Tuesday, October 27, 2020
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Where Do You Stand On the AMA’s Environmental Sustainability Policy?

No one’s dissing the importance of environmental sustainability or denying that global climate change isn’t happening with every breath we take – or have difficulty taking! We don’t believe climate change is a hoax and we do believe that every human being should do their part to protect planet Earth. As the saying goes: There is no planet B.

What we’re not sure about, though, is the role physicians – as a professional collective and not as individual human beings – should play in protecting Mother Nature.

Let’s use both sides of the stethoscope to listen in on the scuttlebutt. (For the record, medgoo is sitting on the proverbial fence. But then it’s not our job to diagnose – only present the symptoms.)

A Treatment For Environmental Sustainability and Global Climate Change

The American Medical Association (AMA), our nation’s premier physician organization, brought together physicians, medical students, and residents representing all 50 states and every medical field during its November 14 through 19 Interim Meeting. As part of the meeting’s agenda, the AMA House of Delegates voted to adopt several new policies aimed at improving the health of our nation. Starring on its list of statements was support for efforts to promote environmental sustainability and halt global climate change.1

As far back as 2016, the AMA has taken the position that it’s no longer an option to stand still and watch climate change continue to affect public health across the world. Past and present policy statements promise to assist physicians in adopting environmentally-sustainable programs in their practices, boldly encourage physicians to assist in educating patients and their community on environmentally sustainable practices, and urge the medical community to serve as role models for promoting environmental sustainability.2

“Scientific surveys have shown clear evidence that our patients are facing adverse health effects associated with climate change,” emphasizes AMA Board Member Willarda V. Edwards, MD. “From heat-related injuries and forest fire air pollution, to worsening seasonal allergies and storm-related illness and injuries, it is important that we make every effort to put environmentally friendly practices in place to lessen the harmful impact that climate change is having on patient health across the globe.”

Preceding and certainly in sync with the AMA’s policy statement is The Call to Action on Climate Health and Equity, released in June 2019 and citing health threats posed by climate change as “a true public health emergency.” The statement is a cumulative effort from more than 70 major medical groups in the US, including the National Medical Association, American Academy of Pediatrics, American College of Physicians, American Heart Association, American Lung Association, American Academy of Family Physicians, and American Public Health Association.3, 4 Although the statement’s language leans toward proverbial legalese, there are moments when the physician’s role in corralling global warming seems implied. For instance, “Proactive support is required to…effectively communicate the health threats of climate change together with the health benefits of climate action.”

Yes, But …

No physicians to our knowledge say that our planet’s climate crisis isn’t a serious threat to human health – including increased respiratory and cardiovascular disease, injuries and premature deaths related to extreme weather events, changes in the prevalence and geographical distribution of food- and water-borne illnesses and other infectious diseases, and threats to mental health.5 Going a step further, some of the country’s greatest leaders in the eco-friendly space are in healthcare, making a difference from their clinics, specialty practices, urgent care facilities, and hospitals.

The question, however, is whether or not the medical community has a responsibility to specifically educate the public – aka their patients – about climate change health threats.

Here are several current thoughts rumbling around out there as to why a physician might not want to discuss global warming and climate change with patients. We’re not saying these arguments hold water; we’re sharing.

Physicians don’t have time for climate change education. A 2018 survey by the Physicians Foundation reports that doctors on average work 51 hours a week and see 20 patients a day, with almost a quarter of their time taken up with nonclinical paperwork.6 Research published in BMJ Open puts the average physician appointment in the U.S. at about 20 minutes.7

Some doctors express concern about bringing up a topic laced with political implications. After all, the exam room is supposed to be a safe place. Are controversial political issues best left in the waiting room?

There are no guidelines for educating patients. In fact, most medical doctors are self-taught in terms of climate change and how it’s creating unprecedented health risks. We know this because a 2018 study, published in Academic Medicine, found that only 20 out of 140 U.S. medical schools even offer classes about environmental health or global warming.

It’s a complicated topic that doesn’t come with definitive do’s and don’ts – like do wear a seatbelt and don’t text and drive. Some might say that the topic’s complexity circles back to a lack of time with each patient.

So, where do you stand? Is it the physician’s responsibility to educate patients about how the current climate crisis can and will affect their health? Are doctors duty bound to teach patients what they can do to help stop, stall, or possibly reverse climate change?

Resources

1. American Medical Asssociation. (2019). Global Climate Change and Human Health H-135.938.

2. AMA adopts new policies to improve health of nation. (2016, November 15).

3. https://climatehealthaction.org/cta/climate-health-equity-policy/.

4. How climate change threatens public health · The Medical Society Consortium on Climate and Health (MSCCH). (2019, August 19).

5. Climate Change and Public Health – Climate Effects on Health. (2019, September 9).

6. Weber, D. O. (n.d.). How Many Patients Can a Primary Care Physician Treat?

7. Irving G, Neves AL, Dambha-Miller H, et al International variations in primary care physician consultation time: a systematic review of 67 countries BMJ Open 2017;7:e017902. doi: 10.1136/bmjopen-2017-017902

8. It’s Time for Medical Schools to Introduce Climate Change Into Their Curricula. Wellbery, Caroline MD, PhD; Sheffield, Perry MD, MPH; Timmireddy, Kavya; Sarfaty, Mona MD, MPH; Teherani, Arianne PhD; Fallar, Robert PhD; [Miscellaneous Article] Academic Medicine. 93(12):1774-1777, December 2018.

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