Going green doesn't have to break the bank

Simple teamwork and strategies reduce waste
at little cost

By Graham Lanktree

It's not easy being green, as Kermit once said. And it's really not easy being green and being a physician — or at least that's the prevailing perception among doctors whose environmentalist inclinations are discouraged by a fear of gigantic expenses.

"No facility is environmentally friendly unless you want to spend mega-bucks," laments Brantford, Ontario FP Ilmar Kents, who's been struggling to make his practice more eco-friendly.

It's a familiar refrain. But, thankfully, it's not true.

In reality, some simple and inexpensive changes in the way you run your practice can make a world of difference, says Dr Jean Zigby, vice-president of the Canadian Association of Physicians for the Environment (CAPE). "You can reduce the amount of waste and energy use by 30% to 50%, just through the choices you make and strategies you use," he says.

PULPING PAPER
Environmentalists' enemy number one is paper.

"I haven't done any major things," says Dr Kents. "But the one thing I do do is take the paper that we accumulate and cut it up to make scrap paper notepads."

He needn't be so modest, says Joel Kreisberg, a sustainable practices consultant in Berkeley, California: reusing paper is one of the first, most efficient and cost-effective things that physicians should do to begin greening their practice. "Most of the waste that clinics are getting rid of is paper," he says.

He suggests implementing a double-sided printing policy or reusing paper for notepads and scrap, like Dr Kents. Conserving resources like paper is essential to reducing medicine's environmental impact. And often green reforms add little to no extra cost to the overhead of running a clinic, says Mr Kreisberg.

BEST PRACTICES
Dr Zigby suggests doctors and administrators integrate sustainable principles into their clinics by educating staff — at all levels — about sustainability. He recommends establishing a "green team" within the office whose role it is to create long and short-term greening goals that are specific, pragmatic and measurable. The idea is that clinics pick an easy and achievable strategy, implement it, and then examine how successful it was — evidence-based environmentalism. Staff can then ask themselves what they should do next and they aren't overwhelmed.

It is easiest and most effective to first begin a recycling program if you don't have one already, says Mr Kreisberg. And be sure to remember to separate out items that must be brought to special recycling depots, like ink cartridges, batteries and lightbulbs. Another thing to consider, if you can manage it, is to start composting food waste.

Landscaping is another big source of waste. "Outside our offices here in Berkeley the sprinkler system was going crazy — running day in and day out," says Mr Kreisberg. "All we had to do was ask the superintendent to regulate it." Doctors and their staff can easily ask the clinic cleaning crew and gardeners to use less toxic cleaning agents or fertilizers, which are widely available in home and garden centres.

PROBLEM AREAS
Studies show that large amounts of pharmaceuticals have leached into the water table around major cities. Anna Gilmore-Hall, the executive director of the green practice advocacy group Health Care Without Harm, suggests this should prompt physicians to think twice about their pharmaceutical practices. "It's not good to just put medication down the drain or throw it away," she says. "Physicians should be relaying this message to their patients and negotiating with pharma companies to take back any unused medication."

Mr Kreisberg suggests you offer to collect unused drugs from your patients. Over-prescription is a big part of the problem. "Give your patient a prescription for the number of days you think they will really need," he asks.

Physicians should also look at the energy consumption of electronics they're purchasing, says Ms Gilmore-Hall. "There are also ways of returning your electronics to the manufacturer after you're done with them," she says. Manufacturers can then dispose of the devices safely or reuse and refurbish them.

Mercury is another environmental hazard that doesn't get treated with enough care, she says. Clinics should collect any devices that contain mercury, like old thermometers and blood-pressure gauges, and have them picked up by the local hazardous waste disposal centre.

ON THE HORIZON
"It's hard for physicians to have completely environmentally sound practices when everything is disposable," Dr Kents complains, identifying a major challenge for physicians. Countless medical tools and products come wrapped in plastic — often to be used only once and then thrown away.

"With the cost of oil being what it is," says Mr Kreisberg, "it doesn't look like medicine will be able to sustain the number of disposable instruments over the next 10 years." Unfortunately, there aren't many suppliers offering environmentally friendly equipment, says Dr Zigby. "What many physicians have to do is demonstrate that there is demand for these products by contacting their suppliers and telling them that this is what they're looking for."

The message is clear: greening your practice isn't the bank-breaking behemoth of a task it's cracked up to be. It all begins by taking a small, easy, cost-effective step — like Dr Kents did with his reused-paper notebooks — and steadily expanding your efforts to tackle medicine's impact on the environment.

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