The Climate Crisis and Clinical Practice

A wave of heat hit us as we opened the door, like we were in the Sahara Desert!”

Sweat was beading on the forehead of the emergency medical technician as he wheeled in an elderly man with a reported fever, whose apparent confusion had led his wife to call 911. In the midst of a record-breaking heat wave, the pair was found in a top-floor apartment with no air conditioning and only one partially open window. The man was transferred to a bed, where a rectal thermometer registered nearly 106°F. We diagnosed heatstroke and rushed him to our highest-urgency area to begin cooling him.

Increasingly, such patients are becoming the human face of the climate crisis, as recognition of its health harms grows. This knowledge has led to fledgling efforts to develop public health solutions to help populations prepare and adapt, and plenty of fundamental work remains to be done. But clinicians spend our days working with individual patients, and we’ve heard little discussion of the implications of the climate crisis for our daily practice.

Effects that climate scientists have been warning us about for decades are now clearly visible in the headlines — the Australian wildfires are only the latest catastrophe. The climate crisis is a quintessential metaproblem and threat multiplier, with frighteningly broad health implications, ranging from climate-sensitive waterborne and foodborne illness to worsening mental health. It is making it more difficult for all of us in medicine to do our job of preventing harm and improving health, one patient at a time. There is thus a profound and urgent need to implement clinical practice improvements that will safeguard the health of our patients and the resilience of our care delivery system in the face of growing climate-related challenges.