Facing Climate Change in the Medical Office: “The Green Doctor Office Program”

1. Facing Climate Change in the Medical Office: “The Green Doctor Office Program” Todd L Sack, MD, FACP Jacksonville, FL tsack@bgclinic.com www.mygreendoctor.org American Association of Public Health Physicians Chicago, IL June 2012

2. About the speaker… • Gastroenterologist in Jacksonville, FL • Past Chair, Jacksonville Environmental Protection Board • Past Chair, Climate Change Advisory Group for Florida Energy Commission • Past Member, Florida Energy Commission • Chair, Environment & Health Section, Florida Medical Association

4. FMA Policy Positions • The Physician’s Responsibility for the Environment and Health (2004) • The Health Risks to Floridians of Lead Toxicity (2004) • Health Risks of Florida’s Coal-Burning Power Plants (2005) • Mercury Toxicity Poses a Significant Preventable Health Risk to Floridians (2005) • Climate Change & Human Health (2007)

5. FMA Policy Positions (cont.) • Urban Development in Miami-Dade County & Everglades Protection (2007) • Incinerators & Risks to Human Health (2008) • Safe Disposal of Pharmaceuticals (2009) • Motor Vehicle Idling in Florida (2009) • Informing Floridians of the Health Benefits of Fish Consumption and Dangers of Mercury Toxicity (2011) • Informing Floridians about the Risks to Municipal Water Supplies & the Limitations of Bottled Water (2011) www.fma.environmentandhealth.org

6. Climate Change & Doctor Offices • Millions of doctor offices worldwide • We use significant resources • Doctor offices are community role models • Billions of patient-hours spent in doctor offices annually • Potential sites for improving public health

8. Drawbacks of Medical Offices • Low awareness of our environmental impact • Low science education levels • Low environmental knowledge base • Low leadership skills • Lack of authority for new initiatives • Lack of time for new initiatives

9. FMA’s Green Doctor Office Program: “Saving money, improving public health”

10. Concepts of mygreendoctor.org • A free, web-based tool to teach doctor office employees how to form and manage their own office Green Teams • Offer simple, prescriptive Actions Steps that the Green Team can undertake to make changes in the office • No science background necessary • Tools for teaching patients & communities

11. Goals of mygreendoctor.org • Increase the environmental knowledge of doctor office workers • Improve office use of resources • Improve office working conditions • Improve home resources use by office staffs and patients • Improve community environmental quality & public health :

12. Why go “green” ? • Save money by improving operations • Create a healthier work environment • Improve office morale • Retain employees and lower absenteeism • Improve public relations through “Green Doctor Office Recognition” • Improve patient & community health

13. What is the “Green Doctor Office Program”? • Located at www.mygreendoctor.org • Administered by the Environment & Health Section of the Florida Medical Association (Tallahassee, FL) • Launched April, 2010 on World Earth Day • Available free to other health professional organizations

14. Suitable for… • Any doctor office providing outpatient services or administrative functions • Medical, diagnostic or surgical centers, dental, psychologists, chiropractors, therapists, or administrative offices • Typically offices with 5-50 employees

15. What viewers will find at www.mygreendoctor.org: • Registration Form • “Quick Start Now!” • Overview pages • “Contact Us” • 7 comprehensive workbooks • Green Team Notes form • Waiting room brochures

16. What else ? • Program Summary • Computer Requirements • Why Businesses Are Going Green • Role of Doctor Offices in Community Health • Why the Green doctor Office Program • How it Works • Achieving Recognition • Building Your Green Team • Meeting Schedule • Web Resources, References, & Bibliography • Confidentiality & Responsibility

17. Seven workbooks offering more than 120 Action Stepsand Education Steps: • Energy Efficiency • Renewable Energy • Water Efficiency • Solid Waste & Recycling • Drug Disposal & Chemicals • Transportation & Commuting • Healthy Foods

18. Energy Efficiency Workbook: • Introduction • Background Information • Office Assessment • Action Steps • Educational Steps Introduction:Energy efficiency is the cornerstone of the Green Doctor Office Program.  This is where a doctor office can capture the greatest financial savings and make the strongest community impact.…

19. “Office Lighting” Action Steps • Change to CFL’s & LED’s • Properly discard fluorescent bulbs • Install T-8/5 fixtures • Turn off lights • Use task lighting • Motion detectors • Hire an energy consultant • Teaching in the doctor office • Education Steps

20. How to get started… • Register at www.mygreendoctor.org (it’s free, no passwords required) • Go to “Quick Start Now!” • Get yourself “hooked” by reading the Overview pages (10-15 minutes) • Find an office Green Team Leader • Schedule a luncheon Team meeting • Order the first pizza

21. Achieving Green Doctor Office Recognition • Required are 5 meetings, 5 Action Steps, & 5 Education Steps • Must demonstrate regular meetings and significant accomplishments • Reporting your progress is easy using the “Green Team Notes” form • Can be ready for recognition in 6 months • Reviewed by FMA physicians

22. GDOP Status Report • Website launched April 2010 • Registered 116 offices • 38 Florida counties • 17 US states, 3 countries • 18,784 employees • 6 offices awarded “Recognition” status

23. “Recognition” Success story • Escambia County Health Department • Five medical offices • Pensacola, Florida • 11 Green Team meetings • 11 Action Steps reported • Awarded “Recognition” January 2011

24. Escambia County HD: Action Steps Completed • Comprehensive recycling • Double-sided copying • Purchase recycled-content paper • Scan all documents • Policy to turn of lights at night • Removed bulbs in multi-bulb lights

25. Escambia County HD: Action Steps Completed • Eliminated personal appliances • Installed motions detectors • Purchased a hybrid vehicle • Discontinued hot water in all offices

26. Escambia County HD: Savings • Saving energy every month • 125,000 kilowatt hours electricity • $14,000 saved annually • 85,600 pounds CO2 per year • Equivalent of 4,349 gallons gasoline

27. Tips for Green Team Success • Gain permission from management • Find an office Team Leader • Reward your Team • Meet regularly (monthly) • Choose small, steady improvements • Find an advocate for each Action Step • Keep “Green Team Notes” • Engage your entire office staff • Inform your patients • Aspire for “GDOP Recognition”

28. Assessment after 2 years • Doctor Office Green Teams are popular • Build office cohesion, pride, & morale • Realistic to save $2500 per office per year • Requires a dedicated team leader • No science background necessary • Best with small, progressive changes • Potential for improving the public health • Requires real work to be successful • Relatively few users so far

29. Current Directions • Increase awareness of the Program • Partner with professional organizations • Develop more educational materials • Begin a website re-design • Consider developing an “app” • Improve metrics for analysis of outcomes

30. Facing Climate Change in the Medical Office: “The Green Doctor Office Program” Todd L Sack, MD, FACP Jacksonville, FL tsack@bgclinic.com www.mygreendoctor.org American Association of Public Health Physicians Chicago, IL June 2012