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Green Medical Practice

Green Medical Practice

These Epocrates members are healing the planet as well as their patients. Read about their experiences and recommendations, and post your own “green” tips and comments below.

Passionate About Protecting the Planet (Dr. Daniel Wolk)
“I’m a family physician in a suburb of Philadelphia with 3 internists. We’ve owned and run our practice independently for almost 16 years. Since I’m passionate about protecting our planet, we’re doing a lot to make our practice as “green” as possible. For example:
  • Using recycled paper products (NOT Kleenex!)
  • All light fixtures are fluorescent. When we renovated and downsized our office 2 years ago, we moved the waiting room and reception area so they have windows (for natural light and ventilation) and installed the most energy-efficient lighting available.
  • Our landlord planted trees in the parking lot (on his own).
  • All the thermostats are clock thermostats.
  • Computers and office equipment are Energy Star.
  • Copies of multiple pages are 2-sided.
  • The coffee maker is on a timer, so it heats only when the office is open.
  • We recycle all beverage containers, alcohol bottles, paper, and cardboard.
  • E-prescribing eliminates most paper prescriptions, and the patients love it!
  • Electronic referrals are paperless.
  • Finally, Epocrates on our PDAs makes a paper PDR unnecessary!”
What My Office Does to Stay Green (Dr. Kathleen Griffin)
“The things we do aren’t difficult to accomplish but when you add them up they are having an impact: Conserving electricity by closing blinds whenever possible; shutting off computers and other office equipment at night and especially on weekends and holidays; replacing all fluorescent fixtures with energy-conserving bulbs; using a timer-controlled thermostat; buying a low-energy consumption refrigerator; re-cycling all paper, plastic, aluminum, and cardboard products; converting to an EMR system with electronic billing; utilizing cloth drapes, not paper, and ceramic cups, not disposable; walking to work; sharing rides whenever possible.”
Tale From Brazil (Dr. Hugo Brito)
“Working as a family physician in Brazil is challenging. I was asked to visit a woman who had just had a baby and was complaining of shortness of breath. When I arrived I noticed a pile of garbage on fire outside her house with smoke coming out, a bad habit of her husband and many others in that district who consider burning easier than putting the garbage out once a week for the collector. They were completely ignorant about the risks for their own health and the environment. That was the starting point for a program of community education and working with local authorities to implement a rational garbage handling and recycling program.”
Saving Energy in My Private Practice (Dr. Jane Kano)
“I have a small private practice. I have recycled paper, including throw-away magazines, and all the mail that comes across my desk that is unidentified. I switched from providing bottled water for my staff to a standing cooler/hot water dispenser. I reuse most of the paper that has no identifiers on the back for copying. I turn off lights as soon as the day is done. Most of my lighting is fluorescent. If I sample a few weeks’ worth of meds in bottles, I combine them and recycle the plastic and cardboard boxes. I reuse chart covers that have been lightly used when shredding old charts. I use cloth gowns and a cleaning service. I reuse notebooks from conferences. Thank goodness, though, that we no longer have to sharpen and reuse needles and syringes like our predecessors. Nothing fancy here but I do what I can.”
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22 Responses

  1. Anne White, MD

    Hello, Epocrates! I couldn’t live without you and thanks for the “Green Issue”!
    We recycle as much as possible. Magazines from our reception area; medical journals, white paper, cardboard boxes medical supplies come in; sample cardboard boxes; plastic containers used for catered lunches for beverages; plastic containers brought in by staff for beverages; batteries are collected in a central location; old and unused computer discs; old computers go to the recycling center on electronics recycling day; all HIPAA sensitive material is placed in designated boxes at every workstation and shredded free at our local recycling center. My husband makes a trip about every six weeks and they shred it while he watches so he is absolutely sure that no one has access to our confidential information. Our community has had curbside recycling for around 15 years so has been way ahead of the curve on this thing. This is really about educating your staff, creating a recycling friendly climate and making it as easy as possible for every staff member to recycle. I challenge all of my colleagues to institute recycling in medical practices. This is part of maintaining the health of our planet and, ultimately, ourselves.

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  2. Dr. David Raskin

    We have a timer on the air conditioner (my office is in Florida) that automatically raises the temperature when office hours are over and only make it cooloer when the office is opening (not at night or on weekends). We also have a recycling bin in the staff kitchen to recycle metal, glass and plastics.

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  3. physician thomas stewart von drashek m.d.

    I do my part with b balanced complex. 250 mgm of complex effects renewed nural growth, so how much redder can you get.

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  4. saba khalid md

    We recycle whatever we can and also use recycled products in our practice.
    We use less disposable equipment and more of what can be sterilised and sanitised.
    All our lights are also flourescent.We turn off and unplug all equipment before
    closing,such as copiers,computers,shreders etc.. You can save electricity by using power strips at your outlets and unplugging just one outlet at night.

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  5. Regina Hampton, MD

    I am a solo general surgeon and have made many moves to go in the “Green” direction:

    1. I use an EMR and electronic billing system. Most of our checks are direct deposited into our operating account. My office manager has found the electronic billing system to more efficient and we get payments back in less than 2 weeks. She uses a system called Claims Tracker which checks our claims for mistakes on the front end to decrease the number of rejections and resubmissions.

