Greening Healthcare: Next Steps
By Dr. Lawrence Rosen
Recently, I led a webinar for Practice Greenhealth detailing our efforts at The Deirdre Imus Environmental Health Center® to reduce the use of endocrine-disrupting plastics in hospitals. Reducing DEHP use in particular is one of our main current initiatives, given its adverse impact on health, especially in newborns. I was inspired by the hospital community’s engaged participation during and after the webinar. Healthcare Without Harm, in addition to Practice Greenhealth, provides terrific resources and opportunities for those dedicated to hospital sustainability. Novel initiatives addressing antibiotic overuse and climate change (emerging issues in pediatric environmental health) complement ongoing programs supporting environmentally preferable purchasing.
As I reflect, though, on the growth in hospital system efforts, I remain dismayed by the relatively slow adoption of green health principles in primary care community practices and clinics. Most of us receive care in these settings, and primary care should be synonymous with preventive care, arguably best represented by the environmental health “precautionary principle.” It remains evident that the safest, most effective and most cost-effective strategies to create and maintain optimal health are preventive in nature. Environmental factors contribute mightily to all causes of disease and may cost the U.S. in excess of $75 billion annually just for children’s health issues alone. Care delivered in primary care settings should be a role model for ecologically sustainable health practices, limiting rather than contributing to environmental hazards in our communities.
When I founded the Whole Child Center with a dedication to ecological sustainability, I learned what I needed to know by witnessing the creation of the Gabrellian Women’s and Children’s Pavilion at HackensackUMC. I understood that what mattered was both selecting the greenest building materials and furniture available as well as optimizing practices like recycling, reduction of material use, and green cleaning. Obstacles to practices like mine at the time included cost increases to build, though these were easily offset by reductions in energy and paper use. Most importantly, we adopted a philosophy of practice that reflected our mission - we serve as role models for our patients and their families, demonstrating that how and not just what we practice actually creates health. Yet in the decade since, very few practices and clinics have “gone green,” despite growing concerns for and increased awareness of environmental health harms. What are the barriers? Why have primary care practices not followed the lead of academic institutions? In part, there remains a misperception that greening our offices costs much more than conventional building/operational practices. Perhaps of greater concern, community-based physicians are unable to locate resources to assist them even if they have the right intentions. Creating online resources and practical, educational workshops for clinicians and administrators interested in developing eco-sustainable practices remains a priority.
Lawrence Rosen, MD is an integrative pediatrician and co-author of Treatment Alternatives for Children. He is the founder of the Whole Child Center, one of the country’s first green and integrative pediatric practices, and he serves as Medical Advisor to The Deirdre Imus Environmental Health Center®. Dr. Rosen’s academic credentials include positions as past Chair of the AAP Section on Integrative Medicine, Clinical Assistant Professor in Pediatrics at UMDNJ, and author of numerous articles and book chapters on integrative pediatrics. He is also the pediatric columnist for Kiwi Magazine and blogs for the Huffington Post.