The low-carbon fruit tree for primary care

Abstract

Primary care practitioners are optimally positioned to reduce the Greenhouse Gas (GHG) emissions produced by the healthcare system, which pose great risk to the health of people and the environment. This narrative review discusses 19 initiatives that can be implemented into primary care practices to reduce GHG emissions and financial costs through decreasing highly intensive emergency room visits and hospitalizations. This article also summarizes the time it may take for primary care practitioners to embed each of these initiatives into their care delivery. Lastly, this article demonstrates how best practice initiatives in primary care may show a higher GHG reduction than commonly conducted initiatives aimed at reducing GHGs.

Figure 1.

Initiatives include: adding a net new family physician, discussing advanced care planning with 10 patients annually, reducing prescription medications by 4%, promoting plant-rich eating, implementing social prescribing to address frailty in older adults, transitioning 10% of MDI users to DPIs, countering mis/disinformation through promotion of pneumovax, influenza, and COVID-19 vaccines, conducting up to 30% of visits virtually, encouraging active transport for patients, reducing OTC medications by 4%, switching to low-carbon banking, attending conferences virtually, using green energy providers such as Bullfrog, adopting LED lighting, using AI scribes to save 3 hours of administrative time per week, refusing products from carbon intensive suppliers, improving office efficiency to save 20 minutes per week, reducing 2% of unnecessary tests, reducing waste, reusing sharps containers, and recycling cardboard. This tree is adapted from an earlier illustration published in Healthcare Quarterly 25(3).

Figure 2.

Carbon emissions saved per initiative, per year.