Prescription: Enviro-Knowledge for Doctors

Chances are your doctor doesn’t know much about environmentally-related
illnesses. Ann Murray looks at why most US doctors and nurses aren’t even
talking about environmental connections to their patients’ health and what’s
being done to remedy the situation:

Transcript

Chances are your doctor doesn’t know much about environmentally-related
illnesses. Ann Murray looks at why most US doctors and nurses aren’t even
talking about environmental connections to their patients’ health and what’s
being done to remedy the situation:


In 1999, Jo Ann Meier was diagnosed with breast cancer. She was shocked
to discover she had the disease. No one in her family had a history of cancer.
And she only had one of the standard risk factors for the illness:


“Of course, you always speculate when you have a disease like this. Was it
something I did or was it something that I was exposed to?”


Meier says her doctors never talked to her about possible environmental
links to her illness. Today, Meier is cancer free and runs a non-profit that
raises money for breast cancer research. She hears similar stories about other
primary care physicians from the breast cancer patients she works with every
day.


“There’s a great deal of anger about the misinformation or lack of
information given to them in general. I mean, it would be great if your PCP would
say you have to look at what you’re doing on a day-to-day basis that might
be affecting your health.”


Jo Ann Meier’s experience isn’t unusual. Experts agree that most doctors and
nurses aren’t ready to deal with the environmental links to dozens of
illnesses like cancer or lung disease. Sometimes crowded doctors’ schedules
or fear of being seen as an environmental advocate get in the way. Leyla
McCurdy directs the Health and Environment Program at the National
Environmental Educational and Training Foundation in Washington, DC.
McCurdy says medical providers don’t know much about environmental
health issues because training is so hard to come by.


One of the challenges that we are facing in terms of integrating environmental
health is the lack of expertise in the area. There are very few leaders who
are willing to take the time and create their own materials to educate the
students at the medical and nursing schools:


“As a result of this small pool of experts, and an already crowded set of
courses, most med students get only about seven hours of environmental
health education in four years of school. Established doctors and nurses have
even fewer training options.


A small but growing number of health care institutions, non-profits and
agencies are stepping in to fill the training gap. On this morning, medical
residents and staff doctors crowd into a hospital lecture hall.


“Welcome to medical grand rounds. Our speaker today is Doctor Talal ElHanowe,
who is going to talk to us about estrogenic pollutants in the environment and
the risk they pose to people.”


“Can these chemicals, which resemble estrogen, in one way or the other, cause an increase in the risk
to develop cancer? And the answer is yes.”


ElHanowe is a medical doctor and research scientist. He works with the
University of Pittsburgh’s Center for Environmental Oncology. The Center
is developing environmental health training for doctors and nurses. After his
seminar, ElHanowe says response to the program has been good. But his job
of relating environmental health risks can be tough because doctors aren’t
used to treating diseases with causes that are hard to pin down.


“In the scientific community, we can’t prove everything. Many things are
very difficult to prove.”


ElHanowe’s boss, Devra Davis, says medical providers will have to be
satisfied with substantial evidence, not absolute proof, that certain
environmental toxins increase the risk of illnesses, and steer patients to safer
alternatives. Davis is a nationally known epidemiologist. She says
environmental medicine’s emphasis on prevention is the shot in the arm
American health care needs:


“Because no matter how efficient the health care system becomes at finding
and treating disease, if we don’t reduce the burden of the disease itself, we’ll
never be able to improve the health of Americans.”


But to make environmental medicine standard issue in schools and practice,
a lot more doctors and nurses will need to be educated. And that means a lot
more funding. It’s hoped as medical providers make the connection between
environmental exposures and public health, funding sources will open up
and environmental medicine will make its way into mainstream health care.


For the Environment Report, this is Ann Murray.

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