We talk to patients about the perils of smoking, but are we ready to talk to patients about the more dangerous perils of climate change? Many health professionals will baulk at such a notion, but we need to at least prepare ourselves to listen to, and answer, expressions of concern from patients about climate change and health: people are becoming more concerned and will raise the subject. 

Two medical students reflect on how to respond to expressions of concern from patients about climate change and health.

Parsa Nazari

As health professionals who are privileged with a good education and an understanding of the health threat of the climate crisis, I believe it is our responsibility to think not only of the quality of life of the patients in front of us, but also the quality of life of others, including future generations. We are living in a time when the choices we make, both personally and professionally, will affect future generation’s ability to live healthy lives.

Engaging with patients who wish to talk about climate change is a critical challenge for modern healthcare professionals. We need to understand the key issues regarding the health and climate crisis so that our response is productive, helpful, and provides hope. But it may be even more important for two reasons not to say much, but to listen actively to the patient’s thoughts and feelings on the matter. 

Firstly, there may be direct health risks to the patient from the climate crisis: for example, patients with asthma may be concerned with air pollution in their area or patients may have general anxiety about the climate crisis. If health professionals listen actively, patients will see them as approachable and be more comfortable in mentioning these issues and having their fears validated.

Secondly, solving a problem as large as climate change will require input from everyone. Although these conversations could incorrectly be perceived as ineffective in tackling climate change, if carried out with active listening, they can benefit the patient, the professional, and the problem. These conversations can pave the way for practical changes.

I suggest that the best things to say to a patient who asks about climate change are “What are your concerns? I’m listening” or “That’s interesting, that’s important. I have concerns too. Let’s share them.”

Madeleine Jones

The responsibility of health professionals goes further than providing care to the patients in front of us. We have a duty of care to ensure we are doing the best we can to minimise the health impacts of climate change globally. We must have an active role in encouraging positive change to mitigate the climate crisis. 

Part of a health professional’s role as an educator includes improving people’s understanding of climate change and empowering them to take an active role in minimising carbon footprints of themselves, their organisations, and their country. Patients may feel anxious about climate change and the effects on them and the planet. Health professionals should validate these feelings and listen to patients as they would with any other concerns the patient might have. 

The recent ruling that Ella Kissi-Debrah’s death was related to illegally high levels of local air pollution is likely to have a big impact on patients’ worries about the health of them and their families. Health professionals must keep up with changes so we can respond to patients’ concerns. We need to know about what we can do to minimise harm to the planet and improve our health. Helping patients to be active in mitigating climate change can help them feel that they are part of the solution not the problem and reduce their anxiety. Lastly, if patients are open to the idea we should help them know how to exert pressure to achieve large scale changes.

Conclusions

Health professionals have a duty of care to respond to concerns from patients, colleagues, and the wider public about the health effects of the climate and ecological emergency. It is not enough for us to feel that we are too busy saving patients to save the wider system on which all health depends. We should consider the climate emergency as an immediate health emergency, not a distant environmental inconvenience.  We should share the anxiety and anger of many of our colleagues and patients that we know so much and are doing so little. Taking action alongside patients and public can be one of the most fulfilling and meaningful parts of our personal and professional careers. The crisis is happening on our watch and how we respond will be our legacy.

Parsa Nazari, Medical Student, Barts and The London School of Medicine and Dentistry, UK.

Madeleine Jones, Medical Student, Barts and The London School of Medicine and Dentistry, UK.

Thanks to David Pencheon and Richard Smith in their encouragement to write this article.

Competing interests: none declared.