Climate Change and the Professional Obligation to Socialize Physicians and Trainees into an Environmentally Sustainable Medical Culture

Climate change has been identified as the number one public health concern of the twenty-first century [4], and yet, as of 2013, the US health care system was responsible for 10% of US greenhouse gas emissions, 12% of acid rain production, 10% of smog formation, 1% of stratospheric ozone depletion, and 1–2% of other toxic emissions [5]. Psychiatry has a unique role to play in addressing medicine’s current environmentally unsustainable culture because, first, a number of psychological factors make addressing medicine’s carbon footprint difficult for physicians and, second, psychiatry has already started taking a leading role among the medical specialties in addressing its professional carbon footprint. [...]in this editorial, we briefly summarize current contributors to the US health care system’s large carbon footprint, reflect on social and psychological factors that may support a medical culture that has not prioritized environmental sustainability, consider how this professional culture may endanger the doctor-patient relationship, and discuss how actions in medicine and specifically psychiatry can be adjusted to socialize medical personnel into a more environmentally sustainable practice that can also sustain the integrity of its fiduciary obligations. Contributors to the US Health Care System’s Carbon Footprint Many factors contribute to the carbon footprint of the medical profession, though the largest are systemic, arising from the hospital sector (39%) and the development and distribution of prescription medications (14%) [16]. In a sample of over 400 international members of the American Thoracic Society, 80% identified that climate change was relevant to patient care, yet nearly half reported lacking knowledge about how to address climate change with their patients, and only 30% were aware of what their hospitals were doing to address their carbon footprints [33].