Counting the handprint as well as the footprint
Footprint thinking in healthcare quantifies and minimises the environmental harm of care, and its perspective may be limited. Handprint thinking adds ways to increase a positive contribution to planetary health, at levels from one's own circle of control through an organisation to national and international policy, and health professionals and medical writers are both placed to spread it.
Where footprint thinking stops
Carbon footprint thinking might be limited by its reductionist perspective on the impact of healthcare. The focus of carbon footprint research is essentially to quantify and minimise the negative effects of regular care delivery, a kind of environmental efficiency. That focus frames the healthcare sector as an isolated service that needs to transition to a more environmentally sustainable way of operating. To make that transition, it has been suggested that environmental sustainability become an integrated characteristic of healthcare quality assessment. In daily practice, however, the suggestion frequently raises discussions about its compatibility with patient safety and the maintenance of high-quality care, and about sectoral challenges such as financial and staffing issues.
A focus on the carbon footprint of healthcare might also downplay concern for other environmental impacts, such as water usage and ecotoxicity. Much work also remains to make the research data underlying footprint recommendations findable, accessible, interoperable and reusable.
What handprint thinking counts
Handprint thinking can be a positive and activating addition to engagement with environmental sustainability. Where footprint thinking reduces negative environmental impact, handprint thinking requires thinking about ways to consciously increase one's contribution to a healthy life on the planet.
That positive impact can be made at three levels: micro, sustainability in one's own work or direct circle of control; meso, engagement at company level, writing for larger audiences, or education; and macro, engagement with policy at national or international level. Examples are food choices that benefit both one's health and the environment (micro), taking part in local initiatives for more vegetation where one lives (meso), and advocating for policies that address the health inequities climate change would enlarge (macro).
In medicine, handprint thinking coincides with a transition to preventing disease through healthy behaviour and healing environments, which frequently overlaps with climate-friendly measures. The literature frequently calls these environmentally friendly, health-promoting options co-benefits.
Why health professionals are placed to lead
The healthcare sector could be one of the leading voices in a regenerative movement that strives to safeguard planetary health. On an individual level, healthcare professionals are regarded as a trusted source of personal advice and healthy behaviours, and on a societal level they have the authority, and quite possibly the responsibility, to represent public interests in health and wellbeing. That role became apparent during the coronavirus pandemic, when health professionals took a leading role in vaccination campaigns and in media debates about preventive measures.
A review of physicians' perspectives on prescribing interventions or behaviours that benefit both the patient's and the planet's health pointed out, however, that the understanding and the guiding policy statements needed to do so are frequently missing.
Where medical writers come in
Medical writers and communicators are in a strategic position to pick up the pen to lead and inspire action for planetary health. Communication about the co-benefits for planetary and human health is crucial to drive conversation about, and knowledge of, the benefits of handprint thinking. Education of healthcare professionals and related industries should be one of the key focus areas for getting the message of planetary health across. Medical writers can also engage their readers to consider the implications of research and healthcare policies for both the planet and the individual, and aid in the valorisation of findings in environmentally inclusive policies. The audience of that writing can be a small group in one's network (micro), a larger company or organisation (meso), or an institute for policymaking at national or international level (macro).
The urgency of the global climate and environmental crises requires each person to act at a level that suits their interests, professional ones included, and their capabilities. The possibilities for a positive contribution to planetary health are many, including the way medical writing is practised and the content of the writing itself, and the choice lies with each individual. The question to ask oneself is "How am I part of the solution today?"