With money and energy on everyone’s minds these days, it’s a very opportune time for healthcare professionals to consider how our industry utilizes energy, and to take a more active role in the evolution of energy efficient health care.

Our current medical system is an intensive energy hog. The scary truth is that the US healthcare industry in aggregate uses 515 trillion BTUs annually. That’s 9% of the country’s total energy consumption, though healthcare facilities only take up 4% of total commercial office space. Hospitals use twice as much energy per square foot as non-medical office buildings (Energy Information Administration, http://www.eia.doe.gov/emeu/cbecs/pba99/healthcare/healthcare.html).

Approximately 85% of this energy consumption is petroleum based. Petroleum products are also used in many pharmaceuticals, medical equipment and accessories like heart valves, radiological dyes, films, intravenous tubing, syringes, disposable plastic instruments and oxygen masks.

In his work on ecological economics, Joseph Tainter looked closely at how to reduce energy dependence in complex systems like healthcare facilities. Improving efficiency and looking for ways to trim energy use certainly have their place. But the biggest impact, according to Tainter, comes from reducing system complexity wherever possible (Tainter J. “Complexity, Problem Solving, and Sustainable Societies,” excerpt from Getting Down to Earth: Practical Applications of Ecological Economics, 1996, Island Press, http://dieoff.org/page134.htm).

A method for reducing complexity was recently offered by Andrew Jameton, MD, of University of Nebraska, who offers a plan for reducing the scale of health care in the US by 50%. Dr. Jameton took a cue from the State of Oregon’s Health which was implemented by “creating a prioritized list of diagnosis-treatment pairs in order to ensure that benefit reductions eliminate only the least effective and valuable treatments” (The Oregon Health Plan, http://www.cwru.edu/med/epidbio/mphp439/Oregon_Health_Plan.pdf).

In Jameton’s plan “we rank-order various healthcare services according to their value, as rated by public meetings, and according to their energy costs. Then cut out the half that offers the least value for the highest energy costs” (Jameton A. Is a Modest Health Care System Possible? Synthesis/Regeneration. Fall 2007; 44, http://www.greens.org/s-r/44/44-08.html).

While this may seem a bit extreme, evidence from public health research provides a very convincing argument that overall population health indicators will not suffer from this type of reduction. Promoting a more conservation-oriented mindset across all industries and social strata, including health care, would actually benefit many people, while saving significant amounts of money and energy.

Jameton further suggests that promoting healthier lives provides even more savings. If we could harmonize preventive medicine and health promotion with efforts to reduce costs of buildings, power production, and transportation we’d be well on to our way to a healthier, low-energy healthcare system.

In the mean time, our small clinics and offices can make significant steps in this direction by focusing on energy efficiency and conservation. Begin with an energy audit. Many energy providers offer this-free of charge.

With a bit of evaluation and a commitment to reduced consumption, the typical medical clinic can save at least 20% on average energy bills. This adds up to quite a savings in bigger clinics. Here’s how to get there:

Evaluation: Conduct an energy audit, review energy bills monthly, and assess progress annually. Conduct monthly inspections and offer conservation incentives to staff.

Equipment: Use energy-saving features on all equipment; set computers to power down when not in use; turn off systems at the source; replace old equipment with Energy Star equipment; insulate heater pipes; recycle old electronic equipment.

Lighting: Replace incandescent bulbs with compact fluorescent, halogen, low voltage track-lighting or high pressure halides; install motion sensors and timers. Use task lighting for work stations rather than constant overheads.

Heating and Cooling: Obtain regular maintenance on heating/cooling systems to ensure optimal function; use ceiling fans; reduce sun exposure with shades or blinds; replace old windows with double pane windows; use UV coating on windows. Keep thermostats set at 68 for heating and 78 for cooling; Seal off unused areas of your building. Blinds, curtains and small fans reduce AC loads in summer.

Smart Work Station Placement: Arrange workstations to take advantage of natural light and turn off lights whenever possible.

“Green” is cool these days, so engage your staffmembers’ eco-enthusiasm and celebrate your successes. Tell your patients about the greening you are doing. In this way your office becomes a living example of how you support a healthy environment as well as a healthy economy. You’ll save money, and everyone will appreciate your efforts.

Joel Kreisberg, DC, MA, a chiropractor and clinical homeopath, is Founder and Executive Director of the Teleosis Institute, a non-profit organization in Berkeley, CA, dedicated to educating health professionals about the principles of ecologically sustainable medicine. Dr. Kreisberg maintains a private practice in Homeopathy and Holistic Healthcare in Berkeley, California.
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