"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 climateandhealth@bmj.com

  Action Who Calculations and comments Tonnes saved – per doctor Tonnes saved – whole profession Health benefits
1 Inform ourselves All doctors        
2

Advise our patients

  1. Better diet
  2. More walking & cycling
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

  1. Food = 2.5 tonnes/person/year; 5% reduction = 0.125 tonnes (e.g. halving of meat consumption). 0.125 tonnes x 120 patients = 15 tonnes per doctor.
  2. Exercise1. Car travel = 1.2 tonnes/person/year; 5% reduction = 0.06 tonnes. 0.06 tonnes x 120 patients = 7.2 tonnes per doctor.

Will increased exercise really substitute for car travel?



15.00 (GPs)



7.00 (GPs)


750,000




360,000
 
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.
0.06

9,000
 
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




0.6



0.3




0.5




90,000



45,000




75,000
 
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)
0.125

18,750
 
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
4.0

200,000
 
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
5.0

750,000
 
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
GPs    
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
Influencing colleagues 5.0 750,000
Total savings for changes in the workplace 5.125 768,750
     
TOTALS 32.5 tonnes per GP
6.5 tonnes per hospital doctor
2.3 million tonnes

Savings equivalent to the carbon emissions per year of nearly a quarter of a million people can be made through the actions instigated by hospital doctors and general practitioners.