End of the roll for examination table paper?

A family physician has become increasingly aware of and alarmed about climate change. She has noticed that it is already affecting the health of not only some of her patients but also people all over the world, especially those who are the most vulnerable due to illness, poverty, and geography. She also worries about how climate change will affect her own family members and transform the world during her and her children’s lifetimes. She immerses herself in literature about climate change and its current and future effects on health and health care systems. She is particularly struck that Canada has the third-highest per capita greenhouse gas emissions from the health care sector in the world, with health care accounting for approximately 4.6% of Canada’s total emissions.¹

With this increased awareness, she recognizes meaningful opportunities for action on climate change by family physicians such as herself. She finds opportunities in her home and daily activities to reduce waste and her own carbon footprint, employing the “zero waste” philosophy, popularized by author Bea Johnson (whose family reduced their annual trash to fit in a jar), as her guide.² In addition to taking personal actions, she finds ways to advocate for a healthy climate, recognizing that as a physician she possesses a trusted voice on societal issues that affect health. She notices that opportunities for climate action and climate change mitigation are everywhere!

In discussions with colleagues, she learns that the Children’s Hospital of Eastern Ontario in Ottawa no longer uses examination table paper in its emergency department. She asks herself, “Do we really need examination table paper in our family practice clinic?” and wonders whether the purpose of the paper is to protect the table or the patient. It seems the paper is mostly for show, and after each patient encounter, if the paper looks even the slightest bit wrinkled, more of it is pulled off and discarded, wasted to maintain the impression of cleanliness. In comparing office practices with colleagues, she finds it is unclear whether the examination tables are consistently getting disinfected between uses in many clinics or if the examination table paper roll is just being advanced. Could the use of the examination table paper be providing false reassurance of the tables’ cleanliness to family physicians, clinic staff, and patients? Could use of the paper be a substandard measure preventing them from using better infection prevention measures?

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