Green Giant
The Hippocratic Oath has served as the foundation of ethical medical practice since the fourth century B.C. Today, one of the oath’s core principles—the promise to do no harm—is guiding more than just bedside care. It is the cornerstone of the green movement in healthcare, a rapidly growing effort to help the profession evolve from one that simply cares for the sick to one that serves as a broader force for healing in society.
Some experts note the medical industry has been slow to understand the effects of its practices on public health. Barely a decade ago, U.S. Environmental Protection Agency (EPA) reports revealed staggering statistics: Medical waste incinerators were the leading producer of airborne carcinogenic dioxins, asthma rates for healthcare workers were among the highest of any profession, and healthcare waste was responsible for 10% of mercury air emissions.1
The incredible irony produced “a teachable moment,” says Gary Cohen, co-executive director of Health Care Without Harm in Arlington, Va., an international coalition established in 1996 to help make the industry more ecologically sustainable. Since then, hospitals have eliminated mercury from many of their supplies, including blood-pressure cuffs and thermometers. Additionally, the efforts to transform buying practices and lessen reliance on fossil fuels have gained considerable traction. And the number of medical waste incinerators in the U.S. has dropped from 5,000 to less than 100.
—ALICE ST. CLAIR / METRO HEALTH
“The healthcare sector began to understand the links between the environment and disease. They realized they were both addressing the collateral damage of a poisoned environment, and they were contributing to it,” Cohen says.
Now, even those who are critical of the profession’s past practices are lauding industry leaders’ efforts to build more efficient facilities, reduce waste, and modify day-to-day practices to lessen their environmental footprint.
“Hospitals have been so focused, rightly so, on patient safety,” Cohen says. “Now we’re at the point where we’re talking about patient safety, worker safety, and environmental safety. It’s changing the architecture of how things are done, and it is becoming much more accepted as a mainstream concern.”
Concern should stretch beyond the C-suite to those on the front lines, says Don Williams, MD, a pediatric hospitalist at Dell Children’s Medical Center in Austin, Texas, and a board member of Austin Physicians for Social Responsibility. “Although it is rare for us to see the direct effects of green choices on the health of individual patients, I think it is important to recognize that less air pollution and less global warming leads to less illness,” says Dr. Williams, who works in the only platinum-rated Leadership in Environmental Energy and Design certified hospital in the U.S. The certification, through the U.S. Green Building Council (www.usgbc.org), means the hospital meets the highest of standards in sustainable site development, water savings, energy efficiency, materials selection, and indoor environmental quality.
Hospitalists should be engaged in environmental stewardship because they often are seen as role models for hospital staff, residents, students, patients, and families, Dr. Williams says. “We are also frequently in positions of influence when it comes to instituting hospital policy,” he adds. “Hospital administration officials usually like to keep a friendly relationship with us, and are therefore typically open to our thoughts and concerns on everything from recycling programs to new hospital design.”
