How specialists can cut carbon emissions in their practice

By Siobhan Calafiore

25 May 2023

Cutting down on unnecessary imaging and encouraging patients to adopt healthier lifestyle habits are some of the ways in which specialists can reduce “tonnes” of carbon emissions, according to findings reported at an Australian major medical meeting.

In a poster titled the ‘Carbon Footprint of Metropolitan Rheumatology Services’ presented at the Australian Rheumatology Association’s 2023 Annual Scientific Meeting in Hobart, Dr John Van Der Kallen showed that 90% of outpatient emissions were the result of travel.

This included travel to specialists’ rooms, pathology testing and imaging.

His team surveyed 100 consecutive patients from a metropolitan outpatient rheumatology service and another 25 rural patients over a 12-month period.

They then measured number of visits, whether face-to-face or telehealth, the number of pathology and medical imaging episodes and distance travelled.

Findings showed carbon emissions for travel for patients in the rural setting was 1.05 tonnes, which would have been 9.01 tonnes for travel to the metropolitan setting, representing an 88% reduction in emissions.

“Some of the implications [for specialists] are around reducing the type of imaging they might do, maybe doing more telehealth or encouraging patients to walk or catch public transport rather than drive,” the immediate past chair of Doctors for the Environment Australia (DEA) told the limbic.

More specialists servicing rural communities would also be beneficial, he added.

His colleague, Dr Katherine Poulsen, also a DEA member who was not involved in the study, said reducing low value or harmful care – which represented about 40% of clinical care – would contribute to both reduced emissions and costs.

“The emissions from MRI, for example, are much higher than ultrasound and there’s also evidence that ordering too many tests often leads to more tests, and that’s associated with quite a large carbon footprint,” she told the limbic.

“We can also benefit the climate and our patients’ health at the same time.

“There’s a lot of data talking about plant based diets being really beneficial for our patients in terms of their gut microbiome and autoimmune disease.

“And encouraging patients to be more active and to use public transport.”

She said doctors could also help in getting the message about the health impacts of climate change “out there”, which had been slow despite decades of evidence and some of the leading journals globally suggesting it was the number one health problem patients would be facing in the next century.

“I think that by being a trusted voice, as doctors, we can really help with that.

“There’s studies that show that doctors are among the most trusted professionals, so I think highlighting the health benefits of taking climate action, as well as the health costs of inaction and delays is a message that will resonate with everyone.”

Dr Van Der Kallen also presented on climate change in a concurrent session.

He called for an “ambitious” national plan to cut Australia’s greenhouse gas emissions, aligned to science-based targets, this decade, and to establish a national sustainable healthcare unit to support environmentally sustainable practice in healthcare and reduce the sector’s own significant emissions.

This equated to 7% of Australia’s total carbon emissions, he said.

Most medical colleges, including the RACP and the AMA, had committed to net zero emissions by 2040 with an interim target of 80% reduction by 2030, he said.

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