Research shows that physicians and patients are interested in the environmental impact of healthcare decisions

Concerns about the environmental impact of healthcare decisions rarely arise in conversations between patients and physicians. However, evidence from a new study led by researchers at the Dana-Farber Cancer Institute shows that there is widespread interest in changing that.

In a series of focus groups held in different parts of the United States, physicians and patients expressed openness to considering environmental factors when discussing treatment options. The findings, presented in an article published in Nature Climate changesuggest that educating physicians about the environmental costs of treatments—and how to reduce those costs while continuing to provide excellent care—may be a first step toward that goal.

“Studies have shown that the U.S. healthcare sector is responsible for 8.5% of national greenhouse gas emissions and approximately 25% of healthcare emissions worldwide,” said Andrew Hantel, MD, faculty member in Dana’s Departments of Leukemia and Population Sciences. -Farber Cancer Institute who led the study along with Dana-Farber colleague Gregory Abel, MD, MPH. “The downstream health impacts of these emissions are responsible for the same loss of life every year as pancreatic or colon cancer.

“If healthcare emissions are contributing to the climate change that is leading to this level of harm, we wanted to assess whether and how physicians view their responsibility to address this problem,” he continues. “We also asked patients how willing they would be to make changes in their care that could reduce emissions and limit harm to others.”

Researchers conducted seven focus groups – three consisting of doctors, four of patients – involving a total of 46 people. Patients were generally interested in talking about these issues and learning about treatment alternatives that are equally effective but less harmful to the environment.

‘Asthma or COPD [chronic obstructive pulmonary disease]for example, can be partially treated using inhalers in powder form or in aerosol cans,” says Hantel. ‘They are equally effective medications for many patients, but powder inhalers have significant environmental benefits.’

Roughly two-thirds of focus group participants identified as members of racial and ethnic minority groups, who often experience the worst impacts of climate change despite being less responsible for those impacts than other groups. Many of them were interested in making environmentally conscious health decisions, but wanted to ensure that the major contributors to climate change were also held accountable, researchers found. Some participants expressed concern that physicians’ paternalism could be a deterrent to having climate-informed discussions with patients.

Many doctors in the focus groups wrongly assumed that patients were not interested in discussing the environmental consequences of health choices, researchers found. Even when patients were interested, doctors said their medical training had not prepared them to adequately address the subject.

At the same time, physicians felt that their ability to act in a climate-informed manner was limited by a healthcare culture focused on the consumption of natural resources.

“There was a sense of systemic pushback against the kinds of changes that could benefit both patients and the environment,” Hantel notes.

Physicians and patients generally agreed that patients’ immediate health should take priority over environmental concerns. However, in situations where there is an additional benefit, both groups were open to actions that reduce the impact on the environment.

“Our findings point to the need to better educate physicians and healthcare professionals about the changes they can make, and the changes they can advocate for within their institutions, that will benefit patients but also be less toxic to the environment ” says Hantel. “The goal is not to shift the burden of climate-based healthcare decisions onto patients, but to engage with them about these issues and ensure they are a normal part of conversations with their doctors .”