Climate-smart practices
The role dermatologists play in a changing environment.
SUN01 – Practical Environmental Sustainability for Dermatologists
The climate is changing. Average temperatures are on the rise, as are extreme weather events like wildfires, flooding, and droughts. Although this can certainly be a problem for patients with climate-sensitive skin diseases, it can also be a problem for health care.
“While we are responsible for treating the health issues from climate change, ironically, the health care sector is also a major contributor,” said Eva Parker, MD, DTMH, FAAD. “The health care industry is among the most carbon-intensive service sectors in the industrial world, contributing 5% of global greenhouse gases. The U.S. health care system is particularly egregious as we are responsible for a quarter of these global health care greenhouse gas emissions — more than any other nation.” Dr. Parker is an assistant professor of dermatology and faculty lead for diversity, equity, and inclusion at Vanderbilt University Medical Center in Nashville, Tennessee.
During Friday’s Leadership Institute session, SUN01 – Practical Environmental Sustainability for Dermatologists, Dr. Parker said dermatology generates a large amount of procedural waste and has a high plug-and-process energy load usage that contributes to its overall footprint.
“Those emissions have a direct impact on public health,” she said. “In 2018, greenhouse gas and toxic air pollutant emissions from health care activities in the U.S. resulted in the loss of 388,000 disability-adjusted life-years,” according to a recent New England Journal of Medicine article (N Engl J Med 2022;387:2469-2476).
Re: Climate-smart practice
To address those issues and limit the negative environmental consequences of health care delivery, Dr. Parker said dermatologists will have to look at ways to structure their practices to be climate smart. For dermatologists, that means considering the six “R’s”:
- Rethink: Do we make too many products? Design a way that considers people and the environment.
- Refuse: Don’t use material or buy a product if you don’t need it or if it’s bad for the environment.
- Reduce: Cut down the amount of material and energy you use as much as you can.
- Reuse: Use a product to make something else with all or parts of it.
- Recycle: Reprocess a material or product and make something else.
- Repair: When a product breaks down or doesn’t work properly, fix it.
A shift in thinking
Dr. Parker said there are practical steps dermatologists can take to reduce waste. These include writing biologic prescriptions for a three-month supply, using pharmacies with sustainable packaging options, purchasing sustainable products, and reducing patient travel by relying more on virtual platforms to deliver care.
“One benefit to emerge from the pandemic is the proof of concept that leveraging teledermatology has the potential to not only increase access to care and save time and money for patients, but to also substantially lower carbon emissions,” she said. “It can be used for routine follow-up visits, including acne and isotretinoin, rosacea, psoriasis, and atopic dermatitis, and can be alternated with periodic in-person visits.”
Consider larger steps as well, such as adding solar panels to your practice, using the Health Care Emissions Impact Calculator from Practice GreenHealth to assess the impact of your practice, and exploring community-based renewable resources that make a local impact.
“In addition to a reduction in carbon emissions, embedding sustainability in your practice’s daily operations brings numerous advantages,” Dr. Parker said, “such as cost savings, reduced regulatory risk, enhanced employee engagement and retention, improved public health, and positive PR.”
