General Practice and Primary Care - Theses
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ItemClimate change: what do doctors think? What can doctors do?: An international survey of general practitioners( 2011)Background: Climate change is expected to become one of the biggest public health issues of this century with the health of billions of people potentially affected. It will be the poorer counties and populations that will be most impacted and least able to adapt. A number of responses to climate change have been proposed including efforts to mitigate climate change, and to adapt to the inevitable and growing impacts. Psychological, social and systemic barriers and enablers for action on climate change have been identified. Doctors may have important roles as communities adapt and respond to climate change. A focus on health may enhance public and political will for climate change mitigation. Health promotion, surveillance, and treatment of climate change related health consequences will also be important. The beliefs and attitudes of doctors regarding the scientific basis, predicted impacts and the proposed responses to climate change are largely unexamined. Objectives: To describe GPs’ understanding of the science and public health impacts, their attitudes, feelings and beliefs as well as potential roles in response to climate change. Barriers and enablers will also be explored. Method: In May to June 2010 an international, cross-sectional online survey of GP members of the World Organisation of Family Doctors (WONCA) was conducted. Results: What do GPs think about climate change? GPs in this cohort overwhelmingly agreed with the science of climate change, the health impacts and a role for GPs. There was least agreement that climate change is driven by human activity. Spatial discounting of perceived impacts was evident. The majority of GPs believed that they don’t have the skills to respond. Although 27.6% of GPs self-identified as sceptical of the science, over a quarter of these “sceptics” strongly agreed that climate change is occurring and has a substantial public health impact. Thus agreement/disagreement with the science may be a more useful terminology than the language of scepticism. What can GPs do about climate change? The majority of GPs in the sample believed that WONCA has a role (83%). In addition key climate change related roles that were supported for GPs included CME (79%), teaching (77%), advocacy (75%), and making significant changes in their clinic or office (60%). Compared to GPs from poorer continents, GPs from richer continents were more likely to believe in a role including making changes in their clinic or office. A minority of GPs rated their current response to climate change as done well, and most agreed that assistance would allow them to initiate or improve their responses. In particular, GPs indicated that they are usually not responsible for procurement of medical supplies (a large contributor to the clinics’ carbon footprints). Conclusion: Even though over a quarter of GPs self-identified as sceptics, overall GPs supported the science, impacts and roles that they may play in responding to climate change. There is a need for efforts to increase knowledge of climate change science, including local impacts, and also to build self-efficacy. This has implications for workforce planning, education and engagement of the profession.