Talking about Climate Change and Environmental Degradation with Patients in Primary Care: A Cross-Sectional Survey on Knowledge, Potential Domains of Action and Points of View of General Practitioners

Abstract

Purpose: General practitioners (GPs) could play a role in mitigating climate change by raising awareness of its impact on human health and implementing changes to improve population health and decreasing environmental footprints. The aim of this study was to assess GPs’ knowledge and perspectives about the health impacts of climate change. Method: A questionnaire was sent to 1972 GPs in the French-speaking part of Switzerland. Knowledge of the impact of environmental degradations and climate change on health and willingness to address climate change with patients, to be exemplary and to act as role models were surveyed as well as demographic characteristics of GPs. Results: Respondents (N = 497) expressed a high level of self-reported knowledge regarding climate change, although it was lower for more specific topics, such as planetary health or health–environment co-benefits. Participants mostly agreed that it is necessary to adapt clinical practice to the health impacts of climate change and that they have a role in providing information on climate change and its links to human health. Conclusion: Most of the GPs were concerned about environmental and climate degradation. However, this study revealed a gap between the willingness of GPs to integrate the impact of climate change on health into their clinical activities and their lack of overall knowledge and scientific evidence on effective interventions. A promising way forward may be to develop co-benefit interventions adapted to the clinical setting on diet, active mobility and connecting with nature.

How to communicate about climate change with patients

“…However, this is not widely or consistently undertaken even by family physicians and general practitioners 9. Consistent integration of environmental history into clinical encounters has the potential to improve identification of climate sensitive harm to patients, although improved training is needed in this area 10. Because time limitation is most often cited as the reason clinicians do not conduct an environmental history, educational efforts should aim to demonstrate how environmental and exposure history taking can be integrated into the clinical encounter in a relatively non-interruptive manner, centred on the patient’s chief complaint or primary concern 9.…”

“…The evidence base for the effective use of climate counselling in the clinical encounter remains thin 1623. However, with the recognition of the urgency of climate change as a health hazard, the demand for the development of meaningful, evidence based, and clinically oriented interventions grows 10. Research is needed on optimal climate related education strategies, how to build clinicians’ competency to implement those strategies, and how to alleviate the previously identified barriers to clinician engagement within the clinical encounter 1424…”

Patients’ perceptions of climate-sensitive health counselling in primary care: Qualitative results from Germany

“…So far, studies show that health professionals feel responsible for conducting CSHC but do not implement it [ 7–11 ]. One main barrier is high uncertainty about patients’ perceptions of CSHC: In several studies, physicians and other health professionals express the fear that patients might perceive climate change to be too politicised for the clinical setting [ 7–9 , 12 ]. Moreover, they worry it could compromise the therapeutic relationship [ 8 , 12 ] or expect low interest among patients [ 7 ].…”

What can we learn from Australian general practices taking steps to be more environmentally sustainable? A qualitative study

“…The focus of research on environmental sustainability in general practice has included the carbon footprint of staff and patient transport, 17 patient and physician attitudes to climate change and health, 18 , 19 general practice trainee education, 20 the environmental impact of social prescribing 21 and the application of an educational tool to reduce the environmental impact of general practice, 22 as well as a review of progress made by primary health trusts in England. 23 Recently a carbon footprint of primary care practices in Switzerland has been published.…”