Climate change is the largest threat to human health and wellbeing globally (WHO, 2021). The healthcare industry itself currently contributes to fuelling the climate crisis with its emissions and material consumption (Karliner et al., 2020). There has been much research on decarbonising hospitals ecological/carbon footprints but very limited study on ways to assist healthcare clinics to transition to a low-carbon healthcare system.  With a gap in the literature, I commenced a structured literature review of existing knowledge and combined the results of this with primary data collection in the form of an online survey completed by healthcare clinic owners (including Physiotherapists) asking about their views on decreasing the ecological footprint of their clinics (Duindam, 2022).

The literature review revealed four important areas to act upon to decarbonise a physiotherapy clinic most efficiently. These are energy use, waste minimisation/management, the behaviours/attitudes of staff, and decarbonising the supply chain.

The following is an evidence-based guide for decarbonising a healthcare clinic (including physiotherapy clinics). To maximise operational effectiveness, how exactly this is done, will differ between clinics as different clinics have varying physical and economic circumstances. The guide is intended to provide evidence-based over-arching principles on which actions will decarbonise a clinic the most efficiently, and which actions are more applicable to individual clinics will vary. This blog is based off a thesis that investigated this topic from an Australian standpoint but will be relevant to other developed countries.

David Duindam (MSc)

David Duindam (MSc)

Senior Physiotherapist, Brisbane, Australia

Originally from New Zealand, David is a musculoskeletal, clinic-based physiotherapist that has been studying climate change and sustainability for more than 9 years. He has completed a Masters in Climate Policy and Sustainability with a thesis focusing on decarbonising healthcare clinics. He has a passion for advancing sustainable healthcare.


It was found that to be most successful individuals needed to first learn about decarbonising a Physio clinic. Research healthcare clinic emissions reduction, there are many helpful resources that may be relevant to your industry/clinic circumstance. Then appoint a passionate and educated “sustainability champion” in your healthcare team to implement, monitor and drive sustainability initiatives. Facilities with a passionate person driving transition are more likely to achieve great sustainability outcomes.


Know your recent electricity usage and cost. If your circumstances allow, switch your electricity provider to one committed to decarbonisation that offers certified carbon offsetting and owns or invests in renewable energy generation.

Promote the benefits of using active transport, public transport, and car-pooling/community cars to your staff/patients.


Photo by Delaney Van on Unsplash

Supply Chain

This is the section of healthcare that contributes the most emissions than any other. Audit clinic supplies, consumables, and sellable items. Possible criteria to track: percentage of products that don’t contain plastic or are made of recycled plastic, the percentage of products that come in sustainable packaging. Alternatively, a traffic light system of green for products that exemplify sustainability, yellow for items that have some element of decarbonisation (the company selling it is trying to decrease their footprint), and red for products that make no attempt in reducing their environmental impact. You then have a baseline of how your supply chain is performing.

Next, try and source items with less plastic, and higher percentages of recycled and recyclable material in their makeup and packaging. Try and source local products.

Tell suppliers that you want these items compared to others. Make sure they are comparable costs. Express concern, if not to pressure suppliers.


Try and reduce the amount of physical material that comes into your clinic

Supply appropriately sized bins at convenient areas of the clinic and train team members to recycle and compost (if appropriate in your clinics situation).

Consider alternatives to single use items where appropriate.


Photo by Steve Johnson on Unsplash

Behaviour Change

Get your team know that the clinic will be reducing its carbon/ecological footprint, stress that this is evidence-based, will help save the clinic money, will improve the health for all staff and patients, will help the broader community in various ways and will not take up more of their time once procedures are set up

Introduce operational procedure change after consulting staff to make them part of the solutions, highlight the simplicity, and benefits of each change. Examples include turning off electronic equipment overnight, lights when not in the room and not printing unless necessary.


Complete a relevant health professional specific sustainability/climate education program, encourage, and enable staff to do the same.

Join relevant industry sustainability groups for support, answers to questions, and ideas. Enquire about industry standard metrics you can be monitoring so your decarbonisation efforts can be more easily quantifiable.

Communicate with your health clinic’s professional governing body and ask what they are doing to support your profession to decarbonise.

Progress Monitoring

Monitor results, electricity bills, number of bags or waste to landfill bins etc.

Keep track of how much money you save each month and as this grows think about spending it on more expensive sustainability initiatives. An example is if you need to replace an old appliance, buy a high energy and water efficiency star model from a company dedicated to reducing its own footprint. If you own the building then other measures such as insulation, double glazing or solar panels could be applicable to your circumstance.

Celebrate and publicise successes. Emphasise that what you are achieving is creating a healthier community for your patients. Your website, social media and local news publications are all good avenues. This improves your reputation and trust with the community. You can inspire and motivate systemic change if others see your success/progress.

The Royal Australasian College of Physicians recommends the health sector reach net zero by or before 2040 (Smith, 2021). This includes healthcare clinics. Healthcare clinics have an opportunity and a responsibility to decarbonise and transition to “net zero” healthcare. Improved individual and population health, economic factors, social factors, and environmental effects are all outcomes of this pathway.



Header image credits: Photo by Nightingale Home nurse on Unsplash 

Duindam, D. (2022). Transitioning to Sustainable Healthcare: Decarbonising Healthcare Clinics, a Literature Review. Challenges13(2), 68. 

Karliner, J., Slotterback, S., Boyd, R., Ashby, B., Steele, K., & Wang, J. (2020). Health care’s climate footprint: the health sector contribution and opportunities for action. European Journal of Public Health, 30(Supplement_5), ckaa165. 843.

Smith, R. (2021). Australia, a laggard in responding to climate change, produces an impressive report on climate change and health. In (Vol. 375): British Medical Journal Publishing Group.

WHO, W. H. O. (2021). Compendium of WHO and other UN guidance on health and environment. Retrieved from WHO: