{"id":2517,"date":"2018-09-19T19:23:41","date_gmt":"2018-09-19T23:23:41","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2517"},"modified":"2018-10-19T13:13:24","modified_gmt":"2018-10-19T17:13:24","slug":"nearly-kicked-cafeteria","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/09\/nearly-kicked-cafeteria\/","title":{"rendered":"I Was Nearly Kicked Out of the Cafeteria"},"content":{"rendered":"
\"Scott<\/a>

Scott Hippe, MD, is a Chief Resident at Family Residency of Idaho in Boise.<\/p><\/div>\n

The nature of the crime? Bringing my reusable food container down for meals. I just wanted to avoid the Styrofoam plates and plastic silverware, but the lunch ladies were convinced I was asking for two portions\u2019 worth of side dishes and then only paying for one. I wasn\u2019t,\u00a0although I admit\u00a0to\u00a0once sprinkling cheese from the salad line on my soup [gasp!]. But\u00a0by that time,\u00a0I already had a large target painted on my scrubs.<\/p>\n

My innocent food container \u2014\u00a0my small attempt at being mindful of waste \u2014 was barred from the cafeteria. The exclusion sent a clear message: Eat on our single-use plates, or do not eat at all. <\/em>Coming from the same organization that tosses all the contents from its recycling bins into the landfill, I shouldn\u2019t have been surprised.
\n<\/em><\/p>\n

My\u00a0cafeteria episode apparently\u00a0was a big deal in the world of hospital food preparation. One of the cafeteria supervisors sent a message straight to my program director. \u201cYour resident isn\u2019t coloring inside the lines,\u201d was essentially how it read. No matter how trivial the issue, having to explain yourself to your program director is obviously undesirable.<\/p>\n

Medical waste is a bigger problem than you might realize<\/h2>\n

Our medical-industrial complex exerts a\"\"<\/a> significant\u00a0negative effect\u00a0on the environment. I\u00a0am likewise not impressed by the degree to which healthcare contributes to pollution. A 2016 study reported that\u00a09.8% of national greenhouse gas emissions\u00a0are attributable to\u00a0the healthcare sector (PLoS One<\/span><\/em> 2016; 11:e0157014<\/a>)<\/span>. For reference, the study authors explain this amount of emissions supersedes total emissions from all but the thirteen highest-producing countries worldwide.<\/p>\n

The problem is bigger than just greenhouse gasses. Medical waste takes up space in landfills. Healthcare\u00a0practices create\u00a0chemicals that are\u00a0carcinogenic to humans and toxic to the environment. Particulates generated by hospitals and\u00a0by production of medical goods are spewed\u00a0into the air. All of these things\u00a0have implications\u00a0to the health of the patients we are supposed to be helping.<\/p>\n

What can be done?<\/h2>\n

With a last name like Hippe, I had best not get too far out in left field on environmental issues. Clearly, some amount of energy has to be devoted to powering our facilities and providing health services. But, \u201chow much energy?\u201d is the important question. In my\u00a0opinion,\u00a0we can be doing much better.<\/p>\n

There are many levels on which the discussion of environmental health needs to occur, from top tiers of hospital administration down to\u00a0each individual person. The environmental impact of our activities needs to be highlighted at the organizational level,\u00a0but lofty aims like this are not readily accessible for the majority of healthcare personnel.<\/p>\n

If you find yourself just trying to survive from one day to the next (cough, I\u2019m talking to you, fellow residents, cough) rather than participating in high-level policy discussions,\u00a0a more realistic place to start might be to decrease your personal waste. Use a coffee mug rather than disposable cups. Stop using sterile gloves for minor skin procedures, because they\u00a0are associated with\u00a0no difference in infection rates. (Wash your\u00a0hands!)\u00a0Among acceptable surgical techniques, choose the one that employs the least amount of single-use equipment. Save trees by writing concise hand-off reports.<\/p>\n

I would be curious to hear other ideas about how you have individually reduced environmental waste, and any inspirational facility-wide policies that have been successful at your institutions.<\/p>\n

Lastly, for the truly brave folks out there: Bring your own dish down to the cafeteria \u2014 but watch out for the lunch ladies!<\/p>\n

 <\/p>\n

\"NEJM<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

The nature of the crime? Bringing my reusable food container down for meals. I just wanted to avoid the Styrofoam plates and plastic silverware, but the lunch ladies were convinced I was asking for two portions\u2019 worth of side dishes and then only paying for one. I wasn\u2019t,\u00a0although I admit\u00a0to\u00a0once sprinkling cheese from the salad […]<\/p>\n","protected":false},"author":1294,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[332,27,37],"class_list":["post-2517","post","type-post","status-publish","format-standard","hentry","category-about-residency","tag-environmental-issues","tag-healthy-choices","tag-resident-experience"],"yoast_head":"\nI Was Nearly Kicked Out of the Cafeteria - Insights on Residency Training<\/title>\n<meta name=\"description\" content=\"Dr. Hippe is looked upon as a nonconformist by the cafeteria staff, because he's trying to reduce his impact on the environment.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/09\/nearly-kicked-cafeteria\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"I Was Nearly Kicked Out of the Cafeteria\" \/>\n<meta property=\"og:description\" content=\"Dr. Hippe is looked upon as a nonconformist by the cafeteria staff, because he's trying to reduce his impact on the environment.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/09\/nearly-kicked-cafeteria\/\" \/>\n<meta property=\"og:site_name\" content=\"Insights on Residency Training\" \/>\n<meta property=\"article:published_time\" content=\"2018-09-19T23:23:41+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2018-10-19T17:13:24+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/07\/AU000_shippe.jpg\" \/>\n<meta name=\"author\" content=\"Scott Hippe, MD\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Scott Hippe, MD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/09\/nearly-kicked-cafeteria\/\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/09\/nearly-kicked-cafeteria\/\",\"name\":\"I Was Nearly Kicked Out of the Cafeteria - Insights on Residency Training\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\"},\"datePublished\":\"2018-09-19T23:23:41+00:00\",\"dateModified\":\"2018-10-19T17:13:24+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/ee4340cb1857fa1b3e172e9572bf210a\"},\"description\":\"Dr. Hippe is looked upon as a nonconformist by the cafeteria staff, because he's trying to reduce his impact on the environment.\",\"breadcrumb\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/09\/nearly-kicked-cafeteria\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/09\/nearly-kicked-cafeteria\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/09\/nearly-kicked-cafeteria\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/blogs.nejm.org\/general-medicine\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"I Was Nearly Kicked Out of the Cafeteria\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/\",\"name\":\"Insights on Residency Training\",\"description\":\"Observation of residents across diverse medical specialties\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blogs.nejm.org\/general-medicine\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/ee4340cb1857fa1b3e172e9572bf210a\",\"name\":\"Scott Hippe, MD\",\"description\":\"Scott is from a small town in western Washington called Snohomish. 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