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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:
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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
What is modern medical
leadership?
…..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 …..
Medical Management and
Leadership Development
• RCP new consultants
programme
• RCP MSc in medical
leadership
• Academy of Medical Royal
Colleges Competency
framework
Medical Leadership
Competency Framework
Enhancing Engagement in
Medical Leadership Project
Medical Leadership
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
Postgraduate
Post-Specialist Certification
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
Public Health – where we
are used to advocacy
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
Health Consequences of Climate Change and
its mitigation
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Deaths from heat
Direct Injury
Pollution
Food-related illness
Altered disease vectors
Crop Failure
Water shortages
Mass Migration
Resource Wars
Benefits for heart
disease, obesity,
cancer and mental
health from:
• Active transport
policies
• Reduction in meat
consumption
Royal Colleges Advocacy on
climate change– using our assets
• organisations seen as
– Authoritative
– Independent
– Influential with physicians
• Doctors remain trusted by our patients and the
public.
• Many doctors are environmentally active in their
personal lives but ‘give up’ at the hospital door
• We can help them take on a leadership role at 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
climate change– presentation to
meeting in Australia calling for:
• Raising the profile within our countries of the
health consequences of no action and the
benefits of mitigation
• lobby our Governments before Copenhagen
December 2009.
• Show a united ‘profession’
RCP Initiatives to date
•
An opinion-formers workshop
•
An RCP conference
•
Partnership in project being launched
•
Bringing International Colleges and Academies together (Lancet ? BMJ
letter)
•
Supporting the creation of an International Climate and Health Council
•
Looking 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 Virchow
Die medizinische Reform
If the planet is febrile…
…we need doctors and other healthcare
workers to mop its fevered brow