SHOULD YOUR DOCTOR TALK WITH YOU ABOUT CLIMATE CHANGE?

Carlos Varas sprays pesticide to kill mosquitoes in the Miami Beach neighborhood of Florida, a state that has experienced localized transmission of the Zika virus. Zika's spread north into the United States is attributed to climate change. (Joe Raedle / Getty Images)

 

Even though the topic can be controversial, some doctors plan to start talking with their patients and communities about climate change...

A coalition of mainstream medical associations that together represent more than half of all American physicians announced this week that it will urge white-coat professionals to link health problems such as asthma, allergies and the spread of certain diseases with environmental shifts that most scientists believe are caused by global warming.

The American College of Physicians, the American Academy of Family Physicians and the American Congress of Obstetrics and Gynecology are among those that have joined the new Medical Society Consortium on Climate & Health. In its first public remarks Wednesday, the group cited the northward expansion of tropical infections like Zika and warming temperatures causing heat-related illnesses as examples of climate change’s impacts on health.

The consortium’s stance runs counter to the opinions of some critics who said today’s science has not yet reached the level of precision and sophistication necessary to make such direct connections between environmental and health effects. Some also wonder whether discussing sensitive political issues with patients could erode trust between doctor and patient.

The consortium is asking physicians to volunteer to become “champions” in their communities by speaking out to their own patients and to local policymakers. Its website — medsocietiesforclimatehealth.org — includes handouts that assert how climate change affects asthma, allergies and heat-related medical problems.

“We believe the risk is there and it’s growing. We really need to speak out,” Dr. Mona Sarfaty, the consortium’s leader and director of the Program for Climate and Health at George Mason University in Virginia, said Wednesday.

Dr. Jennifer Marks, who teaches medical students how to communicate with patients in her role as an associate professor of clinical medicine at the Keck School of Medicine of USC, said the rule is generally to avoid controversial topics on which people may disagree.

“We see patients with all kinds of beliefs about many things that we may not necessarily share, but that should not alter how we take care of their health,” Marks said. “I want them to share whatever’s on their mind and feel that they will not be judged.”

On the other hand, she added, doctors are obligated to keep up with the latest research in their fields. They do need to understand what’s driving patient’s symptoms so they can effectively treat them.

Asked whether she would mention climate change when advising a pregnant woman how she can avoid Zika virus-carrying mosquitoes, Marks said including an explanation of climate change would not necessarily top her list.

Explaining to patients that many scientists link climate change to the expansion of mosquito territory, she said, just seemed a little far afield from specific medical advice.

“I think the conversation I would have with the patient would be focused on their individual needs and maybe not so much on the origins of the virus unless they expressed an interest in that information,” Marks said.

But some physicians are advocating for more.

Dr. Bruce Bekkar of San Diego, for example, recently left a 24-year career as an obstetrician and gynecologist with Kaiser Permanente to advocate on climate change and health issues full time.

Posed the same Zika virus hypothetical, he said he would be comfortable mentioning climate change in explaining to a pregnant patient why she needs to be more careful about mosquitoes today than she would have only a few years ago.

“I wouldn’t go on and on about it and let it dominate the visit. But I think I would say something like ‘science tells us unequivocally this is a new risk to you due to climate change,’” Bekkar said.

What about the risk that bringing up climate change might erode trust or make a patient less open? Bekkar said that, as long as communication on the topic is confined to factual statements backed up by valid research, he’s comfortable with a little discomfort.

Doctors, after all, regularly must tell their patients things they don’t want to hear like that they should quit smoking.

“I’ve always felt that my job is not necessarily to protect their ego but to give them necessary information that could change their lives. That may mean that I piss them off or ruffle their feathers a little bit and so be it,” he said.

It’s difficult to say just how much impact the new coalition’s climate change call will have. While the total membership of the participating societies exceeds 400,000, that doesn’t mean that every member agrees with every position its board of directors takes.

“I’m sure there will be some people who don’t agree, but that’s the reality in any organization,” Sarfaty said.

The action comes after significant focus on the problem by the Obama administration, following the the lead of the World Health Organization which has long labeled global warming a significant threat to human health.

But, more recently, the U.S. Centers for Disease Control and Prevention cancelled an upcoming Climate and Health Summit that was scheduled for February in Atlanta without explanation. The move has been seen by some as a sign that the new administration in Washington will take a different tact on government participation in climate change-reducing programs, though no official statement has been made by the government.

The coalition did say at its news conference Wednesday that it intends to send the Trump administration a copy of its report along with many other organizations but steered clear of directly challenging the White House.

Sarfaty said the intention is to remain as apolitical as possible and focus on informing doctors and patients.

“We are a health group, not a political group,” Sarfaty said.

While the consortium includes conservatives and liberals, Sarfaty herself has made numerous political contributions, nearly all to Democratic groups or candidates. These include former president Barack Obama, 2016 presidential candidate Hillary Clinton and Massachusetts Senator Elizabeth Warren, according to the Federal Election Commission’s website.

The consortium’s other members include the American Academy of Allergy, Asthma, Immunology; American Academy of Pediatrics; American College of Preventive Medicine; American Geriatrics Society; American Podiatric Medical Association; Infectious Diseases Society of America; National Medical Association; and the Society of General Internal Medicine.

The American Medical Association, the nation’s largest society for doctors, is not part of the consortium. It did not respond Wednesday to a request for comment.

Paul SissonPaul Sisson

Contact Reporter

paul.sisson@sduniontribune.com

(619) 293-1850

Twitter: @paulsisson

source: http://www.sandiegouniontribune.com/

original story HERE

 

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