Green Practice News
August 2026

Every health professional that I know entered medicine because they wanted to help people. Let’s help our patients and the public by thinking carefully before prescribing antibiotics!disease after antibiotic use.Clostridium difficile Finally, we think about patients’ quality of life. We know that antibiotics are associated with diarrhea and other side effects. In children, we know that broader drugs like amoxicillin/clavulanate is associated with worse quality of life indicators as reported by parents. We know that antibiotics force many patients to go to the emergency department each year for real or perceived allergy or for other side effects. And we know about the risk for

What about cost? The U.S. health system is one of the most expensive in the world per capita. Many of our patients experience financial stress from medical expenses. In a poll done in 2025, nearly half of adults said that they have trouble affording their healthcare (see figure).  Decreasing unnecessary testing and treatment can help these patients.

Diagnostic stewardship means choosing tests wisely. Such stewardship has been associated with decreased unnecessary use of antimicrobials. For example, doctors who order fewer chest x-rays to diagnose childhood bronchiolitis also tend to order fewer unnecessary antibiotics. Every laboratory test requires plastics, reagents, electricity, transportation, and waste disposal. Microbiology testing requires energy intensive autoclaving or incineration before samples go to a landfill. Refraining from ordering an unnecessary test saves money, saves patients time, and diminishes trash.

Every unnecessary antibiotic prescription carries an environmental footprint. Antibiotics require energy-intensive manufacturing, packaging, transportation, storage, and disposal. When antibiotics are prescribed unnecessarily, these resources are consumed without improving health. Antibiotic production adds to greenhouse gas emissions and unused medications become pharmaceutical waste. For antibiotics, healthcare professionals can help protect both patient health and planetary health by selecting the right drug, dose, and duration, and by embracing diagnostic stewardship.

For most clinicians, antibiotic stewardship mean preventing antibiotic resistance. This goal remains critically important because antibiotic resistance is a persistent threat to human health. In addition, there are other benefits that we don’t often talk about: reducing greenhouse gas emissions and other pollutants, decreasing cost, and increasing quality of life for patients.

Smarter Purchasing Builds Stronger Practices

Judy Holm

Healthcare organizations make hundreds of purchasing decisions every year. From medical supplies and exam room equipment to cleaning products, office electronics, lighting, and pharmaceuticals, every purchase impacts operating costs, patient care, staff well-being, and the environmental footprint of the practice.

Too often, procurement is viewed simply as buying products at the lowest possible price. Today, leading organizations recognize that procurement is a strategic management function that helps build stronger, more resilient organizations.

For healthcare professionals, practice managers, and clinic administrators, smarter purchasing begins by looking beyond the initial purchase price and considering the total value of a product throughout its lifecycle. An inexpensive printer may require costly repairs later. Outdated lighting systems consume more electricity. Low-quality disposable products generate additional waste. In contrast, durable equipment, energy-efficient technologies, and thoughtfully selected products often reduce operating expenses over time while improving the practice environment.

How Strategic Procurement Improves Financial Performance, Resilience, and Environmental Sustainability
This broader perspective also strengthens organizational resilience. Healthcare practices depend on reliable suppliers, efficient equipment, healthy indoor environments, and stable operating costs to continue providing high-quality care during periods of disruption. Procurement decisions made today influence how well a clinic responds to tomorrow’s challenges, whether those challenges involve supply shortages, rising utility costs, extreme weather, or changing patient expectations.

Many purchasing decisions also support environmental sustainability without increasing operating costs. Selecting ENERGY STAR® equipment, reducing unnecessary packaging, choosing reusable products where clinically appropriate, purchasing lower-toxicity cleaning products, and evaluating supplier sustainability commitments can reduce waste, lower energy consumption, and create healthier environments for patients and staff.
Strategic procurement also shapes how a healthcare organization is perceived by the people it serves. The staff and patients notice the waste in healthcare settings and want us to do better. Practices that incorporate sustainability into everyday purchasing decisions often strengthen their reputation while creating healthier indoor environments and reducing unnecessary waste.

An Opportunity To Strengthen Your Practice
The goal is not perfection. It is making better-informed decisions one purchase at a time. My Green Doctor helps practices identify these opportunities through friendly one-on-one coaching, proven tools, and step-by-step guidance. Rather than asking busy healthcare teams to become procurement specialists, the program integrates smarter purchasing into everyday practice management. Participating clinics are shown opportunities to reduce operating costs, improve efficiency, strengthen resilience, and advance environmental sustainability simultaneously.

