Katie Lichter, MD, MPH, a resident physician in the Department of Radiation Oncology and a UC San Francisco Climate Health Fellow, is prioritizing the reduction of greenhouse gas emissions within the healthcare sector. Lichter recently joined colleagues from the National Academy of Medicine to present at the Medical Society Consortium on Climate and Health’s annual meeting in March. The Consortium, represented by 500K physicians, supports educating the public and policymakers in government and industry about the harmful health effects of climate change and the immediate and long-term health benefits associated with reducing greenhouse gas emissions.
Lichter was one of three experts speaking at this year's conference on the issue of decarbonizing the healthcare sector. "There is a lot of momentum in this area," she said. "Leaders across the sector are coming together to not only make commitments towards decarbonization and achieving net-zero healthcare emissions but are taking steps to take action today."
Lichter framed the issue as it relates to oncology using three questions:
1. How does climate change impact cancer care and her patients?
2. How does the delivery of cancer care contribute climate change?
3. How can healthcare professionals organize to inspire the change and action today?
“It really comes down to three terms – adaptation, mitigation, and advocacy,” she said.
As part of the presentation, Lichter explained how she and her colleagues have examined how climate change impacts patients at UCSF. They looked at the record-setting wildfire season of 2020 and how many cancer patients missed treatments because of the fires.
They also created a six-minute waste audit focused on biohazardous waste. “Through the audit, we were able to completely eliminate biohazardous procedural waste within our department for a common procedure called brachytherapy,” she said.
Life cycle assessments were also used to analyze outpatient treatments delivered by UCSF Department of Radiation Oncology. The team found that 90 percent of their impact comes from transportation. For patients receiving transportation assistance to and from the clinic for daily treatments, the team discovered it could reduce emissions by 25 to 30 percent by booking patient rides via Uber Green a low-emission ride option that connects passengers with hybrid and fully electric vehicles.
The team also analyzed emissions related to conference attendance and found that during Covid, everything went virtual. They studied emissions from conference attendance to see how in-person and virtual attendance impacted the environment. With this data, they developed a conference emission calculator called Network Greener, which individuals or conference hosts can use to estimate how their choices impact emissions. Conference organizers can see what the potential reduction would be when hybrid conference formats are permitted rather than in-person only. Lichter sees this issue as not only planetary health but also equity and inclusivity, as hybrid conferences allow individuals who otherwise may not be able to travel for an in-person conference due to financial, caregiver responsibilities, etc., to still participate.
Lichter said many people at UCSF have been involved in analyzing healthcare through an environmental lens, including launching the GreenHealth Lab, which studies the interplay between healthcare delivery and climate change. The lab explores the impact of the healthcare system and health institutions on the environment and the impact of climate change on clinical and patient care.
Lichter believes UCSF students, trainees, and faculty alike have a significant role to play in introducing new initiatives in climate health at the university. "Many of the initiatives in climate health at UCSF have been spearheaded by students. Students have powerful, empowering voices. Taking action today can help protect the health of our future patients, communities, and families."
