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Choosing Wisely and the climate crisis: a role for clinicians
  1. Karen B Born1,
  2. Wendy Levinson2,
  3. Emma Vaux3
  1. 1 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  2. 2 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  3. 3 Department of Renal Medicine, Royal Berkshire Hospital NHS Foundation Trust, Reading, UK
  1. Correspondence to Dr Karen B Born, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T3M6, Canada; karen.born{at}

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There are growing calls for healthcare to confront it’s role in the climate crisis. Estimates suggest that carbon emissions from healthcare constitute 5% of net global emissions. To put this into context, emissions from all air travel are estimated at 3.5% of net global emissions.1 Health systems, organisations and clinicians have been called on to lead efforts to reduce emissions given that the climate crisis presents a major threat to human health.

Ensuring appropriateness of care, and reducing overuse are central planks of strategies suggested in the literature and are increasingly being enacted by large healthcare systems and provider organisations to reduce healthcare’s climate impact.2 However, individual clinicians are often left with little guidance or support in terms of how to do this in practice. To illustrate, the Agency for Health Care Research and Quality (AHRQ) within the United States Department of Health and Human Services recently released a guidance document for healthcare organisations on measures and actions to mitigate climate change, however there is no guidance for clinicians.3

Choosing Wisely campaigns, first launched in the United States in 2012 and now present in over 30 countries globally, can be leveraged by individual clinicians as a feasible strategy to help address the climate impact of their practice. Choosing Wisely emerged from concerns of sharply rising healthcare costs and estimates that a third of all healthcare offered no clinical value to patients.4 Campaigns are anchored in evidence-based lists of recommendations developed by national clinician societies that identify frequently overused tests and treatments that are not supported by scientific evidence and may expose patients to harm. Campaigns seek to raise awareness about overuse among clinicians and are increasingly focused on scaling interventions to implement recommendations.5 The major mobilisation effort of Choosing Wisely campaigns can be leveraged for …

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  • Contributors The idea for this article was developed at the Choosing Wisely International Roundtable meeting in Lisbon, Portugal in September 2022. This meeting is attended by leaders of Choosing Wisely campaigns from over 30 countries. The article was written by KBB and WL, with input from EV. KBB and WL are equally contributed first authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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