2. McKinsey & Company. A New Era for Procurement—Value Creation Across the Supply Chain. https://www.mckinsey.com/capabilities/operations/our-insights/a-new-era-for-procurement-value-creation-across-the-supply-chain

3. Harvard Business Review (Sponsored). Optimizing Business Outcomes by Investing in Sustainable Supply Chains and Procurement. https://hbr.org/sponsored/2023/10/optimizing-business-outcomes-by-investing-in-sustainable-supply-chains-and-procurement

Wildfires are no longer just a concern for communities near forests or grasslands. Today, wildfire smoke has become a widespread public health issue that can affect patients hundreds or even thousands of miles from an active fire. For primary care practices and for certain specialties such as geriatrics, pulmonary, and cardiology, preparing for wildfire season is no longer optional. It is an important part of being a resilient practice.

Smoke from wildfires contains fine particulate matter (PM2.5) that can penetrate deep into the lungs and enter the bloodstream. Exposure has been linked to worsening asthma, chronic obstructive pulmonary disease (COPD), cardiovascular disease, diabetes, pregnancy complications, and other chronic medical conditions. A recent systematic review also found that wildfire smoke exposure is associated with increased respiratory hospitalizations and higher mortality.

The challenge for healthcare professionals is that patients often underestimate their risk. Many assume that if they cannot see flames nearby, they are safe. However, research from the record-breaking 2023 Canadian wildfires demonstrated that smoke traveled across North America and even reached Europe, exposing hundreds of millions of people to unhealthy air quality. The health impacts of wildfire smoke are not limited by geography.

Fortunately, preparedness does not require expensive new programs. It begins with practical planning and proactive patient education.

As wildfire season approaches, healthcare teams can use their staff meeting to review asthma and COPD action plans. Part of your plans should be for physicians and nurses to encourage patients to follow every day the local Air Quality Index (AQI) and to provide them the free link: https://www.airnow.gov/aqi/aqi-basics/. Clinics can recommend that patients remain indoors during smoke events, recommend high-quality indoor air filtration in the home, and check that vulnerable patients have adequate supplies of rescue inhalers before poor air quality develops. These conversations are particularly valuable for children, older adults, pregnant women, and patients living with chronic respiratory or cardiovascular disease.

Healthcare organizations should also consider their own operational resilience. Wildfire smoke events can disrupt normal clinic operations, making preparedness essential for maintaining continuity of care. Reviewing HVAC maintenance schedules, evaluating indoor air filtration systems, expanding telehealth capabilities, developing communication plans for high-risk patients, and educating staff about smoke-related health risks can help practices continue serving their communities during prolonged smoke events.
These actions represent more than emergency planning. They are part of building healthcare resilience. A resilient practice anticipates changing conditions, prepares in advance, and continues providing safe, high-quality care even during environmental challenges. As wildfire seasons become longer and more intense, healthcare organizations that prepare today will be better positioned to protect both patients and staff tomorrow.

My Green Doctor offers a library of free state-of-the-art waiting room brochures for your patients covering a dozen topics, including our brochure, “Air pollution and Wildfires in a Changing Climate: Protecting Your Family.”  These can be read on a computer or smart phone using a URL link or by the QR code that you can give to patients and families. Most are provided in English, Spanish, and Chinese. You are welcome to print these yourself or purchase them economically by emailing My Green Doctor. For Entire Practice Green members, new orders come with a complemenary six-brochure display stand for the waiting room. This is about protecting your patients and their families!

Waiting Room Brochures:
https://mygreendoctor.org/resources/waiting-room-brochures/

My Green Doctor has just launched our long-anticipated Workbook 8 on the topic of resilience planning. Outpatient healthcare organization must consider their own operational resilience. Disasters may come from severe storms, extreme heat, wildfire smoke, floods, electrical grid failures, or even threats from visitors to your building. Disruptions can be expensive, time-consuming, and dangerous to health. Resilient practices protect their property and continue serving their communities during or shortly after a disaster. Resilience planning keeps a threat from becoming a disaster!

Workbook 8 is here is for outpatient clinics, practices and other facilities to strengthen resilience while improving patient outcomes. Practice managers and administrators worldwide have never had such as a practical, step-by-step guide as this new Resilience Planning workbook (https://mygreendoctor.org/workbook-8-resilience-planninng/). Contact one of our expert sustainability coaches for help adding this essential tool to your operational plans: [email protected] .