The 'green' pediatric office

Introduction

Medicine in the 21st century...what a marvelous, though sometimes overwhelming, time to be in the practice of pediatrics! Technology has become both our boon and our bane: more tools to help our patients, yet daily increases in the slope of our ongoing learning curves. Such rapid change has us struggling toward a techno-future without a clear overview of how to combine all the pieces of this giant techno-puzzle.

One area of medical care provision that is often more piecemeal than complete picture is the design and construction of the physical spaces where care is delivered. While some advanced design technology is slowly moving into the offices of private physicians, it is rarely implemented with an overall plan that takes into account its full impact on the health care we are attempting to provide.

No, we're not speaking of whooshing Star Trek doors, or tricorders that diagnose patients with the wave of a hand. Rather, new tools, concepts, and practices available today can be used to enhance the delivery of pediatric care using cutting-edge technology combined with the practical application of current knowledge from many fields of study.

It is with these thoughts in mind that we begin an ongoing dialogue on the importance of design, materials, and operations in the "green" pediatric office by Lawrence D. Rosen, MD.

-GREGG M. ALEXANDER, DO

Ecologically sustainable medicine; it has been done

Many of us are increasingly aware of how the environment can have an adverse impact on our children's health. Increasing rates in asthma and other atopic disorders, certain types of cancer, obesity, and neurodevelopmental disorders have all been linked to the environment.^1-11

This growing body of evidence is driving hospitals and private offices to adopt ecologically sustainable medicine (ESM).¹² But what exactly is ecologically sustainable medicine? The Teleosis Institute defines ESM as "an approach to health and wellness that focuses on sustainable, cost-effective health care and preventative self-care education."¹³ ESM is also protective of human and environmental health.

New Jersey's Hackensack University Medical Center (HUMC) is home to one of the world's first ecologically sustainable children's hospitals. By using energy-efficient and environmentally friendly building and cleaning materials, healing space design, and waste minimization and recycling, HUMC demonstrates that health care facilities can themselves be models of health and wellness.

Using the lessons learned from working at HUMC, I opened a new "green" primary care pediatric office in northern New Jersey. The three key "green" concepts we considered were design, materials, and operations.

DESIGN

The entire space is ADA (American with Disabilities Act)-compliant including reception space and bathrooms, which is crucial for practices working with children with special health care needs.