reduce and recycle practice waste, and include environmental programs in medical education. The AMA has a less-ambitious environmental policy, and Davis considers the CMA’s environmentally-friendly meetings an inspiration.

Healthcare is headed toward greener pastures, though the road may be slow-going. Have you made an environmentally friendly practice improvement? I’d love to hear about it.

Elyas Bakhtiari is a managing editor with HealthLeaders Media. He can be reached at
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