Q&A: Medical Clinics - Can they be Eco-Friendly?
by Warren McLaren, Sydney on 11.11.05
Q. Hi, I am a surgeon and part-owner of a small surgery center in Washington state. Every day I gasp at the amount of waste we produce, some of which requires special handling, and most of which is either paper product or plastic. Do you have any ideas or resources to get me started on the road to being eco-friendly when it comes to medical and surgical supplies and waste? Thanks, Curtis R, MD.
A. Great question, Curtis. Had a dig around on your behalf, to see what we could unearth. Probably turned over all the wrong stones, but no doubt we’ll have some readers who can shed more light on the subject. So without any further metaphors, let’s see what the stork carried in. On the broader platform, of doctors taking on issues outside their waiting rooms, you might wish to contact the Washington based Physicians for Social Responsibility (PSR), who had been around for over 40 years. Similar concerns are pursued at EnviroHealth Action and The Collaborative on Health and the Environment, who it seems have a branch in Washington.
A robust online discussion, regarding deliberation on sterlisation of gowns and instruments, and environmental aspects of such practices can be found at the Canadian Centre for Pollution Prevention (CCPP), both here and here, with one doctor saying she uses a grapefuit-extract soap for non-invasive applications.
More directly addressing your question of how to green a medical practice is Ecologically Sustainable Medicine, who promote “effective healing and wellness practices that do no harm to people and the global environment.” ESM have some short PDFs on their site, which will help you define what an eco-friendly medical practice might entail. In a similar vein is an article by Dr Shiroko Sokitch from the Heart to Heart Medical Centre discusses some of the endeavours they undertook in setting up a greener clinic.
But the best example we could find in a quick trawl of webworld goes by the very clever and funky name of the Transcendentist, whose claim to fame is having the “first eco-friendly dental office in North America.” Their wallpaper is from reclaimed paper pulp and bark and floors of natural linoleum, with reclaimed timber furniture. “We use only steam-based instrument sterilization, which contains no harmful chemicals. We installed a special filtration system to allow environmentally sound disposal of old mercury fillings, to prevent pollution of our water system. first eco-friendly dental office in North America. We use digital imaging (not traditional x-rays), which means 75 to 90% less radiation for our clients and no toxic x-ray development chemicals. They wash cotton patient bib on-site with an “energy efficient washer and dryer using natural detergents and disinfectants”. And much more besides. Well worth a look.
If you aren’t yet ready to be as full-on green, as the Transcendentist, maybe try the range of cleaning products developed by EcoLab for the healthcare industry. Ecolab has a comprehensive environment policies, where they note they’ve reduced consumption of non-renewable chemical feedstock by about 30% in the past decade and pioneered concentrated ‘solid’ detergent which resulted in up to 80% less packaging.
Summit Lighting are one company that appear to have targeted the medical industry for energy savings, suggesting that their line of products can reduce lighting load by 12 to 75% depending on the application.
If not steam sterilising kidney trays, and similar containers, maybe you could consider the likes of biodegradable options from Ecomatrix and EcoPack, who both claim strong environmental attributes, being derived from agricultural fibres. The latter seems to have more data to back up their case, being both microwave proof, while meeting international standards for compostability.
While in no way comprehensive Curtis, we hope these leads might encourage yourself and fellow medical practitioners to continue investigation of the greener options for your clinics. Thanks again for the question.




















For what it's worth: the larger the health care "system" the greater the power that the purchasing department has over policy, with the obvious aim of tying down suppliers for low unit costs on multi-year contracts. Suppliers respond to the need to keep staffing costs down by featuring single use "consumables", with the intent of minimizing handling time and doing an end run around the sterilizing department. The more consumables, the greater the packaging waste. To tease out the fix, you need to analyze the work process to locate bias and enlist the purchasing department to identify alternatives. You also need to examine the tradeoffs between energy inputs for sterilization, consumables manufacture/shipping, and incineration. I believe USEPA had initiated just such a study not long ago.
Actually, the U.S. Environmental Protection Agency has an entire program for this -- it's called Hospitals for a Healthy Environment. While the program may be slightly more directed towards large facilities, I'm sure they would have ideas for smaller, as well. Here is the web site:
http://www.h2e-online.org/
Good luck!
My institution has set up an organization to donate unused medical supplies to developing countries.
Check it out:
http://www.med.unc.edu/medworld/unchospitals.htm
Health Care Without Harm is an international coalition of groups working to "green" the practice of healthcare. Lots of resources at www.noharm.org.