Vision

Most healthcare extends lives and reduces suffering.

But the way we currently practice medicine is unsustainable for patients, clinicians, health systems, societies, and the planet

  • It is estimated that a fifth of what we do in healthcare is not needed.1 All those unnecessary tests, treatments, and diagnoses bring direct harm to people through adverse effects of drugs and surgeries,2 psychosocial harms of labelling,3 and an overwhelming burden of treatments.4 
  • Since resources for healthcare are finite, waste is also harming patients indirectly because the overuse of some medical interventions means there are fewer resources to tackle underuse and underdiagnosis in other areas.5 
  • A tsunami of recommendations, performance indicators, quality metrics, incentives and penalties – altogether impossible to implement6,7 – contribute to burnout and disillusionment amongst clinicians.8,9
  • When healthcare spending grows, as it is doing everywhere,10 resources are drawn from other societal sectors which can improve public health far more effectively than interventions within healthcare.11
  • Considering the substantial carbon footprint from health systems themselves, medical waste also harm the planet.12

Building on the existing work of many people and organizations around the world, we aim to collaborate with a broad range of partners on activities ranging from short‐term research projects to longer‐term reform initiatives. Specifically, we will:

Conduct original work

  • We aim to explore novel ways to forge a more sustainable healthcare (i.e. not only describe the problem). Check out our ongoing research projects here.

Disseminate and promote the work of others

Be a deliberative/policy proposing body

  • We will arrange webinars, in-person meetings/workshops, and podcasts.
  • We will post freely available resources (such as PP slides and presentations) to help people advocate for a more sustainable healthcare in their context. If you have relevant material that you want to share – reach out to us!
  • We will advocate to change processes – e.g., for guideline development, evidence synthesis, and policy making to adequately consider aspects of sustainability.

Our vision is to create a platform for collaboration – permeated by generosity, curiosity and creativity –shaping a new appreciation of human, financial, and environmental resources in healthcare

Photo at top of page by @___sebastian_dijkstra___

  1. OECD. Tackling Wasteful Spending on Health. Paris (France): OECD Publishing, 2017. https://doi.org/10.1787/9789264266414‐en
  2. Welch HG, Schwartz L, Woloshin S. Overdiagnosed: Making People Sick in the Pursuit of Health. Boston: Beacon Press, 2011.
  3. Cotter AR, Vuong K, Mustelin LL, Yang Y, Rakhmankulova M, Barclay CJ, et al. Do psychological harms result from being labelled with an unexpected diagnosis of abdominal aortic aneurysm or prostate cancer through screening? A systematic review. BMJ Open2017;7:e017565. https://doi.org/10.1136/bmjopen‐2017‐017565
  4. May C, Montori VM, Mair FS. We need minimally disruptive medicine. BMJ2009;339:b2803. https://doi.org/10.1136/bmj.b2803
  5. Glasziou P, Straus S, Brownlee S, Trevena L, Dans L, Guyatt G, et al. Evidence for underuse of effective medical services around the world. Lancet2017;390:169–77. https://doi.org/10.1016/S0140‐6736(16)30946‐1
  6. Porter J, Boyd C, Skandari MR, et al. Revisiting the Time Needed to Provide Adult Primary Care. J Gen Int Med 2022. Epub ahead of print. doi: 10.1007/s11606-022-07707-x
  7. Petursson H, Getz L, Sigurdsson JA, Hetlevik I. Current European guidelines for management of arterial hypertension: are they adequate for use in primary care? Modelling study based on the Norwegian HUNT 2 population. BMC Family Practice 2009;10:70. doi: 10.1186/1471-2296-10-70
  8. West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med 2018;283(6):516-29. doi: 10.1111/joim.12752
  9. Montori V. Why We Revolt. 2nd edition. RosettaBooks, 2020. 
  10. OECD. Fiscal Sustainability of Health Systems: Bridging Health and Finance Perspectives. Paris (France): OECD Publishing, 2015. https://doi.org/10.1787/9789264233386‐en
  11. Marmot M, Allen J, Bell R, Bloomer E, Goldblatt P, Consortium for the European Review of Social Determinants of Health and the Health divide. WHO European review of social determinants of health and the health divide. Lancet2012;380:1011–29. https://doi.org/10.1016/S0140‐6736(12)61228‐8
  12. Barratt A, McGain F. Overdiagnosis is increasing the carbon footprint of healthcare. BMJ 2021;375:n2407. https://doi.org/10.1136/bmj.n2407
  13. Woloshin S, Schwartz LM. Communicating data about the benefits and harms of treatment: a randomized trial. Annals of Internal Medicine2011;155(2):87–96. https://doi.org/10.7326/0003‐4819‐155‐2‐201107190‐00004
  14. Schwartz LM, Woloshin S. Communicating uncertainties about prescription drugs to the public: a national randomized trial. Archives of Internal Medicine2011;171:1463–8. https://doi.org/10.1001/archinternmed.2011.396