When the University of Florida in Gainesville built its new freestanding Orthopaedics and Sports Medicine Institute five years ago, the practice made the decision to be eco-friendly. It was a good move, both for environmental sustainability and for the practice’s pocketbook, says the institute’s administrator, Leslie Jebson.

 

“We set a goal of making the workplace more green without spending any extra green. That was our motto,” he recalled.

 

When it comes to improving practice operations, more and more physicians and medical office managers are jumping on the green bandwagon. Yet the benefits go far beyond saving the environment and saving cash. There’s a goodwill dividend as well, with patients, with the community and among employees gratified by their role as environmental stewards.

 

The University of Florida set about making an environmental splash with its attractive facility, which is Leadership in Energy and Environmental Design (LEED)-certified “It’s considered one of the most green buildings on a university campus in the United States,” Jebson said. Built using varied recycled materials and with extra insulation, the building boasts a thermostat that automatically adjusts depending on the day of the week and time of day. The rooms feature motion-activated lights, and a system is in place for water reclamation. During construction of the adjacent ambulatory surgery center, displaced earth wasn’t hauled away, but was used instead to create an attractive berm around the property that serves as a natural sound barrier. That strategy alone saved the clinic about $250,000, Jebson estimated.

 

“The spirit continued with the employees,” he added. While he acknowledged that “there was some hesitation at first” as changes were implemented, staff members didn’t take long to recognize the benefits. Recyclable plastic coffee mugs have replaced Styrofoam cups, and the move saves nearly $2,000 a year; patients are asked to bring their own mugs or reusable water bottles, too. An ongoing initiative to scan and electronically manage documents cut the bill for paper and toner by $12,000 in the first year alone. Jebson said the goal is to be “completely paperless with an outpatient electronic medical record.” The clinic has eliminated pagers – and thus the need for those batteries – and now uses cell phones as the primary communication tool. That change saves “several thousand dollars per year,” he said, adding, “There’s no need for pagers, in my opinion, anymore, even in an academic center. You just need to know who’s on call and how to get in touch with them.”

 

A big change for everyone was the addition of comprehensive recycling. “That was a very simple and significant addition to our clinical and administrative space – a provision of dedicated recycling boxes throughout the facility for papers, toners, magazines. We have multiple, blue recycling boxes in place,” he said.

 

Jebson added, “We continue to challenge ourselves by looking at the most creative ways in which we can minimize our footprint and continue to be good stewards in the building environmentally. Frankly, that turns into a financial savings.”

 

Joel Kreisberg is founder and senior director of the California-based Teleosis Institute, a nonprofit organization founded to encourage “sustainable medicine.” Kreisberg recommends much of what the University of Florida has accomplished with its orthopaedics operation. “It’s an important thing to say right off the bat that the amount of money you save pays for everything you do,” he said, pointing to six categories that physician practices should tackle to alleviate their negative environmental impact. They are:

When it comes to solid-waste reduction, Kreisberg recommended recycling first, but then suggested that practices take the next, more difficult, steps. Alleviation of single-use devices is a good place to start. “In the 20^th century, we went to single-use devices. We thought it was a great solution. We’re not set up for autoclaving in offices and reusing, but we’re going that way,” he said. “Medicine is pretty far behind on this one, but you can see the natural growth industry. It’s a little bit like solar technology. It’s going to take 20 years, but you’re going to see more and more.” He noted that the dental industry is leading healthcare’s way when it comes to reusables. A good next step? Cloth rather than paper patient gowns, as long as the practice is set up to handle sanitizing on site.

 

For the sake of environmental protection, physician practices are in a unique position to set the standard for proper disposal of unused pharmaceuticals. When not properly disposed of, pharmaceutical ingredients can leach into the water supply from landfills and can pollute water if flushed down the toilet. Considering the copious amounts of sample pharmaceuticals many clinical practices store and dispense, it’s a good idea for practices to establish disposal guidelines.

 

Julie Becker is a Philadelphia-based environmental consultant with a doctorate in public health and director of pharmaceutical management for Health Care Without Harm, a nonprofit that promotes ecologically sound medicine. She says smaller healthcare practices may dispose of occasional amounts of pharmaceuticals by mixing them with used coffee grounds, tea leaves or kitty litter, double bagging the mixture in plastic and simply tossing it in the trash.  Larger practices should turn to their commercial waste haulers for guidance. “I have found from my research that when people don’t know what to do with things, they put them in the sharps container, which really isn’t the right way to go,” she said. Practices that accept unused pharmaceuticals from patients and then properly dispose of the drugs deserve a gold star, she added.

 

Becker encouraged physicians to push pharmaceutical companies to do away with the practice of dispensing drug samples, encouraging them to instead provide vouchers that patients may redeem at their pharmacy. She said Maine and Minnesota are successfully making such trial programs work.

 

Other recommendations from green experts include: