A Kimberley-based physician, Dr. Ilona Hale, and a team of health care professionals, have produced a new resource, specifically aimed at clinicians called ‘Planetary Health for Primary Care’.
“It’s an online guide for healthcare providers meant to make the job of reducing our environmental impact in healthcare easier,” said Dr. Hale. “The Planetary Health for Primary Care guide offers a new way to think about the problem and practical tips on incorporating solutions into everyday clinical practice.”
“I think a lot of people in health care are looking for ways to make a difference,” she said.
The guide outlines ways clinicians can be climate advocates in their day to day work.
But it’s not just the standard green office practices, Hale says.
And for health care, it can go far beyond turning off lights and trying to use less paper.
The health care sector is one of the most polluting sectors, contributing five per cent of Canada’s total greenhouse gas (GHG) emissions.
Hale says a study in the UK a couple of years ago found that 80 per cent of the pollution created by the healthcare industry is related to medications and lab test.
“This resource outlines different strategies that address the bigger impacts—the upstream waste generated in the supply chain to produce materials required for medications, lab tests, surgeries, and hospitalizations—and offers tangible actions to decrease it, such as reducing unnecessary care, empowering patients, and shifting to prevention.”
It’s going to require physicians to think differently about the care they provide, she says. And it’s all part of the move to thinking about wellness and prevention.
“If you do a good job on wellness, no one really notices,” she said. Our system, she says is geared to providing tools, and medications, for various acute illnesses.
“The people who make the drugs are motivated by that,” she said.
But what if physicians, instead of just prescribing medication for say, blood pressure, spent more time talking to patients about eating healthier and a better diet, that could lead to them not needing medication at all?
“A lot of the tools to fix people are just common sense but we don’t think about it,” Hale said.
The Planetary Health for Primary Care guide can be accessed by the public on the Cascades Canada website or by healthcare providers on Pathways, a comprehensive, password-protected physician’s resource website.
Asked about getting buy-in to the guide, she said it will take time, but in speaking to individual practitioners she thinks they are interested. And the Ministry of Health is getting more and more interested in environmental impacts, she says.
The steps suggested in the guide are fairly straightforward:
• De-prescribe whenever appropriate.
• Ensure diagnosis of asthma or COPD have been confirmed when refilling inhalers
• Think of ways to reduce driving and encourage patients and staff to do same
• Start writing social/nature/exercise prescriptions
• Celebrate every patient who quits smoking in some way
• Avoid unnecessary testing
Hale notes environmental action in healthcare is becoming an increasingly important topic, and there is strong potential that sustainability will soon become a necessary component of value in the healthcare system.
“Low-carbon, high-quality care is a win-win-win: it improves patient care, reduces our environmental impact, reduces our workload, saves money in the system, and increases equity,” said Dr. Hale.
The Planetary Health for Primary Care guide was supported by the East Kootenay Division of Family Practice and Cascades Canada, a Government of Canada initiative. Prior to writing the guide, a working group on Planetary Health in Primary Care was engaged. As well, a multi-disciplinary review was conducted in two rounds by healthcare professionals from across Canada along with input from patient partners.