CleanMed Europe LastDay: “Sustainable health system” definition : different here

CleanMed Europe Day 3 30890

What does ‘sustainable’ mean. View on

  • One that meets the needs of the present generation without compromising the ability of future generations to meet their own needs.
  • Requires the reconciliation of economic, environmental and social demands – the ‘three pillars’ of sustainability of ‘the triple bottom line’

This is the best question – which is taken from the sustainability world more than the health world. I don’t think it’s the way Americans think about our health system. We seem more ‘health care system’ focused.

The people in the room when this slide was shown agreed across the board that their health system is not sustainable. 

I had an inkling there was a difference when I was doing research for this conference (I need to be a good @PioneerRWJF Advisor). When I talked to people here about sustainability, they included a lot more than carbon reduction or environmental stewardship in the definition. 

This approach is really simple – it’s “is the system we’re designing capable of supporting the next generation?” And this doesn’t mean the “next generation health system,” it means “the next generation of society,” which is what health care is for.

This is exactly what Andy Williamson, our patient, caused him to act, and what the next generation physician, Isobel “Izzy” Braithwaite (@izzybraithwaite) said to us from the stage.

Maybe it’s because European health systems are not struggling with the amount of GDP used by health care as it is in the United States that they can think this way.

I really enjoyed sharing space with everyone from architects, to chemists, to educators, to city planners, to legislators, all of whom want to amplify the work of health professionals.

It was worth coming here to experience this approach, it was quite novel for me.

At the same time, it brought healthy (continued) respect for the health system I work in. I became a Permanente physician because I wanted to be part of an aligned-for-society future-oriented model of care, with a 100% rating on the Corporate Equality Index (What it means to earn a perfect score on the Human Rights Campaign Corporate Equality Index | Ted Eytan, MD), Healthcare Equality Index (inclusion is very important to me, without inclusion, there can be no sustainability).

Nevirapine: life saving, as a drug, hazardous to manufacture. Chemists want to help us, too. See

It has turned out that I’ve also joined a health system that’s the only health insurer with a strong position on climate, with actions in support (Now Reading: Addressing Climate Change among Insurers, some are doing more than others | Ted Eytan, MD), and a place where patient/member involvement is encouraged (What “Patients included” looks like : 2012 Permanente Executive Leadership Summit | Ted Eytan, MD). These are things that make me think “sustainable”, which are in addition to excellent quality, service, access to health care.

What health professional wants all the hard work they do inside hospitals and medical offices destroyed by the operations of their own health care system or other forces outside their doors? None of them, they don’t have to, and we can be leaders rather than followers in preventing this (and yes, prevention is the new HIT).

I’m going to post about two papers that show the differences in approach (American/European) next. In the meantime feel free to write a comment or two about what sustainable means to you as a patient, community member, health professional…

Oh, and Google Glass (@GoogleGlass) continues to make friends. I love how the device makes people think positively about the future, their facial expressions show it. Enjoy.

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Ted Eytan, MD