    2. We take our outdated magazines to a local Bally’s fitness center so many other people may read them.

    3. Our office park has finally installed a recycle bin and we are using it faithfully. We use a company called Shred-It for recycling our confidential patient documents. They provide a large bin and the staff just tosses the papers into the bin. Once a month, Shred It comes by with a large truck and shreds the papers on-site. It is a great service and inexpensive. We do not have to listen to the annoying noise of a shredder going throughout the day.

    Going green is a must for us all. If everyone made one small change, it would go a long way to save our planet for our future generations. Happy Earth Week!!

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  6. Roland O’Leary

    Whether or not global warming is a hoax has little or nothing to do with the benefits of “going green.”
    Saving energy saves money if nothing else. In the southeast US much of the electricity is produced from coal much of which is produced by mountain top removal. There are also significant air pollution issues leading to forest(and human) health issues in the Southeast–how much due to electricity generation versus automobile exhaust I do not know. Recycling aluminum, glass, plastic(#1), paper, cardboard,batteries, and steel on a household or office basis takes some effort and unfortunately does not yield much financial reward at an individual level. However, most of these materials are in demand on the international commodities market which helps our trade deficit (we sell more overseas or we for example import less raw aluminum). It generally uses less energy to recyle these commodities and it puts less strain on our natural ecosystems than obtaining the materials at their source. Conserving water? That is a no brainer given the drought we have had here.
    “Going Green” has benefits for society as a whole just like practicing quality medicine does even if no one ever notices or says thank you.
    BTW, I recycle the coffee grounds from the hospital where I work and my plants are doing great (coffee grounds are high in nitrogen and add organic matter to my heavy clay soil).
    Thanks, Roland O’Leary MD Johnson City TN

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  7. Dr Sickels MD

    I’ve worked hard to find everything I can recycled: printing paper (100% post consumer, though for some reports I need a thicker paper and can only find 30% recycled), envelopes, TP, table paper, trash bags, note pads, sticky notes, even some of the letter trays are recycled. We use an EMR, so use less paper and printing that way, too (and then the patient gets whatever labs come in which they quite like). Faxes go straight into the computer, though for labs we still print them to put notes on them.
    Medications are persistent in the environment, so using a little as possible is also a good idea. When we can find a natural substance that gives good results, there’s no concerns about polluting with them. Certainly the popular practice of giving antibiotics for colds (bedsides being unjustifiable scientifically and actively discouraged in the journals) does us all a disservice by exposing bacteria to chronic low doses of antibiotics, encouraging resistance.
    Finally, the best term for what’s happening in our environment is probably “climate destabilization” since the “warming” is being targeted as false (by people with interests in the status quo, or people funded by them) by pointing in many places winters have been harsher than in the past.

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  8. Pam Rhodes, Managed Care Coordinator

    In our office we replaced water bottles with a water filter in our employee lounge. We also have recycling bins for plastic and aluminum (our P.A. volunteers to take them to the recycling center!) The office complex has a dumpster for paper goods, and we also use a shredding service that recycles the paper and gives reports on how many trees have been saved with our recycled paper.We have cotton gowns for patients and use a laundry service. Most of our paper products (toilet paper, tissues, etc.) are made from recyled paper.All bulbs are flourescent.

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  9. Terrye Reahr

    I take the used medicine (brown prescription ones)containers that are donated and give them to medical missions which use them to give out medications in 3rd world countries.

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  10. S. T. Moss, M.D.

    Anyone with a rudimentary scientific education is aware that Global
    Warming is a HOAX! Stop publishing this garbage, and get on with real
    medical information we can use!
    S. T. Moss, Rome , GA

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  11. Elizabeth Seet

    Changing our diet and moving more in the direction of a plant based diet is one of the best things we can do for the enviroment. There is a excellent book regarding why we should do it for health reasons but the side benefit is less waste and less pollluting the environment. “The China Study” by T. Colin Campbell. For anybody with cancer and coronary risks, this is the book to read. It totally changes the way we think about food.

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  12. Patty

    Use sterilizeable procedure instruments instead of the disposable ones.

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  13. Cathi Dries

    My suggestion for nurses will help keep landfills from growing!

    When a patient uses a bedpan or urinal, PLEASE rinse it and re-use, I know this is an unpleasant part of our job, but there are many times one patient will use several of these items during their stay, when one would have been enough. Also, don’t throw out bedpans and urinals when patients are transferred to another unit, they travel well. Just try to keep them out of sight, so the patient will not feel uncomfortable.

    When preparing new IV bags, use the tubing that is already attached to the patient. Be sure to always check compatibility of solutions, and continue to change bags and tubing as per your hospital policy.

    When changing linens only remove what is soiled. If patient questions this practice, remind them, no one changes all of their sheets at home everyday.

