How can we talk with our patients about climate change and health without disrupting the office visit? Dr. Andrew Lewandowski, a mid-career pediatrician in private practice in Madison, Wisconsin, has found a solution. He struggled for years to find a way to incorporate environmental sustainability and climate change into his practice. He recognized from the start that these topics could be time-consuming and even controversial with the potential to jeopardize the trust of some patients. In his words, the “lack of clinician education, perceived political nature of the issue, and limited understanding of practical prevention all present potential barriers.” Finally, he found few clinical guidelines or standards of care on how to educate patients about the health risks they face and how to protect themselves.

Many professional societies, including the American Academy of Pediatrics, the American Medical Association, and the World Medical Association, urge physicians to incorporate climate change teaching into routine patient care. Until now, there has been no easy way to do this.
Dr. Lewandowski and colleagues offer his solution in a 2021 paper, “Patients value climate change counseling provided by their pediatrician: The experience in one Wisconsin pediatric clinic”*. Lewandowski describes a forty-five second climate conversation that he conducts in the exam room as part of every well-patient visit.

Here is the script for Dr. Lewandowski’s 45-second teaching.  He adds this at the end of his patient history and before starting the physical exam:

“In the last two years, the American Academy of Pediatrics and 100 other health organizations declared climate change a health emergency. Air pollution alone caused over 64,000 premature deaths in the United States in 2016, and worsening air quality is only 1 out of 9 ways that climate change is harming people, disproportionately harming children. So just like I want your children to eat healthy foods and be in the right car seat for their health and safety, we now know that decreasing our energy use, increasing energy efficiency, and supporting clean energy initiatives are also important for improving our children’s health. Any questions?”

Lewandowski received confidential surveys from 138 of his patients after their office visits. The patients were highly in favor of receiving the information and many reported that they were likely to change their choices made at home because of the information that the doctor provided. This was true even for patients who described themselves as political conservatives.

This approach works best, I think, when supported by further resources for patients and families. My Green Doctor provides dozens of free brochures, handouts, and blogs on topics of environmental sustainability, climate change, and health. The brief conversation that you begin in the exam room can continue when you recommend My Green Doctor as a useful tool. Patients can access My Green Doctor for free at or at Si, en Espanol tambien!

Dr. Lewandowski’s script is simple, persuasive, and non-controversial. It manages to harness the trust that patients have of their nurses and doctors but without unwisely exploiting that trust. Each nurse, nurse practitioners, and physician can create his or her own short script and find where best to insert it into their office routine.

I’ve written two more scripts for you to consider:                                                                           

“There’s another health issue I’d like to tell you about before we do your physical exam. In the last two years, more than 100 health organizations declared climate change to be a health emergency. Burning fossil fuels is causing climate change, but also creates air pollution that kills more than 64,000 Americans every year and far more around the world. So just I worry about your medical conditions, and eating healthy foods, and wearing your seat belts, I want to share with you that decreasing our energy use and supporting clean energy like wind and solar power, and the use of electric cars, are also important for improving our health. Any questions?”

And here is my third script:

“There’s another health issue I’d like to discuss with you. In the last two years, more than 100 health organizations declared climate change to be a health emergency. This is because burning fossil fuels like natural gas, coal, and petroleum, and how we manage our farms, is causing climate change, but they also create air pollution that kills more than 64,000 Americans every year and far more around the world. So just I worry about your medical conditions, your lab tests, eating healthy foods, and wearing your seat belts, I want you to know that the things your family does for the climate will really help save lives. It’s for better health that we decrease our energy use, support clean energy like wind and solar power, and choose electric cars. Any questions?”

Now you have three scripts with which to build your own! Please send us yours and we will share it with the more than 250,000 health professionals who receive My Green Doctor’s newsletter. You can do this!

Author:  Dr. Todd Sack is Executive Director of the My Green Doctor Foundation that manages and (en Espanol).  Please share your ideas and your own forty-five second climate change script:  [email protected] .

*Journal of Climate Change and Health, 2021, free online at doi:10.1016/j.joclim.2021.100053.


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  1. Electric car , i’m not sure that it is the best we can propose!

  2. I love to the message and it is imperative to see how ‘Air pollution alone caused over 64,000 premature deaths in the United States in 2016’
    This certainly has profound impact on our patients. There is however one thing that left me a little confused in this article: The statement “even those who identify as conservative” part. I can tell you from experience and even our dearest nearest circles that conservative doesn’t equal being reckless or careless about the environment as such implies. That is precisely what politicians want us believing so they can maintain control and keep up financial interests back and forth. I believe even our governor stated the environment was a top priority and encourages such organizations as this (conservative). “conservatives” I know use Electric cars, minimization of fossil fuels, carpooling and conscious consumerism- all being practiced among mostly them, while the ignorant and other political party Id say less.
    I have written viral articles for psychology today on the topic of environmental toxicity because that is one of my specialties even and Just because some of the conservative leaders think there is no such thing as climate change doesn’t mean the people believe that. Freedom I think is of utmost importance among conservatives which is why they may identify with such, given that’s why most of our ancestors came here and to have these convos. I think most people would say pollution is wrong all around.


    • Dr. Dinetz,
      Thank you for your thoughtful note of March 23. I apologize for this delay. You are absolutely correct that one should not be surprised that people who self-identify as “politically conservative” are also very concerned about the environment and about climate change. A great example of this was President Richard Nixon, certainly quite conservative and who was proud to have created the U.S. Environmental Protection Agency. It has been gratifying to me personally to observe that both conservatives and liberals, when provided with sound science, are willing to roll up their sleeves and get to work on problems such as environmental toxins and climate change. The My Green Doctor program was launched in 2011 by the Florida Medical Association, an organization known for both its conservatism and wisdom.

      Our December 2022 newsletter will be on a complex environmental toxins subject, the PFAS chemicals.
      Todd L Sack MD FACP
      Executive Director, My Green Doctor Foundation [email protected]

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