BMJ Best Practice and climate change: planning for the future
Dr Christine Bowen, Lead Section Editor, BMJ Best Practice
Dr Kieran Walsh, Clinical Director, BMJ
Climate change is no longer a concern for the future. It is a current reality with implications for patients, populations, and healthcare systems worldwide. As temperatures rise, there has already been an increase in climate-related health problems. (1) These range from infectious diseases to heatstroke to mental health problems. Healthcare professionals are tasked with dealing with the immediate effects of climate change but also with considering how best to prevent climate change and its effects on healthcare. This is important as healthcare also contributes to 4.4% of global net carbon emissions and, if considered its own country, “healthcare would be the fifth largest emissions producer in the world.” (2) BMJ is committed to playing its part in the field of climate change and healthcare. (3) And our clinical decision support resource - BMJ Best Practice - must play a role also. BMJ Group has been paying particular focus over the last year on how we can ensure that we are a responsible and sustainable business, supporting people and communities around the world, protecting our climate and enabling nature to thrive. We have been working to evaluate our own carbon footprint as a business, with a goal to achieve Net Zero throughout our operations by 2040. We will also continue to provide regular educational content to help clinicians and researchers tackle climate change and work sustainably, equipping them to make a difference in their practices. For BMJ Best Practice, this might mean providing practical content on how clinical decisions might impact the environment, such as through highlighting more sustainable choices of inhalers in asthma or COPD to consider when prescribing (metered dose inhalers are estimated to contribute to 3-4% of the entire NHS carbon footprint in the UK). (4) We also plan to do more to promote our content on heatstroke, dangerous pandemic infectious diseases, and mental health - especially in light of the growing prevalence of climate anxiety. We are keen to explore how to make our content more sustainably minded and welcome any feedback on what would be clinically useful. As a clinical decision support resource, BMJ Best Practice generally gives advice on what tests and treatments to do in different circumstances. But sometimes it gives advice on what tests or treatments to avoid. Our new Tests to Avoid section gives guidance on when you should not do certain tests. For example, in a patient with hypothyroidism but no palpable abnormality of the thyroid gland, a thyroid ultrasound is usually not necessary. Avoiding unnecessary tests will save costs for the healthcare system, inconvenience and worry for the patient, and the climate impact of a procedure or test. In this scenario, the climate impact of not doing a simple test like this will likely relate to saved energy and preventing unnecessary travel to have the test. The carbon footprint of healthcare can come from direct delivery of care but also other sources such as patient and visitor travel and commuting by staff. (5)
BMJ Best Practice is used as a source of continuous professional development (CPD) for healthcare professionals. It is accredited for CPD by many institutions around the world. Traditional face-to-face CPD often requires travel to national or international conferences and this has an environmental impact. Using BMJ Best Practice for CPD can save on this travel and resultant impact. We would not recommend that healthcare professionals do all their learning online but climate impact should be one factor among many in deciding on the format of CPD. Even doing some CPD online and saving on travel will have an impact.
These are just a few examples of how BMJ Best Practice can have an impact on climate. We plan to do much more in the future. We also plan to evaluate the impact of what we do. (6) If you have any suggestions about what more we could do, we would love to hear from you. Please email kmwalsh@bmj.com.
Competing interests
KW and CB work for BMJ.
References
1. Stancliffe R, Eling J, Barker J. Climate change is a clear and present danger to health, says UKHSA BMJ 2024; 384 :q66 2. https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(24)00048-2/fulltex t
3. Abbasi K. Climate change: defeating misinformation with trusted knowledge BMJ 2024; 387 :q2211
4. https://www.greenerpractice.co.uk/information-and-resources/information-for-patients/inhalers/
5. https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(20)30271-0/fulltext
6. Walsh K. E-learning in medical education: the potential environmental impact Education for Primary Care 29 (2), 104-106
Page 1 Page 2Powered by FlippingBook