Reducing waste in a busy health clinic

Healthcare generates a lot of waste. Australian hospitals produce tens of thousands of tonnes of it annually, and while an allied health clinic operates at a different scale, the categories are similar and so are the trade-offs.

This is an honest account of what a clinic like this can and cannot change, because a lot of published “sustainable clinic” material glosses over the point where sustainability and infection control disagree.

Where the line is, and why it does not move

Single-use items exist because reusing them transmits infection. That is not a matter of preference.

Colonic irrigation tubing is single-use on every session, and it will remain so. Acupuncture and dry needling needles are single-use sterile, and will remain so. Gloves, dressings and anything contacting broken skin or mucous membrane are single-use.

Any clinic offering to reduce its environmental impact by reusing those items is offering something you should decline. The place to reduce waste is everywhere else — and everywhere else turns out to be most of it.

Where the volume actually is

Audits of healthcare waste consistently find that the largest contributors in an outpatient setting are not clinical items at all:

Paper. Patient forms, printed exercise programmes, receipts, appointment cards, marketing. Historically the single biggest stream in a clinic.

Packaging. Everything arrives wrapped, and the wrapping is discarded immediately.

Laundry. Towels and linen, and the water and energy of washing them.

Energy. Lighting, heating and cooling across a building open six days a week from 8:45am to 7:00pm.

Consumables that could be reusable. Cups, couch roll, cleaning materials.

What actually reduces it

Going digital where it does not cost care quality. Online booking, digital intake forms, emailed receipts, exercise programmes sent by link rather than printed. This is the largest single reduction available to a clinic and it also happens to be more convenient — patients lose a printed exercise sheet within a week and never lose a link.

Buying in bulk with less packaging, and choosing suppliers who will take back or reduce it.

Efficient lighting and considered heating. Unglamorous, and the largest energy line in a building this size.

Reducing water in laundry, through efficient machines and full loads, and using couch protection efficiently rather than by habit.

Correct waste segregation. Genuinely important and frequently done badly. Clinical waste disposal is far more energy-intensive than general waste disposal, so putting general waste into a clinical waste stream multiplies its footprint for no benefit. Getting segregation right reduces impact without touching infection control at all.

Repairing rather than replacing equipment, and buying equipment that can be serviced.

What patients can do, if they want to

Nothing here is asked of anyone, and none of it changes the care you get:

• Book online rather than by phone, if that suits you
• Take your receipt and exercise programme by email
• Bring your own water bottle
• Combine appointments where you are seeing more than one practitioner, which halves the trips
• Consider the tram — route 58 runs along Melville Road and stops at the door

The honest limits

A clinic of this size will not have a large environmental footprint in absolute terms, and claiming otherwise would be overstating both the problem and any solution. The genuinely material choices in healthcare sustainability are made at hospital and system level.

What a clinic can do is avoid obvious waste, segregate correctly, digitise the paper, and not pretend that any of this justifies compromising on the single-use items that exist for a reason.

If you have a suggestion — something we throw away that we obviously should not — reception will pass it on. Most of the improvements above came from someone noticing rather than from a policy.