From clinics to community: the physician’s prescription for a healthier planet

The traditional role of the physician has centred on diagnosing disease, treating illness and preventing complications. However, many of the major health threats of the twenty-first century originate beyond the walls of hospitals and clinics. Air pollution, climate change, extreme heat, unsafe water, environmental contamination, biodiversity loss, inappropriate waste disposal and unsustainable patterns of consumption increasingly influence the spectrum of human disease. Climate change is already associated with increasing heat-related illness, infectious diseases, malnutrition, respiratory and cardiovascular morbidity, mental-health consequences and disruption of health systems [1,2]. Physicians occupy a unique position at the interface between science and society. Their responsibility therefore need not end with treating the consequences of environmental exposure; it can extend to identifying environmental determinants of disease, educating patients, making health-care facilities environmentally responsible, participating in community interventions, generating evidence and advocating for policies that protect population health. This responsibility is particularly relevant because the health-care sector itself contributes substantially to greenhouse-gas emissions and waste generation [3]. India's National Programme on Climate Change and Human Health (NPCCHH) provides an important framework for translating climate-health knowledge into surveillance, capacity building, preparedness, resilient health infrastructure and multisectoral action.[4] This paper proposes a practical framework—Recognise, Reduce, Resilient, Reach and Represent—through which physicians can progress from individual clinical care to environmental health advocacy. Environmental advocacy should not be viewed as an activity outside medicine; when grounded in scientific evidence and directed toward disease prevention, it represents an extension of the physician's fundamental duty to protect health.