By Cary Tanner, MD

Dr. Lutsky posed the above question for consideration in ASSH Perspectives. Anyone can correct me if I am wrong, but I propose that the best model for conservation is one in which the human spirit is unfettered with regulation, government survey standards, the specter of liability, and where financial support is sparse. Under such conditions, experience tells us that humans will conserve!

All of our colleagues who have generously served as hand surgeons on international missions understand what real conservation is. They return enriched by the experience but with one common sentiment: “We waste so much!” It does appear to many of us that we have become a “throw away” culture, and this affects for more than medicine.

It is not just us. Consider this: our region of California has one of the highest farmland yields in the world. It produces over half the vegetables, fruit, and nuts consumed in the nation. Not all of it makes it to market, yet there are people that are hungry. There are many causative factors for this but a spirit of generosity is not one of them: our growers, packers, and shippers are very willing to and do participate in programs of charity but to a far less extent than many would like.

Conservation in our ASCs, hospitals, and office practices is much the same.  We can recycle, minimize or eliminate Styrofoam, reprocess equipment when possible, operate low energy systems, use clean fuels in back-up generators, etc. We reprocess 12,000 otherwise “throw-away” instruments per year.  But that is a small number of the total used.

But instead of throwing everything else away, we send what we can to a culture that appreciates it and gets far more mileage out of it. We have physicians who grew up as missionaries and they help to organize the filling of shipping containers of usable supplies that are sent to a foreign land.

This is a global form of conservation, and we are thankful for that. We just don’t have much else.