the health impacts of climate change – the role of health professionals ian gilmore prcp london...
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The health impacts of climate change – the role of health professionals
Ian Gilmore PRCP
London School of Hygiene and Tropical Medicine
25th November 2009
Why the Royal College of Physicians got involved as a partner in the present
work•Origins in principles of medical professionalism and RCP report
•Enthusiasm of students and juniors in our roadshows ‘Understanding Doctors’
•Interface with our work on health inequalities
By the beginning of the 21st Century the Medical Profession no longer had exclusive control over:
• Knowledge base
• Independence from the state
• Professional associations that serve as ultimate authorities
• Influence over public policy
• Education and training
• Sole determination over substance of training
• Right to discipline
• Workplace autonomy
• Right to regulation Creuss and Creuss 1999
Why did the Royal College of Physicians seek to reassess the basis of ‘professionalism’ in 2005?•Uncertainty about the role of doctors
•Reshaped attitudes and expectations of both public and doctors
•Questioning of traditional values and behaviours
•An unprecedented interest in medical ‘scandals and disasters’ in the UK:
–Shipman, Alder Hey, Bristol
•Changing environment:–training–practice – the work place–doctor patient relationships
Doctors in Society
RCP definition of Medical Professionalism :
..signifies a set of values, behaviours, and relationships that underpins the trust the
public has in doctors
Doctors in Society
six vital themes emerged in RCP report:
– Team working– Education– Appraisal– Career management– Research – Leadership
•British Medicine had risen in public esteem in the 19th century by emphasising the primacy of the doctor-patient relationship
•But 20th century clinicians used this to absolve themselves from engaging in the needs of the wider public
…..doctors being at the heart of shaping and developing health care delivery for the good of patients as an integral and valued part of their core duties …..
What is modern medical leadership?
Medical Management and Leadership Development
• RCP new consultants programme
• RCP MSc in medical leadership
• Academy of Medical Royal Colleges Competency framework
Framework Application
•Application of the Framework will differ according to the career stage of the doctor and the type of role they fulfil.
Undergraduate Post-Specialist Certification
Postgraduate
Public Profession of Values
“Physicians should speak about their values. ‘Profession’ means, from the
Latin, ‘speaking forth’. Public avowal of values has been a distinctive feature of the professions from before medieval
times”
Wynia MK
The Black Report
• first robust strategy to address health disparities
• drew attention to actions needed beyond health (eg education, housing
• called for measures and targets to aim at
• ‘buried’ by incoming Conservative Government
• Deaths from heat• Direct Injury• Pollution• Food-related illness• Altered disease vectors• Crop Failure• Water shortages• Mass Migration• Resource Wars
Health Consequences of Climate Change and its mitigation
Benefits for heart disease, obesity, cancer and mental health from:
• Active transport policies
• Reduction in meat consumption
Royal Colleges Advocacy on Royal Colleges Advocacy on climate change– using our climate change– using our
assetsassets• organisations seen as organisations seen as
– AuthoritativeAuthoritative– IndependentIndependent– Influential with physiciansInfluential with physicians
• Doctors remain trusted by our patients and the Doctors remain trusted by our patients and the public.public.
• Many doctors are environmentally active in their Many doctors are environmentally active in their personal lives but ‘give up’ at the hospital doorpersonal lives but ‘give up’ at the hospital door
• We can help them take on a leadership role at We can help them take on a leadership role at work work
Health professionals and the NHS need to act on climate change right now.
Here’s why and here’s how
From ‘The Age of Stupid’, sponsored by the following:
Royal Colleges Advocacy on Royal Colleges Advocacy on climate change– presentation climate change– presentation to meeting in Australia calling to meeting in Australia calling
for:for:• Raising the profile within our countries of Raising the profile within our countries of
the health consequences of no action and the health consequences of no action and the benefits of mitigationthe benefits of mitigation
• lobby our Governments before lobby our Governments before Copenhagen December 2009.Copenhagen December 2009.
• Show a united ‘profession’Show a united ‘profession’
RCP Initiatives to dateRCP Initiatives to date
• An opinion-formers workshopAn opinion-formers workshop
• An RCP conferenceAn RCP conference
• Partnership in project being launchedPartnership in project being launched
• Bringing International Colleges and Academies together (Lancet ? BMJ letter)Bringing International Colleges and Academies together (Lancet ? BMJ letter)
• Supporting the creation of an International Climate and Health CouncilSupporting the creation of an International Climate and Health Council
• Looking to support the integration of sustainability into training programmesLooking to support the integration of sustainability into training programmes
The physicians are the natural attorneys of the poor, and social
problems fall to a large extent within their jurisdiction.
Rudolf VirchowDie medizinische
Reform