The Importance of Sustainable Healthcare

Are you a physician or other clinician who wants to help advance sustainable healthcare directly in your practice? The National Academy of Medicine (NAM) has created a shortlist designed for health professionals in clinics and similar settings who are interested in practical, individual actions to advance sustainable healthcare in their workplace. It offers a set of steps that promote environmentally sustainable practices and encourage clinicians to consider the environmental impact of their care decisions. The document created by NAM discusses individual action areas where healthcare professionals can take action. Following is a summary:

A. Optimize Medication Choices

Prescribe medications with a sustainability lens by considering different medication types, administration methods, prescribing quantities, deprescribing, patient needs, and optimizing the number of refills to reduce waste emissions. When appropriate, consider non-pharmaceutical treatments. Examples include:

• Use lower environmental impact alternatives when possible and clinically appropriate such as choosing dry powder inhalers over metered-dose inhalers (MDIs), choosing alternatives to desflurane anesthetic gas, and prescribing nature-based solutions and non-pharmaceutical treatments when applicable and clinically appropriate. This includes osteopathic manipulative treatment (OMT).
• Design clinical decision support systems in electronic health records that support environmentally preferred options and minimize medication waste and emissions.
• Consider prescribing a shorter initial duration (e.g., 30-day supply instead of 90) for starting new medications, before committing to a larger supply, while also considering patient costs and insurance plans that may offer lower co-pays for 90-day orders.
• Educate patients on the importance of antibiotic stewardship and on the proper disposal of medications, including over-the-counter medications and MDIs.

B. Engage with Telehealth

Use telehealth tools for patient visits, when appropriate, to reduce patient and staff travel, emissions, and resources.

• Consider telehealth for simple visits, such as patient follow-ups for test results.
• Create easy pathways to simplify scheduling for telephone and video visits.
• Encourage patients to identify adjunctive treatments closer to their home (e.g., serial imaging or lab testing, physical or occupational therapy, speech therapy, nutritional therapies, etc.), when appropriate and available, to minimize travel.
• Consider opportunities for home-based care, including home exercise programs, as alternatives or supplements to programs that require travel.

C. Optimize Diagnostic Testing

Consult evidence-based practice recommendations to reduce low-value testing and treatments. Reduce duplicative lab work by reviewing the need for additional testing based on past results and in consideration with clinical guidelines.  

D. Reduce Waste

Implement practices that reduce waste and emissions and conserve resources while maintaining quality and patient safety. For example:

• Optimize resource use in clinical workflows by minimizing use of single-use plastics in clinical care when appropriate by appropriately sizing surgical, suture, or procedure kits to avoid unnecessary use of instruments. Conduct workflow assessments to identify hotspots where plastic waste can be minimized.
• Reconsider glove use when performing low-risk examinations on patients who do not otherwise require contact precautions (i.e., chest auscultation, musculoskeletal exams, HEENT exams, etc.). In such situations, proper hand hygiene provides sufficient protection.
• Gauge whether patient exams can be performed in the patient’s own garments. Where patient garments are necessary, consider reusable options to minimize waste.
• Become familiar with, and if necessary, re-evaluate waste disposal practices to ensure that regulated and non-regulated waste are properly separated and disposed of in the appropriate disposal bins.
• Ensure that recyclable, re-processable, universal, hazardous, and pharmaceutical wastes are disposed of in the appropriate bins, when available.
• Reduce printing waste by using digital tools and electronic health records. Re-evaluate the use of disposable paper products, such as exam table paper, when clinically appropriate.

E. Assess Personal Protective Equipment (PPE)  

Minimize overuse and inappropriate use of PPE while prioritizing staff and patient safety.

F. Promote Sustainable Procurement

Identify and encourage procurement from vendors who prioritize sustainability efforts. Such vendor efforts could include: reuse, refurbishment, and single-use device reprocessing programs; use of recycled materials; providing electronic instructions for use; and clear product labeling for disposal pathways and recycling. The Collaborative for Healthcare Action to Reduce Med Tech Emissions’ (CHARME) procured services program can assist with this.  

G. Educate on Climate, Health, and Health Care

Leverage the trust people have in health professionals to educate peers, trainees, and patients on the health impacts of climate change, how climate and health care intersect, and what opportunities exist to reduce the impact of healthcare on the environment.

H. Integrate Climate Resilience into Care

Incorporate climate resilience into care plans of patients at higher risk by considering how climate hazards, such as extreme heat, can impact their health conditions and ensure they are prepared for disruptions in care. Encourage organizational leaders to develop and release a climate resilience plan for continuous operations, anticipating and incorporating the expressed needs of groups in the community that experience disproportionate risk of climate-related harm.

For additional steps hospitals and offices can take, see NAM’s report and other tips here.

Physicians can drive meaningful change by adopting sustainable practices in daily care. Small, intentional steps can help protect both patient health and the environment. By leading these efforts, clinicians advance a more resilient and responsible healthcare system. Perhaps your New Year’s resolutions for 2026 might be to include some of these steps.

References:

Clinical Prioritization tool for health care decarbonization

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Health care actions to reduce plastic use and pollution. doi:10.1001/jama.2024.17961

Kusturica et al. Minimizing the environmental impact of unused pharmaceuticals: Review focused on prevention. Frontiers in Environmental Science 10.3389/fenvs.2022.1077974

Levinson W. The Role of Clinicians in the Climate Crisis. JAMA Netw Open.2025;8(3):e252519. doi:10.1001/jamanetworkopen.2025.2519  

McLean R, Singh H. Professional Responsibilities for Planetary Health Stewardship. J Gen Intern Med. 2025 Jul 25. doi: 10.1007/s11606-025-09748-4. Epub ahead of print. PMID: 40715956.