Hospitals generate large amounts of waste, pollution, and greenhouse gas emissions through energy use, material waste generation, pharmaceutical use, testing, and temperature control. In fact, hospital care represents the largest share of U.S. health care emissions.1
Dr. Liu
By being in the center of hospital care, hospitalists are uniquely positioned to lead environmental health and sustainability efforts in their everyday work—clinically, operationally, educationally, and academically, said Katherine T. Liu, MD, who chairs a newer SHM Special Interest Group (SIG)—Environmental Health.
Dr. Chen
“We wanted to create a community of hospitalists who share our passion for understanding and mitigating the health impacts of climate and environmental factors,” said Catherine Chen, MD, who is vice chair of the SIG and also an associate professor of medicine and vice chair of quality and safety for the department of medicine at Robert Wood Johnson Medical School, a 650-bed academic hospital in New Brunswick, N.J. “Hospitalists have a lot of opportunities to decrease the carbon footprint of hospital care and promote health.”
“My goal in creating this SIG was to signal to other hospitalists that this is not only work that we can or should be doing, but it’s work we’re already doing through our roles as clinicians, educators, researchers, and leaders,” said Dr. Liu, a clinical assistant professor in the department of medicine, division of hospital medicine, at MaineHealth, a 700-bed academic hospital in Portland, Maine. “We need to amplify the dialogue and fill our toolkits so that this work can be effective and recognized.”
Founded in 2024, the Environmental Health SIG is intended to be a community for all facets of environmental health in hospital medicine. Dr. Chen’s work in this space currently focuses on healthcare sustainability, quality improvement, and medical education. Other members focus on a broad range of topics, including leadership, health care access, environmental justice, and advocacy.
Ultimately, the SIG’s core goals are these:
- Reduce the environmental impact of patient care delivery
- Promote clinical practices that support both healthy patients and a healthy planet
- Disseminate climate-smart practices (including tools and resources) through collaboration and education
- Build a national community of hospitalists engaged in environmental health, research, quality improvement, and leadership
When people don’t have a stable climate, clean air, safe water, and resilient infrastructure, Dr. Liu believes that their health suffers. Hospitals experience this routinely through heat and air quality-triggered exacerbations of chronic illness, infectious outbreaks, supply chain disruptions, and widening health inequities.
The Environmental Health SIG also emphasizes resilience, i.e., prevention at the healthcare systems level, and being prepared for climate-driven hazards such as heat waves, hurricanes, flooding, wildfire smoke, power outages, and optimizing resource use in anticipation of supply shortages, Dr. Chen said. All of this directly affects inpatient care.
Much of this work already includes what hospitalists do well, such as reducing unnecessary testing, early transitions from intravenous to oral medications, preventing readmissions, and improving resource stewardship.
“We’re building this SIG to amplify all of these good works,” Dr. Chen said. “The environmental health field is very much about accelerating change by sharing ideas and breaking out of silos.”
During the SIG’s kickoff event in January 2025, participants came with a shared desire to integrate environmental health into practice. They cited a diverse range of motivations, including the negative human health impacts of microplastics, emerging infectious diseases, environmental justice, high-value care, quality improvement, research, and administrative leadership. “We will strive to incorporate these topics into events as we move forward,” Dr. Liu said.
Early achievements include launching regular programming, building a presence on SHM’s online forum platform, HMX, and hosting a Special Interest Forum at SHM Converge Las Vegas 2025.
The SIG’s greatest ongoing effort is the “Sustainability Works in Progress,” or WiP, series on the HMX forum. These sessions allow hospitalists to present ongoing projects, get feedback, and learn from peers. A Special Interest Forum will be held at SHM Converge in Nashville in 2026.
Already 210 members strong, the Environmental Health SIG aims to increase educational offerings for hospitalists on environmental health and related topics, both through online continuing education and at venues such as SHM Converge, Dr. Chen said.
Recently created SHM learning modules on climate health feature topics that range from quality improvement and high-value care to practical guidance on carbon footprints so that hospitalists can quantify the environmental impact of current or future projects.
“Professional development and mentorship are important to our members,” Dr. Chen said. “We plan to continue to grow our offerings around these topics and hope that our current events serve as a platform for early career hospitalists and future hospitalists to learn from others doing this kind of work.”
“We’re looking forward to more members joining us,” Dr. Chen added. “Many hospitalists have been engaged in this work for years; others are interested in hearing more and want to figure out where to get started. Finding this like-minded group in SHM will hopefully spur more discussions and exchanges of ideas.”
Karen Appold is an award-winning journalist based in Lehigh Valley, Pa.
Reference
1. Eckelman MJ, Sherman J. Environmental impacts of the U.S. health care system and effects on public health. PLoS One. 2016;11(6):e0157014. doi: 10.1371/journal. pone.0157014.