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Climate change is a public health crisis, and health care is responsible for 8.5% of U.S. carbon emissions. Victor Dzau, MD, president of the National Academy of Medicine, joins to discuss how the Action Collaborative on Decarbonizing the U.S. Health Sector is bringing together organizations across medicine to take action. AMA Chief Experience Officer Todd Unger hosts.
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- Victor Dzau, MD, president, National Academy of Medicine
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about the impact of climate change on health care and the efforts of the National Academy of Medicine Action Collaborative on Decarbonizing the U.S. Health Sector. Here to discuss this is the president of the National Academy of Medicine, Dr. Victor Dzau in Washington, D.C. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Dzau, welcome.
Dr. Dzau: Thank you. It's great to be with you, Todd.
Unger: Well, the action collaborative started back in 2021 and it's been hard at work ever since. Why don't we just start with background? And tell us a little bit about what initially motivated the National Academy of Medicine to form the collaborative in the first place.
Dr. Dzau: Well, you know, we are a national academy, and what we do best is to really address critically important and pressing issues that affect health and the health care of the nation and globally. And what more important topic than climate change? When we recognize that it's becoming an existential threat, our question is, what do we do with this? When we recognize that impact is really on health and human suffering, it becomes very obvious that we have to jump in and do something about this, hence the idea of launching a grand challenge.
Unger: When you think about the health care sector itself, why is it so important to think about the work that needs to be done there?
Dr. Dzau: Well, to begin with, as I was saying, climate change really affects human beings. You can argue the planet—you can argue the polar bear that's missing the ice it's on. But at the end of the day, it's killing people and it's causing suffering.
And so no question, therefore, the health care sector has to play a role. Because in addition to the fact that we take care of patients, in the emergency room from heat stress, you name it, from floods and hurricanes, we need to really be resilient in building the health system that can take care of both acute emergencies as well as ongoing heat-related illnesses.
What are those? Vector-borne disease, where mosquitoes are traveling much further north. I think this weekend, I believe Washington Post says malaria is on the rise again. Right? Heatstrokes and heat-related disease and, of course, you know, wildfires, smog and floods and hurricane—you name it.
So we need to take care of those things. But what's really interesting is, health care is also contributing to the carbon emission. That's not that well recognized. But when you think about the MRIs and the surgery and the machines that you use and the car you drive to the clinics and hospital, we are emitting a lot of carbon and greenhouse gas.
Actually, the data shows that we are emitting 8.5% of total carbon emission of the country. That's why I think health and the health community has to be involved. We're the trusted—we're the trusted professionals. Last I looked, we're still the highest trusted—nurses and doctors.
So we need to tell our patients and the public the message that climate change is really hurting people. We need to do something about it. And most likely, you're more likely to react to this message than to say, you know what? Your future generations—and guess what? If I look at what's happening to the penguins and polar bears, it's less meaningful than the public—to the public.
Unger: And I think that statistic of accounting for 8.5% of U.S. carbon emissions will surprise a lot of people out there. Dr. Dzau, talked to us a little bit more about what the action collaborative is actually doing.
Dr. Dzau: Well, let me say a word about 8.5%. Because not everything is directly related to the care of patients. No question, our buildings and our heat and cooling consumes a lot of energy in hospitals, et cetera. No question that a lot of disposables, a lot of waste in hospitals—that creates a tremendous amount of greenhouse emission.
No question that the way we ask patients to come to—in New York City, for example, you drive one block or two blocks just to see a doctor or the hospital—no question that's all part of this. But that is only a part of this. A big part of this is also related to what they call supply chain.
That is, we buy things from pharmaceuticals. We buy things from devices. We buy things, purchase services. And those services require a supply chain. Supply chain contributes a lot by having to mobilize transport, manufacturing, things like this.
So I want to be sure that we understand the totality of 8.5%. Hospitals and direct patient care—about 20% of that. And supply chain is a big deal. Now, why do I say this?
Because I think hospitals and others can make a difference. Because if you start putting pressure on supply chain to say, unless you reduce your decarbonization, unless you do things, we're not going to necessarily purchase with you. That's a big deal.
What am I saying? Well, if you think about many places now—hospitals are ran through the health system—say to the vendors, I want to see how much you're doing in terms of equity. I want to give preference to minority-owned vendors. I want to give preference to community-owned businesses. We can do the same with supply chain. There, we can cut down the emission in addition to what we do, which is changing the way we practice medicine. Do a lot more virtual care. Right? A lot less surgery, a lot more prevention. That's all good stuff.
