Climate change efforts

We thank Dr Ladouceur for his invitation to consider our role as family physicians relating to climate change in his November editorial, “Our fight against climate change.”¹

We see an ability to act at various levels: personal level; practice level; community level; and provincial and national levels by advocating for change.

Dr Ladouceur’s article¹ highlights some of the things that individual family physicians are doing personally, including changing their diets² and adopting active transportation (cycling and walking instead of driving).³

Interventions that can be implemented at the practice level (eg, choosing energy-efficient equipment) have been described in a previously published Canadian Family Physician article, “Greener medical homes. Environmental responsibility in family medicine,”⁴ as well as in the Green Office Toolkit.⁵ Establishing a clinic “green team” can help to support these office-based initiatives, as physicians are often looked to for leadership.

The Climate Change Toolkit for Health Professionals, produced by the Canadian Association of Physicians for the Environment (CAPE),⁶ is a solid resource for both practice-level changes and advocacy work.

We know that translating clinical knowledge from study to practice takes time. Translating knowledge about climate change from basic science to practice and advocacy will also take time. Recognizing that time is not on our side in this issue, we need to create ways to decrease translation time by sharing with patients and colleagues. One example of an opportunity to share information with patients is through the use of shared information sheets, like those that CAPE has provided in its tool kit.⁶

At the community level, family doctors are good candidates to become involved in teaching about the effects of environmental degradation, as we tend to be prominent members of remote and rural communities—communities that are already feeling the effects of climate change.⁷ We can also share the information with our colleagues in training. A recently published article in the CMAJ highlighted the formation of a medical student group called HEART (Health and Environment Adaptive Response Task Force) that is calling on medical schools to provide more teaching on the subject of climate change.⁸ We are in a position to teach learners about tools that are available to them such as Choosing Wisely, which helps support appropriate (and usually less) testing. Furthermore, as students learn by example, we can be role models by putting some of the above into practice.

To encourage local colleagues in the advocacy effort, it would be helpful to have templates of letters or presentations with key messages that could be used in presentations to local organizations, whether it is a clinic, hospital, or community. Another resource we recommend sharing among colleagues are letter templates that can be used for writing newspaper comments and communicating with politicians.

We also suggest that the College of Family Physicians of Canada create a repository of links on its website to other well informed organizations (like CAPE), tool kits for use in practice, and letters and tools of advocacy and education that could be used to support the busy clinician in the climate change effort. Recent articles on green changes have been very helpful in inciting us to action. Canadian Family Physician could also encourage others by including a regular column or section to keep this issue at the forefront of our minds and family physicians at its leading edge.

We will keep trying to effect change but it will take time. We believe we have a large part to play.

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