How Green is Your Practice?

The world's natural resources are quickly vanishing, and a tremendous amount of reusable materials are being wasted at rapid speed every day. What can you do in your office to make a difference?

Coverage of the act of “going green” is all over the media; if you haven’t been hit in the face with it by now, you must be living under a rock. But most of the coverage has focused on how to make your home an eco-friendly place, with little information out there on what to do in the office environment, and even less on the physician office. So, maybe you’ve made some changes at home (eg, turning lights off when you leave a room, making a more conscious effort to recycle paper, plastics, and cans), but what can you do in your office to make a difference? Let MDNGLive.com show you the way!

Be sure to check out our going green checklist!

Why?

For starters, the world’s natural resources are quickly vanishing, with people in 2050 expected to have just 25% of the resources per capita as those enjoyed by people just 100 years earlier. As long as we want future generations (our kids and grandkids) to enjoy the standard of living that we have, we need to make sure the finite amount of natural resources isn’t used up before they can enjoy them. “We save for college education, orthodontia, and weddings, but what about saving clean air, water, fuel sources and soil for future generations?” reads text at the Go Green Initiative website. So, how do we save these natural resources?

How?

Without a doubt, the authority on going green in the healthcare sector is Health Care Without Harm, “an international coalition of hospitals and health care systems, medical professionals, community groups, health-affected constituencies, labor unions, environmental and environmental health organizations and religious groups.” With the mission to “transform the health care sector worldwide, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment,” as well as a robust, informative site surrounding this mission, Health Care Without Harm served as a key source for the following points on how to go green in your medical office. Be sure to download, share with colleagues, and print the MDNG Going Green Physician Office Checklist.

Mercury

Mercury—known as “a potent neurotoxin that can affect the brain, spinal cord, kidneys and liver”—is found in thermometers, blood pressure devices, lab chemicals, cleaners and other products used in healthcare. Do your part by working with pharmacies that don’t use mercury-containing products and becoming one of the more than 1,400 healthcare facilities that have pledged to go mercury-free. Learn virtually all there is to know about the mercury issue from Health Care Without Harm.

Laptops vs desktops

Even an oversized laptop runs more efficiently and takes less energy than a desktop computer.

Patient records

The average patient visit can result in the use of at least four to five pieces of paper; with large practices seeing as many as 1,500 patients per day, going paperless via EMRs and EHRs can result in saving 7,500 pieces of paper every day and 37,500 pieces (about four and one-half average trees) every week.

Communication

Use e-mail, attaching necessary documents when possible, instead of sending faxes and letters through “snail mail.” You’ll reduce the use of paper tremendously.

Prescriptions

EPrescribing, provided for free by NEPSI (National ePrescribing Patient Safety Initiative), eliminates the use of paper scripts, which will usually end up in the trash and not recycled.

Printing

When you have to print something out, program your printer to use both sides of the paper. You’ll use half the paper—duh!

Drinking water

Bottled water isn’t just expensive; it produces large quantities of wasteful containers. Instead, put a filter on your tap—if necessary—to obtain drinkable water.

Cups

Styrofoam cups will be sitting in our landfills long after we’re all dead. If you insist on using them, refill your cup throughout the day, instead of tossing it out and grabbing a new one when you want more water—because you’re not drinking bottled water anymore—or coffee. An even greener option is to bring in a mug or cup that can be refilled throughout the day, taken home to wash, and brought back (maybe even use a rotation of a couple so you’re not washing a mug every night).

Online billing

Paying your bills online not only reduces paper waste significantly, but is quicker and easier than paying via the mail. Of course, you’ll want to bill for your services electronically as well.

Electronics recycling

Cell phones, computers, PDAs, and other electronics can all find a new purpose when you’re done with them. Look into a local or national organization serving your area that will refurbish them for low-income families.

Paper recycling

This has to be the most obvious means of going green. If you’re not at least recycling paper, then shame on you!

Lighting

“With medical facilities operating 24/7, the interior lighting accounts for about 40%-50% of total electricity usage,” according to Summit Electric Supply. “Applying good lighting design can benefit all by providing a quality well lit environment to patients and staff alike while saving money on total energy usage and maintenance.” Check out Summit’s full line of energy-saving lighting solutions. Of course, simply turning out the lights when leaving an exam room, bathroom, or other area in the office that won’t be in use for a while is a simple way to save energy and money. Further, motion sensors, dimmers, and timers can be set to turn things on and off when needed.

If you want to go to extremes, check out Solatubes for those rooms with no windows; the aluminum-lined tubes run from the roof to the ceiling, reflecting daylight and creating natural light throughout the day.

Gray water tanks

These systems recycle water from your building’s toilets and other appliances. Ask your commercial building manger about putting them to use. Learn more at the website of New Water.

Furniture

Furniture made of recycled woods, covered in cottons, silks, and wool, and stuffed with kapok—which comes from a silk-cotton tree—allows for 100% eco-friendly and biodegradable seats, desks, tables, and more.

Flooring

Many floor choices minimize toxic exposure, including bamboo, a sustainable resource; hardwood floors with nontoxic finishes, although very expensive, which can be refinished with water-based polyurethane; natural linoleum; Marmoleum, a natural alternative to vinyl that is made of flax, wood flour, and rosins; and carpets made of untreated wool. If you’re office is on a cement slab, ask the flooring company to use special concrete nails instead of glue to adhere the padding and carpet, as many glues are toxic.

Walls

Walls can be painted with nontoxic primers and paints, including those provided by Envirocoat or papered with wallpapers made of reclaimed paper pulp and bark.

Instruments

Choose surgical-grade cloth—which can be sterilized and reused—over disposable plastic and paper wrapping. And use metal, reusable speculae instead of those that are disposable. They’re easier to slide of tissue, have more “heft,” and lend themselves to being heated with warm water for certain exams, according to the Canadian Centre for Pollution Prevention.

Imaging

Digital imaging not only eliminates paper use, but results in 75-90% less radiation exposure to patients and also eliminates the use of toxic x-ray development chemicals.

Gowns and table covers

Try cotton terry cloth robes and exam room table covers, instead of paper, which will obviously reduce waste. One physician said “Drape contamination is rare and minimal. I’ve examined patients with hepatitis B and C, various soft tissue infections, and acute upper and lower respiratory infections many times over the years with any problems.” The same physician adds “I rarely put gowns on patients. I usually use my own clothing as a gown, and slip or slide it around as needed. Patients prefer it, and it saves the use of extra drapery.”

If you decide to go the cloth gown route, try setting up a contract with a linen company that will supply and wash them; otherwise, you’ll be stuck with the task. If you decide to take it on yourself, wash them in hot water and a hydrogen-peroxide-based disinfectant, as opposed to one that’s chlorine-based. Dry them on the hot setting too, helping inactive any organisms.

Devices

The most widely used plastic in medical devices is PVC, which is harmful to patients, the environment, and public health, according to Health Care Without Harm. The key problems with PVC are dioxin—a known human carcinogen that can be formed during PVC manufacturing and during the incineration of PVC products—and DEHP—a phthalate used to soften PVC plastic that can leach from PVC medical devices and has been linked to reproductive birth defects and other illnesses in animal studies. Check out an extensive list of PVC-free medical devices from Health Care Without Harm.

Decontamination

According to the Canadian Centre for Pollution Prevention, it’s absolutely necessary for a doctor’s office to have tabletop steam sterilizers, which don’t use chemical disinfecting agents. The Centre says they must first be thoroughly washed after use and then wrapped (if necessary) before sterilizing. Check out the environmentally safe cleaning products provided by Ecolab.