"Ten Practical Actions for Doctors"
1. Inform ourselves about the basic science of climate change, the health benefits of taking action, and the urgency of doing so.
2. Advise our patients. Better diet and more walking and cycling will improve their health and reduce their carbon emissions.
3. Use less energy ourselves (and reduce costs) by more insulation in the roof, walls, and floors; turning off appliances and lights; and, where possible, reducing use of goods and services.
4. Drive the car less; fly less; walk or cycle more; use public transport; drive an efficient car; share cars; hold meetings by teleconference, videoconference, or webcasting; attend fewer international conferences.
5. Influence food menus wherever we go—ask for local food, less meat, and less processed food; a low carbon diet is a healthy diet. Drink tap water.
6. Advocate locally, especially in primary care, to maximise home insulation and uptake of relevant grants.
7. Advocate for personal carbon entitlements within an equitable, fair shares global framework, such as Contraction and Convergence.
8. Advocate to stabilise population—by promoting literacy and promoting women’s access to birth control, through the International Planned Parenthood Federation (www.ippf.org) or Marie Stopes International (www.mariestopes.org.uk).
9. Be a champion: put climate change on the agenda of all meetings—clinical teams, committees, professional networks. Doctors can tip opinion with chairs and chief executives.
10. Gear up your own influence and that of all health professionals by joining the Climate and Health Council (www.climateandhealth.org).
In 2008, the Climate and Health Council and the Health and Sustainability Network proposed these Ten Practical Actions for Doctors to Combat Climate Change, (BMJ 2008;336: 1507).
The primary focus is on action by doctors as health professionals, therefore estimates have been made for the potential carbon equivalent reductions that can be achieved through actions in the workplace (hospital or general practice).
The figures show that each GP, for example, could save the equivalent annual carbon emissions of three people through advocacy with patients and in the community (and probably a lot more if they really exercised their influence.)
These actions, which have deliberately been chosen because they require little or no money, are summarised in the table below, together with a first attempt at calculating the potential tonnes of carbon that might be saved
The next step is to quantify the health benefits of these actions. Could you help with this project? If you can contribute in any way, please contact us at firstname.lastname@example.org
|Action||Who||Calculations and comments||Tonnes saved – per doctor||Tonnes saved – whole profession||Health benefits|
|1||Inform ourselves||All doctors|
Advise our patients
GPs = 50,000
Realistic to expect action on both food & exercise?
Hospital doctors should make some contribution
Advice to 3 patients/week x 40/weeks/year = 120 patients
Will increased exercise really substitute for car travel?
|3||Use less energy at work||All doctors = 150,000||20% improvement assumed (reducing heating by 1 degree saves 8% on energy use; changing all light bulbs and switching off can save up to 20%). Public services infrastructure 1.2 tonnes per person. Assume 25% of this NHS = 0.3 tonnes. 20% x 0.3 = 0.06 tonnes.||
|4||Drive less, fly less||All doctors = 150,000||
Car travel 1.2 tonnes/person/year
Air travel 1 tonne/person/year
Car mileage: Halve car travel from 10,000 to 5,000 miles per year (Socolow wedge). Reduce emissions from 1.2 to 0.6 tonnes.
Fuel consumption: Drive cars with 60 mpg rather than 30 mpg (Socolow wedge). Assume remaining 0.6 tonnes halved to 0.3 tonnes.
Fly less: Halve to 0.5 tonnes
|5||Influence food menus related to work||All doctors = 150,000||Assume 5% reduction in emissions of 2.5 tonnes per doctor for food (e.g. halving of meat consumption = 0.125 tonnes)||
|6||Improving home insulation via community advocacy||GPs = 50,000||Assume 10% improvement in 10 houses due to action by each doctor. Energy at home = 4.0 tonnes per household. 10% = 0.4 tonnes x 10 houses = 4.0 tonnes per GP||
|7||Advocate for personal carbon entitlements within global framework|
|8||Advocate to stabilise global population|
|9||Being a champion||All doctors = 150,000||Assume each doctor influences 10 colleagues to reduce their carbon by 5% = 5 tonnes||
|10||Join the Climate and Health Council|
1NICE rapid review of effectiveness of brief interventions in primary care to promote physical activity in adults (2006) suggests that 5% probably a reasonable figure to use. However, follow-up sessions to the initial consultation are needed for long-term effect.
CONCLUSIONS: TONNES OF CARBON SAVED PER ANNUM
||PER DOCTOR (tonnes)||MEDICAL PROFESSION AS A WHOLE|
|Energy and transport (all doctors)|
|Use less energy at work||0.06||9,000|
|Drive 5,000 miles (not 10,000) in a 60 mpg car||0.9||135,000|
|Savings for energy and transport changes by health professionals||1.46 tonnes or approx 15% of total per doctor||219,000|
|Improved diet in patients||15.0||750,000|
|Reduced car usage by patients||7.0||360,000|
|Home insulation in the community||4.0||200,000|
|Savings for behaviour change in patients seen by GPs||26||1,310,000|
|Changes in the work place|
|Influencing work-related food menus||0.125||18,750|
|Total savings for changes in the workplace||5.125||768,750|
32.5 tonnes per GP
6.5 tonnes per hospital doctor
|2.3 million tonnes|