Did your doctor ask you questions about climate change?

When Michael Howard arrived for a checkup with his pulmonologist, he was worried about how his body would react to the heat and humidity of the summer in Boston.

"I lived in Florida for 14 years and I came back because the humidity rate was too high," said Howard to the respirologist, Mary Rice, while he was settling in a test room chair at a Beth Israel Deaconess HealthCare clinic.

Howard, 57, has Chronic Obstructive Pulmonary Disease (COPD), a progressive lung disease that can be exacerbated by heat and humidity. Even in a comfortable, air-conditioned room, her oxygen levels worried Rice.

Howard reluctantly agreed to try to use portable oxygen, resigned himself to wearing the clear plastic tubes looped over his ears and inserted into his nostrils. He badured Rice that he had an air conditioner and that he would stay inside in extremely hot weather. The doctor and the patient agreed that Howard should go for walks in the evening to make sure he's doing enough exercise without too much heat.

Then, Howard turned to Rice with a question that she had not met at the medical school: "May I ask you: Last summer, why Was it so hot? "

Rice, who studies air pollution, was ready.

"The general trend of the hottest summers we observe [is] because of climate change, "Rice said.

For Rice, linking the consequences of climate change (heat waves, more pollen, longer allergy seasons) to the health of her patients is becoming a routine. She is part of a small but growing number of doctors and nurses who discuss these links with patients.

In June, the American Medical Association, the American Academy of Pediatrics and the American Heart Association were part of a long list of groups of doctors and public health experts who issued a call to action asking US government, business and leaders to recognize climate change as a health emergency.

The World Health Organization calls climate change "the greatest health challenge of the 21st century," and a dozen US medical societies urge action to limit global warming.

Some medical societies provide patients with information explaining the badociated health risks. But there are no guidelines on how providers should talk to patients about climate change.

There is no concrete list of things to do – like wearing a seatbelt, using sunscreen, and exercising – or not doing – not smoking, not drinking too much and not texting while driving? that doctors can talk with patients.

Climate change is different, Rice said, because a patient can not stop it. Rice is therefore focusing on the measures that her patients can take to deal with the consequences of heat waves, such as a more powerful pollen and a longer allergy season.

That was the main complaint of Mary Heafy. At age 64, asthma is worse during the allergy season. During his meeting with Rice, Heafy wanted to know why his eyes and nose were sinking and that his chest was stretched for longer periods each year.

"It's like once [the allergy season] it starts in the spring, it does not end until there is a deadly frost, "Heafy told Rice.

"Yes," Rice agreed, "because of global warming, plants bloom earlier in the spring, and after hot summers, trees release more pollen the following season."

Thus, Heafy may need more powerful medications and more air filters, said his doctor, and could spend more days wearing a mask – although the effort to breathe through a mask is painful to him .

While she and her doctor were finalizing a prescription plan, Heafy observed that "doctors talk about things like smoking, but I do not know if every doctor is talking about the environmental impact."

Why are so few doctors talking about the impact of the environment on health? In addition to the lack of guidelines, doctors say they do not have the time, during a 15- to 20-minute visit, to tackle something as complex as climate change.

And the subject may be controversial: although a recent Pew Research Center survey reveals that 59% of Americans think that climate change affects their local community "a lot or sometimes", only 31% affect it personally and opinions vary considerably according to political circles. Party.

We contacted energy groups to ask what role, if any, medical service providers should play in the climate change discussion, but neither the American Petroleum Institute nor the American Fuel & Petrochemical Manufacturers have not responded to calls or requests for comments by e-mail.

According to Dr. Nitin Damle, former president of the American College of Physicians, some doctors say they fear to question the beliefs of a patient on a sometimes difficult subject.

"It's a tough conversation to have," said Damle, who practices internal medicine at Wakefield, R.I.

Damle said that he "takes the temperature" from patients, with some general questions about the environment or the weather, before deciding whether he will suggest that climate change is affecting their health.

Dr. Gaurab Basu, a primary physician at the Cambridge Health Alliance, said he was ready if patients wanted to talk about climate change, but he did not talk about it. He must first ensure that patients feel safe in the examination room, he said, and raising a controversial political issue could weaken that feeling.

"I have to be honest about the science and the threat that exists, and it's pretty alarming," Basu said.

If alarming, said Basu, he often invites patients to consultations. Psychiatrists concerned about the effects of climate change on mental health claim that there are still no standards of care in their profession, but some common responses emerge.

An environmental group is not waiting for doctors and nurses to find out how to talk to patients about climate change.

Molly Rauch, director of public health policy at Moms Clean Air Force, a project of the Environmental Defense Fund, urges the more than one million members of the group to seek medical advice and advice. nurses. For example: when should parents keep children indoors because the outside air is too dirty?

"It's not too scary for us to hear about it," Rauch said. "We are hungry for information about it – we want to know."

© 2019 Kaiser Health News

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