Practicing medicine with greater environmental responsibility can mean many things. We can prevent the mercury from the broken thermometer from ending up in the medical waste incinerator, or limit our use of polyvinyl chloride, or reduce the volume of waste taken to transfer stations and landfills. But our “environmental impact” extends even further, and includes the emotional environment of our clinics. Respecting the environment starts with respecting coworkers and our places of work.

Medical practices are in the difficult position of balancing cost while maintaining quality of care. When working towards the goal of a more satisfied patient, care must extend beyond the patient to our colleagues and staff-members. Patient satisfaction is not only a result of how we treat our patients, but how we treat each other. Working together towards this common goal requires taking responsibility for our actions, listening to each other, and helping each other work effectively. It requires us to “walk the talk.” If we don’t do it ourselves, it’s just words. It all comes down to respect—for ourselves, our coworkers, our patients, the communities we serve, and the environment.

In caring for a patient we sometimes forget the colleague standing right next to us. In the rush to “deliver care,” we are blind to the staff-member in the elevator, the people picking up the waste, scheduling appointments, maintaining medical records, or repairing medical equipment. Every job function is a vital piece in the health care puzzle. When put together properly, the puzzle reveals an image of a satisfied patient and a healthy work environment. But when certain pieces are missing, the image becomes unclear. One or two missing pieces may not be noticeable, but the more that are omitted, the more incomplete and incoherent the picture. And it doesn’t matter how clear and nice some of those individual pieces are. Without the rest, they are nothing. A physician may be highly revered as a clinician, but without a strong support team, clean equipment and offices, and good scheduling, patients get frustrated and move on towards a more cohesive practice.

Nothing makes a staff-member feel worse about work than to be faced with an unsafe work environment—such as finding a needle in the waste stream or left on a counter top. Sloppy waste practices not only impact the environment and increase the risk of fines, they can also impact the health of our coworkers. What an irony—in the process of providing health care, we might make the person right next to us sick! Staff deserves a safe work environment—a clean workplace, proper personal protective equipment, a neat place to change and to have lunch and break time, proper orientation, and clearly communicated expectations. Anything less will not sustain employee satisfaction. And dissatisfied employees make for dissatisfied patients. You might not be aware of low morale in your office, but you can bet a lot of your patients are.

Simple things can help staffers do their jobs and make operations run more smoothly for everyone. Little things like holding the door for coworkers, removing protective equipment before leaving the practice, cleaning up after yourself whether in the lunch room, at the photocopier or in the exam room, stepping out of the elevator to let patients in, washing your hands, turning off computers at the end of the day, and making sure all sharps are properly discarded into a sharps container can really add up to a tremendous improvement of the environment in your practice.

When making major decisions that will affect the daily operations of the practice, try to include representation from all departments and areas. There is less resistance to change when staff-members are involved in the decisions. Regular staff meetings offer opportunities to learn from each other and to listen to all ideas. Responding to these suggestions, even small ones, leads to better morale, potential cost savings and improved operations.

Compliments and recognition go a long, long way. Remember to compliment the cleaning service personnel for getting the floor to shine. Make an effort to remember people’s names. Say good morning to staff members you pass in the hallway. If you work in a hospital or large group setting, take a walk through an area that you don’t usually frequent. You might learn something interesting, and you’ll be able to recognize the importance of the work that goes on outside of your normal view.

And those people that take that extra step? They should be recognized and rewarded for their commitment. Gift certificates, raffles, awards and simple public recognition are a great way to say “Thanks.” Staff members work hard and they need to be recognized. If they think no one cares, they might stop caring too.

The bottom line is, if you want to show how much you care about the patients and communities you serve, start with the staff who work so hard to make the patients’ care run smoothly—the people that schedule the appointments, clean the offices, prepare your equipment, manage your files, greet and aid your patients. Patient satisfaction begins with professional satisfaction, and it all starts with listening.…

Janet Brown is the medical Waste Manager for Beth Israel Medical Center, New York City. Beth Israel is firmly committed to reducing the volume and toxicity of its waste stream. Many of the strategies that work for Beth Israel can also work for you.