Primary care sits at the centre of health system demand, where clinical decisions around prescribing, investigation, and follow-up significantly shape resource use and environmental impact. A substantial proportion of care delivered in this setting offers limited clinical benefit while contributing to overdiagnosis, patient harm, and avoidable system strain. Climate change is simultaneously increasing primary care demand through worsening air quality, wildfire smoke exposure, climate-sensitive infections, and mental health effects, while extreme weather events disrupt access to services and deepen health inequities. These pressures position primary care as a critical lever for both mitigation and adaptation.
Sustainable primary care is grounded in reducing unnecessary care, empowering patients, prioritizing prevention, and selecting lower-impact alternatives. Key approaches include reducing overtesting and overprescribing, addressing diagnostic creep, supporting deprescribing and antimicrobial stewardship, and using shared decision-making to avoid medicalization of normal human experience. Expanding non-pharmacologic care and virtual models can reduce travel and resource use. Clinic-level changes such as reducing single-use materials, rethinking infection control practices, and optimizing laboratory and prescribing practices further reduce environmental burden.
Sustainable transformation requires embedding planetary health into everyday primary care practice. Integrating Choosing Wisely principles, strengthening team-based longitudinal care, and improving information sharing can reduce duplication and low-value care. Coordinated action across clinicians, health systems, and policymakers is essential to deliver high-value, low-carbon care that improves outcomes and system resilience.
This document was authored by Dr. Ilona Hale and proudly supported by the East Kootenay Division of Family Practice and CASCADES Canada, a Government of Canada initiative.
An infographic for planetary health in primary care featuring four principles for environmentally sustainable healthcare: avoid unncessary care, empowering patients, choose environmental alternatives, shift to prevention.
This simple QI project demonstrates the feasibility of implementing a small change in a primary care clinic that can improve environmental sustainability with multiple co-benefits. If all family physicians in Canada eliminated exam table paper in their offices, it would result in savings of approximately 95 940 km of paper, 121 680 trees, $C8 400 600 and 3054 T CO2 emissions, equivalent to driving around the world 360 times.
Adopting a planetary health lens provides a new way to think about environmental sustainability in primary care. With many providers working together to incorporate the 4 principles of sustainable health care into our everyday work, we can help reduce the health sector’s environmental footprint with additional benefits for patients, providers, and the health care system.
This webinar features Ilona Hale, MD, exploring new ideas in environmentally sustainable clinical practice. It goes beyond basic measures like recycling and energy-efficient lighting, highlighting the connection between environmental sustainability and high-quality care, including patient-centred care, de-prescribing, and health promotion. The session explains how practicing high-quality, low-carbon care can improve patient outcomes, reduce healthcare system burden, decrease provider workload, and help address climate change. Ilona Hale is a family physician with the East Kootenay Division of Family Practice and an Assistant Clinical Professor in the Department of Family Practice at the University of British Columbia.
This webinar presents a fireside chat hosted by CASCADES, the Indigenous Primary Health Care Council, and the Alliance for Healthier Communities. Panelists share insights on the role, responsibility, and capacity of the primary health care sector and health professionals in identifying and addressing climate change vulnerability and leading adaptation efforts. The discussion features Imara Rolston, Dakota Recollet, Selma Tobah, and Bev Taylor, and is moderated by Fiona Miller and Natasha Beaudin.
This webinar is part of the “Climate, Health, and Healthcare” speaker series for health professional learners. It features Ingrid Waldron, MA, PhD, who discusses environmental racism, environmental justice, and their impacts on the health of communities.