    In addition to being environmentally responsible, these few ideas will save your hospital money. (Maybe they will use it to improve staffing!)
    As an industry, health care needs to become more responsible, these are just a few suggestions for nurses that will allow us to do our part.

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  14. Robert Holmes Herzstein

    I am encouraged to hear from busy medical professionals taking some actions to green their practices. I work with many medical practices, and unfortunately many do not think about the environment.

    I would like to hear what others are doing to dispose of expired medications (such as samples). Even here in California, there is a confusing array of regulations and recommendations but no clear directives on the most responsible way to do this. Clearly, flushing down the toilet is terrible for the environment and human health (pharmaceuticals are now present in most rivers and streams and drinking supplies). Yet some practices still do this!

    I look forward to hearing how others are addressing this challenge.

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  15. Mark Schwartz PA-C

    Our Community Health Center joined our local (walking distance from the clinic) community garden. Patients and staff work together to grow and provide organic fresh veggies. The Gardeners get the benefit of naturally increasing activity, sunlight, freash air and engagement in our broader community. The community garden gets volunteers from the clinic (part of the commitment of our community garden) and the waiting room is stocked weekly-biweekly with produce harvested same day from the garden (usually gone in the first couple of hours we’re open.

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  16. Cindy Hall DO

    -I personally car pool to work and ride my bike on nice days.

    -Our office staff recycles all paper, plastic and metals.

    -We use cotton drapes and gowns for our patients.

    -We collect surgical and medical supplies for reuse on medical and spay/neuter missions.

    -Our heat and AC turn off on a schedule after hours and on weekends.

    -We use a paperless EMR for almost all applications including presciptions and are actively working towards a truely paperless system.

    -With staff support we are able to do all this with relatively little added effort reulting in large payoffs.

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  17. David Fraser, MD

    I am in solo-practice but have taken what steps I can to “go green”. We do recycle paper, buy 100% recycled paper prodicts when we can, will transition to all cloth draps and gowns by the ummer, and have installed a timer on the exisiting hot water heater. We use CFUs or flourescent lighting and have motion detectors in all bathrooms, storage areas. We have programable thermostats. We have installed metered water faucets in all bathrooms and patient rooms. This past year we installed two solar panels. The federal tax and state (NC) rebates actually work and we will install a larger (10 Kw) system this year. We also educate our patients in what we are trying to accomplish. There is more we can do and it does take time to slowly integrate “green” into your practice.

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  18. Donna

    I have started to avoid the PM courier pick up from the lab as I work in a rural site. The preserved samples can be delivered to the lab station in the morning. Also scheduling appointments that usually require labs in the AM when our lab is open saves a return trip for the patient. Walking orders and signed reports over to PT instead of faxing saves paper.

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  19. Suzanne Lahr

    We recycle our empty prescription bottles marked #2 on the bottom

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  20. Jerry Manoukian

    Recycling paper is a good start, but the rest of the story depends on our patronizing and supporting dealers who sell recycled paper. Many high quality 100% postconsumer recycled paper products are available.

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  21. Hunter Johnson, PSS

    Today I walked into a small physicians office that has table lamps in the waiting room. I looked over at the lamps to see it compact fluorescent bulbs (CFBs)were installed and they were not. On my next call, I plan to bring a couple of CFBs to save the practice $92 per bulb in energy costs while lasting 9 years in comparison to using 10 standard 1,000 hour 100 watt light bulbs.

    I realize folks have mentioned lighting, but let us not forget simple steps to save energy by replacing standard bulbs with CFBs in lamps when appropriate.

    Live Green!
    Hunter Johnson

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  22. Dr. Michael Zysik

    My wife and I are optometrists in private practice. Two years ago, when our lease on our office space was up, we built a new building for ourselves. During the planning stages to build, we learned of an incredible product, Nudura. Nudura is an ICF, or Insulated Concrete Form. We only had to spend a bit more to use an ICF for our exterior walls, considering the overall cost of the building and it was well worth it. The ICF literally means our exterior walls are made of foam on the inside and outside, and sandwiched in between is about 10 inches of concrete. From the exterior and interior it looks like any normal builing, and also gives it a very professional look from the inside since the windowsills are thick. But the real benefit is how energy efficient it is. The building is 3,000 sq. ft. We live in North West Ohio, where it gets quite cold and very windy, dropping temperatures well below freezing, and sometimes below zero. We heat the building with natural gas. Here is the benefit; are largest bill in the middle of winter during the coldest month, when our home bill was over $360, the same month to heat our office was only $100. The savings is substantial and the building is incredibly energy efficient!

    Other things we have invested in is paperless charting, or EMR’s. We also have all of our four exam rooms networked, so most all of our medical equipment, such corneal topographer, retinal digital camera, and aberrometer are viewed on computer screens in each room and electronicall stored, also saving on paper waste. We soon hope to have our other equipment linked up, such as visual fields, to be more efficient and green. All eyeglass orders and contact lens orders are filed and placed electronically, with no need any more for paper to fax and confirm orders. All these benefits have paid off in tremendous ways to help encourage energy efficiency, curb waste, and has even helped our practice grow since it is seen as very modern and up to date.

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