Assessing hospitalists' opinions regarding the role of environmental health within the practice of hospital medicine

Abstract

Background Environmental health represents the concept that a stable climate and clean environment are fundamental prerequisites for good human health. Despite growing awareness of the impact of climate change more broadly, knowledge of environmental health has not fully entered mainstream medicine in the United States. Objective To understand practicing hospitalists' perspectives regarding the current and future roles of environmental health within the practice of hospital medicine, as well as existing barriers and potential motivators to its further inclusion. Methods We conducted virtual focus groups of practicing hospitalists in partnership with the Hospital Medicine Reengineering Network from across the United States. Structured interviews elicited hospitalists' thoughts pertaining to environmental health. Transcripts then underwent descriptive coding to identify and group comments into themes. Results We conducted three focus groups with a total of 14 physician participants. Four themes emerged: the negative environmental impact of the healthcare system, a lack of prioritization of environmental health within hospital medicine, the potential for expanding environmental health in nonclinical roles including medical education, and the importance of systems‐level support. Conclusion Environmental health is felt to be of importance, and while there exist avenues to do better, there is limited understanding of hospitalists' most effective role in making change.

Hospitalists can learn from antimicrobial stewardship programs when it comes to environmentally conscious prescribing

“…Although there is widespread understanding by physicians that human health is dependent upon a stable climate and a clean environment, it is still regarded as outside of the hospitalist's role to address. 9 A cohesive and structured approach that also values the work of the physician and patient health through thoughtful prescribing would highlight the concept that hospitalists can make impactful change in their day-today clinical work.…”