ORIGINAL RESEARCH
Frank Müller, MD, PhD; Jesse I Skok, MD; Judith E Arnetz, PhD; Michael J Bouthillier, PharmD; Harland T Holman, MD
Corresponding Author: Frank Müller, MD, PhD; Department of Family Medicine, Michigan State University
Email: muell313@msu.edu
DOI: 10.3122/jabfm.2023.230027R1
Keywords: Climate Change, Family Medicine, Pharmacology, Primary Health Care, Shared Decision-Making
Dates: Submitted: 01-23-2022; Revised: 03-18-2023; Accepted: 03-27-2023
Status: In production for ahead of print.
BACKGROUND: Climate change poses a threat to the health of people worldwide. Little is known about the awareness of primary care providers towards climate change and if they are open and prepared to address climate change issues with their patients. As pharmaceuticals are the main source of carbon emissions in primary care, avoiding the prescription of particular climate-harmful medications is a meaningful contribution to the reduction of greenhouse gases.
METHODS: This is a cross-sectional questionnaire survey among primary care providers in West Michigan conducted in November 2022.
RESULTS: 103 primary care providers responded (response rate 22.5%). Nearly one third (29.1%) were classified as climate change unaware providers who perceived that global warming is not happening, or expressed that it is happening but not caused by human activities or is affecting the weather. In a theoretical scenario on a prescription of a new drug, providers tended to prescribe the less harmful drug without discussing options with patients. While 75.5% of providers agreed that climate change aspects have its place in shared decision making, 76.6% of providers expressed a lack of knowledge to advise patients in this regard. Additionally, 60.3% of providers feared that raising climate change issues in consultations may adversely affect the relationship with the patient.
DISCUSSION: While many primary care providers are open to addressing climate change in their working environment and with their patients, they lack knowledge and confidence to do so. In contrast, the majority of the US population is willing to do more to mitigate climate change. While curricula on climate change topics are increasingly implemented in student education, programs to educate mid- and late-career providers are lacking.