The health effects of climate change are no longer a theoretical concern and are now causing human morbidity and mortality through storms, flooding, heatwaves, droughts, bushfires and changing patterns of infectious diseases.

Writing in the NEJM, Dr Caren Solomon and Dr Regina LaRocque of Massachusetts General Hospital, Boston, say it is time for clinicians to take action, both as individuals and as part of healthcare organisations.

“Physicians are well placed and, we believe, morally bound to take a lead role in confronting climate change with the urgency that it demands,” they write.

Their suggested actions are:

1. Recognise that you are part of the problem, since the health sector accounts for a disproportionately high amount of greenhouse gas emissions. If the US healthcare system was a country it would rank seventh in emissions internationally.
2. Lobby healthcare institutions to reduce fossil fuel use and work toward carbon neutrality through using renewable energy sources.
3. Adopt and recommend individual lifestyle actions such as walking or cycling rather than driving, eating less meat, reducing food waste, and conserving energy). These offer benefits for heath as well as reducing the carbon footprint.
4. Take an active role as educators and advocates for change on the health impacts of climate change, targeting patients, managers and legislators.
5. Use financial pressure. Divestment policies by medical groups and physicians’ personal retirement portfolios were effective against the tobacco industry and are now being adopted by groups such as the AMA and specialist colleges against the fossil fuel industry.
6. Take direct protest action against policies that contribute to climate change and harm health.

In their commentary, the authors say physicians should no longer feel that climate change is a distant problem that will not affect them or their patients. Likewise physicians are influential, and there is no case for feeling despair and powerless to act.

“There are currently more than a million physicians in the US, and our actions matter. When the next generation asks us, “What did you do about climate change?” we want to have a good answer,” they conclude.