I. Eco-Warrior vs. Energy Vampire: A tale of two lives: impeccable green credentials at home, wanton energy consumption at work. Can one physician reconcile his hypocritical existence?
“Like most relationships, my relationship with the environment is complicated.”
At home I do all the things. I change all the light fixtures to LEDs, program my thermostats to the margins of comfort, replace windows, plug insulation leaks, install Energy Star appliances, turn off the lights, recycle, compost, use cloth napkins, and even drive an electric car. At home, it’s been this way for 20 years.
At work I do nothing. Lights on, computer on, equipment on, temperature at 68F, throw everything away, and no place to recycle. It was only a few years ago when I had a “light bulb moment” and asked myself why my behavior is contextual. After all, I’m the same person wherever I am.
II. The Price of Virtue: Domestic eco-frugality driven by personal cost savings. But altruism also plays a role. Why does this logic fail within the hospital’s walls? An exploration of misaligned incentives.
At first, I didn’t have an answer, but as I considered my life, I came up with a few. The easiest answer for my behavior at home was money. At home I’m paying the bills, and any household efficiency directly helps my family. However, it does not explain why I recycle or compost. The other actions at home tap into my desire for efficiency, my connection to nature, and my feelings about stewardship for my children.
So why is my behavior completely different at work? Once again, the easiest answer is about money. At work, I do not pay the bills. I’m employed by a large health system where we’ve focused on capturing market share while keeping costs down.
Like most health systems, we work to supply materials across a massive organization and then effectively cart the waste away. And like most health systems, we have increasingly moved to adopt lower-cost single-use disposable items. To be clear: this wasn’t done with bad intentions, our industry has simply evolved over time. When I look around my hospital, we are not paying attention to saving costs and cutting waste while continuing to deliver high-quality care.
III. Confessions of a Medical Dumpster Diver: One physician’s unorthodox approach to resource management. From scavenging expired equipment to supplying global health missions and veterinary clinics. A commentary on medical excess and the circular economy’s untapped potential.
Most doctors’ office spaces are filled with personal items, photographs, children’s art projects, framed certificates and awards, and career mementos.
Mine is filled with hundreds of thousands of dollars’ worth of expired medical equipment.
I do not know when I started “dumpster diving” in my department. When I was younger, I looked for expired devices to practice my skills. I wanted to use them in a no-stakes situation so that they became second nature to me while performing a high-stakes interventional radiology procedure in a patient.
“Some call me a hoarder.”
After our stock manager caught me with my feet hanging out of a huge plastic dumpster throwing stents over my head, she now just places “the good stuff” in my office. Today, the good stuff is used for Resident Education, Global Health Missions, and by a local Veterinary Interventional Radiologist. Looking at my office has framed how I perform surgery, engage with my partners, and work with my medical supplies manager. All these expired devices add costs to medicine and society while adding volume to our landfills.
IV. Healthcare’s Green Awakening (or Lack Thereof): The glacial pace of sustainability in medicine. A nascent movement faces institutional inertia and budgetary constraints. Can one physician’s crusade inspire systemic change and a healthier future for patients and the planet?
My experiences coupled with conversations with other physicians, friends, and family have helped to shape my engagement in medical sustainability. I now turn off the lights in my office and power down my personal workstation at the end of the day. I have also become involved in sustainable medicine at the Departmental, Institutional, Health System, and National levels.
Most medical organizations have only seriously considered their environmental impact within the past 5 years. As a result, there are many opportunities to cut costs, improve efficiency, decrease our carbon footprint, and improve the quality of healthcare.
Because we have only recently begun to climb the mountain, the summit still seems far away. I’m happy to start the climb knowing that I’m unlikely to see the long-term effects of my efforts. However, I remain hopeful that future physicians will continue to work towards a sustainable future where the world and healthcare are healthier for all.
Will you join me?