Unger: Tell us a little bit more then, specifically about what the action collaborative is doing.
Dr. Dzau: Yeah. So we recognize, to do this, everybody has to be playing together, roll in the same direction. So a collaborative—the whole idea of collaborative is to bring together every single player to the table. This is hospitals and health care systems, doctors and nurses, educators to educate a future generation about this—doctors and nurses—about climate communication, but also supply chain, the private industry, the pharmaceutical, and then importantly, the government.
Because so much policy is made by the government. So by having everybody at the table, we begin to design solutions together. We begin to make commitments together, hence the idea of a collaborative. So this way, we are saying, look, let's all commit to decarbonization, with the goal of 50% reduction of total carbon emission by 2030 and net zero by 2050. How can we do this together? Let's measure together. Let's start learning from each other. Let's create what we call "journey map," which allows you to say, if I want to enter this journey, where do I start? Well, step 1, step 2, step 3. We want to measure where do I start. So we are pulling everybody together to row in the same direction. That's the idea of a collaborative.
Unger: Absolutely. And I think you hit on one of the big points, which is, how do I go about getting started doing this? It's a big challenge. Sounds like a lot of organizations are eager to make progress, but they just don't have that guidance and the knowledge to proceed confidently.
And I think that's where the action collaborative fits in. Tell us a little bit about how you then help an organization move ahead.
Dr. Dzau: So we had these four working groups. One looking at care delivery—what kind of changes do you want to make in care delivery? One on education—what kind of curriculum education? One on supply chain, one on policy.
Let me talk about the policy piece first. Because people say—hospitals say, gee whiz, do I need to do this? I'm already miss—I'm up to my neck with COVID-19, nurse shortages. I'm losing money, and you got one more thing to do, right?
So the whole idea is to create policies, incentives, to help them get things done. Right? So that's the key issue. I want to start with that first. So last week, I was at White House.
The White House had a meeting, bringing together people to learn about the Inflation Reduction Act. And what it is, is that it can tell you—if you only know how to take advantage of the IRA, or IRA, you're going to end up with tax credits and grants, whereby you can begin to decarbonize your facilities.
So that's what the collaborative does. It works with the government, works with others, to say, here are the different things that you can do to decarbonize, and here are the opportunities to get tax credits and to get funding for it. So what are those? So we started doing carbon clinics. People would then—webinars about how to decarbonize.
We have a journey map, as I told you, which, in fact, maps out, step by step, how you go forward. We have people, experts, that say, how do you measure this? How do you report this? And together, we're not only learning from each other, but we're trying to create a common way of doing things together.
Unger: Tell us a little bit more in closing about what's next for the action collaborative. What's biggest on your agenda for the coming year?
Dr. Dzau: Oh, yeah. So we started with this collaborative. We invited 70 core members who are experts in education, in care delivery, industry and in government. For example, the co-chair of this collaborative with me is Admiral Rachel Levine, the Secretary of Health—government; Andrew Witty, the CEO of United—private sector; George Barrett, the past CEO of Cardinal—supply chain; and me, the academic physician, right?
So the whole group is made of this kind of public-private relationship. Then everybody wants to join us. We say, wait, we can't handle them. And so we created a network of 200-plus hospitals and organizations, which itself has many hospitals. So we talk about several hundred network.
But not enough. Right? The White House has a pledge. They have something like 600 organizations they'll pledge. But this country has 5,000 hospitals.
Under AHA, there's the safety-net hospitals. There's all those clinics, right? And all those. So what we want is to get everybody on board on this. So the next big thing is to start a national movement, a movement by which anybody who can join can join to start learning about this, start working towards it, and eventually, they can scale to a level where they can really make a difference by doing exactly those things that's needed, as we talked about earlier.
So our idea is to launch a national movement in January 2024, working up to it, so we can—therefore, anybody who can join can join. So we expect that hundreds of thousands of organizations join us, and then we're going to start moving in the right direction.
Unger: Well, that sounds very exciting. Dr. Dzau, thank you so much for joining us and giving us that perspective. And it's great to learn more about the collaborative. In the episode description, we'll include a link where people can learn more about the action collaborative and how to join it.
That wraps up today's episode. If you enjoyed this discussion, you can support more programming like it by becoming an AMA member at ama-assn.org/join. We'll be back soon with another AMA Update.
In the meantime, you can find all our videos and podcasts at ama-assn.org/podcasts. Thank you for joining us. Please take care.
Dr. Dzau: Thank you. It's a pleasure.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.