Recommendations on the Role of the General
Practitioner in Environmental Protection
Discussed and approved at the ISDE Workshop organized in collaboration with WONCA (Cortona, 1993)
Written by: Mauro Biagioni (Italian Federation of Pediatricians); Marcello Bordiga (Italian Association of Doctors for the Environment, Italy); Eva Buiatti (President of the Scientific Committee of the Italian Association of Doctors for the Environment); Eddie T. Chan (Vice-president WONCA, Hong Kong); Mario Costa (ISDE, Italy); Dario Grisillo (ISDE, Italy); Duane M. Koons (Doctors for the Environment, USA); Lotte Newman (Vice-president WONCA, UK); Franco Nocera (Arezzo Association for Epidemiological Research, Italy); Werner Nussbaumer (President ISDE, Switzerland); Roberto Romizi (Co-president ISDE); Lorenzo Tomatis (President of the ISDE International Scientific Committee, Director, IARC, Lyon); Luigi Triggiano (Arezzo Association for Epidemiological Research, Italy).
Aims of the Recommendations are the following:
contribute to the understanding of the role of physicians in the protection of the environment;
suggest practical opportunities to develop this role at an individual and social level;
clarify reasons for self-identification as a member of Doctors for the Environment organisation;
promote sharing of methods and experiences of intervention in Environmental protection;
identify the contribution of Doctors for the Environment to individual colleagues to help them in their commitment for environmental protection.
The Doctor for the Environment (DE) is aware of his/her role as a family doctor, in orientating the social behaviour and personal life-style of the patients and of the community at large from the point of view of personal and community health. He/she is also aware of the need for scientific self-education and instruction on communication techniques of specific topics. He/she currently dedicates some personal time to this up-dating and also to disseminating useful and accurate information on environmental and behavioural matters within the community.
For the same reason, the DE personally behaves consistently with the contents of the environmental orientation he/she gives to the community. In fact, the first rule is to use an example as the main method of personal communication. His/her method of education of the population is carefully oriented to avoid the development of inappropriate guilt feelings at an individual level.
The DE acts in the local situation by promoting the participation of physicians in social decisions on environmental matters. This participation represents at the same time a duty and a right of physicians, as their competence is needed to point out the relevance of environmental protection action in preserving human health.
The DE currently utilizes his/her competence on environmental risk factors for evaluating symptoms of individual patients and for orientating the diagnosis. For this purpose, he/she evaluates the appropriateness of currently using an Environmentally Focused Clinical Record.
The DE develops a competence for epidemiological evaluation of environmentally-related diseases at a community level and is actively committed in the production of data and information on this matter for the community.
The Doctors for the
Environment Association (ISDE) promotes activities of permanent education of physicians in
the field of environmental health, communication techniques, epidemiological methods. This
activity is developed through an appropriate School in Cortona (Arezzo, Italy).
The School of Cortona organizes courses, workshops, seminars on specific matters; produces didactic material both on paper and on video in Italian and English; implements a data bank collecting international literature and individual documents produced or provided by ISDE members.
ISDE institutes a Working Group for the study of an Environmentally Focused Clinical Record, to be translated in several languages and sent to DEs who are willing to use it in their practice.
ISDE promotes meetings and workshops dedicated to the exchange of information on practical experiences conducted by individual physicians on environmental protection or on environmental-related health problems in their area, which involved ISDE members.
ISDE promotes awareness and knowledge among its associates on the methods of "Active Medicine", suggesting fields of application through the exchange of experience at an international level.
ISDE promotes the participation at a local, National and International level of physicians in the development of politics for environmental protection.