By Ioannis P. Pappou, MD, PhD

The answer to the former question is simple: Yes, there is a place for conservation and the effort needs to be increased significantly.

The answer to the latter question is more complicated. We live in a wasteful era and the American society does not prioritize the environment. Unfortunately, we are not doing enough for the environment in our professional lives as surgeons.

I see ample opportunities to improve the environmental impact of healthcare delivery. I will attempt to set some realistic goals and give some simple examples of how they can be implemented in daily activities of hand surgeons.

1. Understand there will always be some waste and residues that will be harmful to the environment. That will probably will never change, but there needs to be a conscious effort to minimize that type of waste and improve on all other sustainable aspects. Right now, our effort is minimal to non-existent. There is no upside to becoming more environmentally conscious and no punitive measures for waste and pollution.
2. We should recycle more and convert to recyclable materials. Take injections, for example. The syringes, though plastic, are not recyclable. We could convert to syringes from recyclable plastic. Also, medication glass vials are not routinely recycled either.
3. Convert to recyclable or green plastic: There is bioplastic available now commercially, composed out of biodegradable sugars. This bioplastic holds great promise for the future to replace conventional plastic should we be able to make the material properties similar to what we use now and the bioplastic durable enough to withstand sterilization procedures. At the very minimum, some plastic packaging can hopefully be replaced by bioplastic.
4. Reuse rather one-time use. This is particularly applicable to the operating room, where gowns and drapes are commonly one-time usage in the USA whereas in many other parts of the world, they are sterilized and reused.

What are the biggest deterrents to improve the environmental aspects of healthcare deliver?

1. Cost. Currently, it is cheaper to be wasteful society and not be environmentally conscious. If we were to contemplate the true cost of trying to cleanse the environment from residue that is non-biodegradable, our current society would be rather expensive. All we’re doing is we are creating a huge environmental debt for next generations to pay off, which is unfair for our children.
2. General societal disinterest: The society disregards the environment. The policies and rules should be nationwide, not just in healthcare. If we lived in a society that prioritized the environment, those conservation efforts would permeate all of the society fabric and transfer to healthcare as well.

I believe there is great hope. We physicians are caring and conscientious human beings. The society is becoming increasingly aware of the need for environmental conservation/protection and pollution minimization. I’m hopeful that we will soon start to implement such policies in healthcare. Not only should we. We must, for the sake of our children and future generations.