Health care saves lives, but at what cost?
Current health care practices might be creating a large carbon footprint, according to ASU Online student Dr. Michele Domico, who says a healthier world begins with sustainable health care.
Domico, a pediatric cardiac intensive care physician at Children's Hospital of Orange County and current Master of Sustainability Leadership online student at Arizona State University's College of Global Futures, is working to advance sustainability in ICUs through her appointment as co-chair of the Society of Critical Care Medicine’s Sustainability Task Force.
Domico and the task force recently published their first article, titled “Environmental Sustainability in ICUs: A Report From the Society of Critical Care Medicine Sustainability Task Force.”
Physician with a vision for sustainable health care
With over 15 years of experience in pediatric critical care, Domico has seen firsthand the sustainability challenges present in medical settings.
"I have noticed throughout the years that the hospital system produces a spectacular amount of waste, including single-use plastics, food waste, leftover pharmaceuticals and much more. Once you start to notice these things, it is hard to unsee them," Domico said.
This observation sparked her interest in sustainability and led her to pursue formal education in the field. Despite her demanding medical career, Domico decided to pursue a Master of Sustainability Leadership through the School of Sustainability and ASU Online because of its interdisciplinary approach and the flexibility of its online format.
"As a physician working in the intensive care unit, I work highly variable hours and sometimes 24-hour shifts. With the flexibility that ASU offers, I have been able to work, pursue a Master of Sustainability Leadership degree and spend quality time with my family, albeit with some sleep deprivation," she said.
Domico sees clear connections between her medical field and sustainability principles. She believes that the medical field's core mission of healing and protecting human health is fundamentally linked to the health of our planet. In her view, we usually fail to make this connection between the two, as institutions dedicated to healing simultaneously harm public health through their environmental footprint of waste, pollution and emissions.
Leading change through publication
Domico's recent publication with the Society of Critical Care Medicine, a global medical community with more than 17,000 members committed to providing exceptional critical care, represents a significant step toward addressing health care's environmental impact.
"As a first step toward environmental sustainability action, the SCCM selected a task force to write a report on actionable items and ways that clinicians could reduce their carbon emissions," Domico said. "The report focuses on strategies such as using medications that are equally beneficial to patients but less toxic to the environment."
The publication focuses on practical strategies that health care professionals can implement without compromising patient care. For example, it highlights alternatives to certain anesthetic gases with high environmental toxicity.
"There is an inhaled anesthetic gas used to put people to sleep during surgery (called Desflurane) that is 10 times more toxic to the atmosphere than similar agents. Our published work highlights this issue and recommends alternatives."
Future impact
Looking ahead, Domico has ambitious plans for integrating sustainability into health care systems, both locally and globally.
"The SCCM task force, which I co-chair, has several projects in mind which would help embed sustainability into medical education and scientific grant funding. SCCM also hopes to partner with other medical societies in Europe and Australia," she said.
Domico also hopes to create a new leadership position at her hospital, either a medical director of sustainability or a chief sustainability officer.
Reflecting on her educational experience at ASU, Domico expressed gratitude for the opportunity to further her education through an online graduate program.
"Going back to school after more than 20 years was difficult for sure, but absolutely worthwhile," she said.
Domico emphasized how her ASU education has complemented her medical expertise with crucial leadership and communication skills.
"I might have great ideas about sustainability, but I needed to learn how to communicate them in a meaningful way that connects with my audience," she said. “Certain leadership skills around how to lead a transformational change process are not taught in medical school."
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