Government, GPs, and practice teams must act decisively and ensure the nation's general practice care system is prepared for the rising impact of climate change.
It comes following the College's submission to the federal Government's National Health and Climate Strategy, which aims to protect the health and wellbeing of Australians from the effects of climate change. The RACGP recommendations include:
· data from general practice and primary care being incorporated in the measuring, monitoring, and reporting of emissions
· the need for guidance for practices on how to reduce the environmental impact of healthcare
· ensuring prevention activities are in place to protect vulnerable patients as well as boosting access to telehealth.
Recently, the RACGP joined 11 other leading medical colleges issuing a joint statement stating that Australia's healthcare system remains unprepared to grapple with the risks to health and health systems that climate change poses. Last week, Chair of RACGP Specific Interests Climate and Environmental Medicine, Dr Kate Wylie, and College spokesperson, Dr Catherine Pendrey, attended the Doctors rally in Canberra and spoke out against new Northern Territory fossil fuel projects. They called for the extraction and processing of gas to be stopped because of the potential health impacts.
RACGP President Dr Nicole Higgins called for action.
"Natural disasters in Australia, including bushfires and floods, will increase in frequency and severity as climate change progresses, and we must be prepared," she said.
"Recent news reports about the heatwave and bushfires striking parts of the northern hemisphere are just another reminder of what the new 'normal' looks like in a world impacted by climate change and GPs and practice teams have an important role to play.
"Preventive action is crucial and something that must be front of mind. We know that people aged 65 years and over, children, and those with underlying health conditions are particularly vulnerable to climate-related extreme events and that includes the loss of health infrastructure and disruption to care. So, before a disaster occurs, GPs have a role in discussing and motivating patients to prepare emergency plans based on local climate threats and their own personal circumstances and health needs.
"We must also consider the environmental impact of primary care. Our entire healthcare system contributes to 7% of the nation's total carbon emissions. While general practice only accounts for 4% of the health sector's total, we have a role to play and data from general practice care should be incorporated in the measuring, monitoring, and reporting of emissions. However, we do need to make sure that any reporting doesn't tie us down in overly burdensome red tape because that is the last thing busy practices need.
"Telehealth is vital too. A telephone or video consult can help facilitate access to care and reduce emissions associated with patient travel. So, for example, for some rural and remote patients a telehealth consult may be perfectly suitable rather than a long drive to sit face-to-face with their GP. The Government has announced funding to enable access to longer telehealth consults for patients registered through MyMedicare. Let's go a step further and make Medicare rebates for longer telehealth phone consultations a permanent fixture of our telehealth system for all patients."
Chair of RACGP Specific Interests Climate and Environmental Medicine, Dr Kate Wylie, labelled the current state of climate action a "health emergency" that she is already seeing play out in her own practice and called for action.
"At the rally in Canberra last week I saw a large group of people committed to protecting the health of people in the Northern Territory," she said.
"We are talking things like bad pregnancy outcomes, miscarriage, low birth weights, we are talking childhood cancers. We are also talking obviously the effects of pollution on adults as well – so heart attacks, strokes, chronic lung disease, and then also the effects of lack of water.
"It's time for change – the health of our communities must come first. As a doctor I have a duty of care to look out for my patients' health. The politicians have a duty of care to look out for the best interests of the people of Australia and they are not doing that when they expand coal and gas. We should not be throwing petrol on the climate change fire."
Dr Wylie also urged practices to explore how they can make a small but important difference in the fight against climate change.
"Making information public about the environmental impact of different drugs and treatments would be an important tool for GPs' decision making in day-to-day practice," she said.
"For example, I want to know out of Crestor and Lipitor, which one has the highest carbon footprint. The two most prescribed drugs in Australia, if one has a lower carbon footprint than the other, I can save a whole heap of carbon just by what I choose to prescribe. Easy."
The RACGP advocates for policies to protect human health from risks of climate change at local, state, national and international government levels. The College's guide on environmental sustainability in general practice can be found here.
College has published the Red Book: Guidelines for preventive activities in general practice (9th edition), which takes an evidence-based approach to limit screening and case finding activities to those with sound evidence backing. This reduces overuse of pathology testing, diagnostic imaging, and preventive pharmaceutical treatments with associated environmental impacts.
