Healthcare system – Unorthodocs- a meandering

Getting hospitals to ditch Fossil Fuels? How to pitch the case? I asked Bard and Bing Chat to help.

At a planning day at Healthy Futures (please consider joining), this is a prime campaign. Of course it’s a no-brainer if you ask the general public: we must do it, but the modern hospital doesn’t represent public needs like small local hospitals used to. Management has bigger fish to fry than just making people feel better and acting in the public interest. Imploring a hospital to do its bit to help the environment and mitigate the disastrous effects of climate change is no easy task. Population health seems to be not a major priority when you are lobbying the stakeholders who can influence change. Environmental considerations and public health live in the shadow of the budget sheet. The argument has to be pretty much an economic and political pitch.

.. so I asked for assistance from AI.

Here’s how it went- I’ve shortened it to make it an easy read, plus provided the sources it (says it) used. I put it to both Bard and BingChat (a version of ChatGPT) as well.

BARD, can you research the economic costs for a large hospital to convert its heating from gas to electric heat pumps. If no data is available, extrapolate from any commercial estimates you can access.

Sure, I can research the economic costs for a large hospital to convert its heating from gas to electric heat pumps. Here are some estimates I found:

According to a study by the U.S. Department of Energy, the average cost to convert a hospital’s heating system from gas to electric heat pumps is $1 million. However, the cost can vary depending on the size and complexity of the hospital.
A study by the American Hospital Association found that hospitals that converted to electric heat pumps saved an average of $1 million per year on their energy bills.
The cost of electricity is generally higher than the cost of natural gas, but the efficiency of heat pumps can offset this difference. Heat pumps can be up to 300% efficient, meaning that they can generate 3 units of heat for every 1 unit of electricity they use.

Overall, the economic costs of converting a hospital’s heating system from gas to electric heat pumps are significant upfront, but the long-term savings can be substantial. Hospitals that are looking to reduce their energy costs and improve their environmental impact may want to consider converting to electric heat pumps.

Here are some additional factors that may affect the cost of converting a hospital’s heating system:

The age of the hospital’s heating system. Older systems may be more expensive to convert than newer systems.
The size of the hospital. Larger hospitals will have higher conversion costs than smaller hospitals.
The climate in which the hospital is located. Hospitals in colder climates may have higher conversion costs than hospitals in warmer climates.

If you are considering converting your hospital’s heating system, it is important to get quotes from multiple contractors. You should also consider the long-term savings and environmental benefits of converting to electric heat pumps.

Comment- This was interesting information but didn’t help with a pitch, so I asked for one.

Can you elaborate, giving me some figures that might appeal to hospital administrators?

Yes, a study by the American Hospital Association (AHA) found that hospitals that converted to electric heat pumps saved an average of $1 million per year on their energy bills. The study, which was conducted in 2017, looked at data from over 300 hospitals across the United States. The study found that hospitals that converted to heat pumps saved an average of 40% on their energy costs. The savings were even higher in hospitals that were located in cold climates. For example, hospitals in the Northeast saved an average of $1.5 million per year on their energy bills after converting to heat pumps.

There are several reasons why heat pumps can save hospitals money on their energy bills. First, heat pumps are more efficient than traditional heating and cooling systems. Heat pumps can transfer heat from one place to another, which means that they don’t have to generate as much heat or cold as traditional systems. Second, heat pumps can be used to both heat and cool buildings, which can save hospitals money on their energy bills during both the heating and cooling seasons. Third, heat pumps can be used to provide ventilation for buildings, which can also save hospitals money on their energy bills.

The AHA study found that the savings from converting to heat pumps can offset the cost of the equipment in a few years. In addition to saving money, heat pumps can also help hospitals reduce their environmental impact. Heat pumps don’t produce any emissions, which can help hospitals reduce their carbon footprint.

If you are a hospital administrator, you may want to consider converting to heat pumps. Heat pumps can save your hospital money on its energy bills, reduce its environmental impact, and improve the comfort of your patients and staff.

COMMENT; But I needed my evidence referenced. These days, BingChat has stopped confabulating so much, and I like the way you can prompt it to give references and URLs, so I switched to BingChat for some evidence to back up what Bard was telling me-

Bing, could you please compile me a list of references on the topic of “converting hospitals from fossil fuels to heat pumps” or similar, focussing on articles that outline the economic considerations and the future benefits?

Sure! Here are some references that might be helpful for you:

These articles outline the economic considerations and future benefits of converting from fossil fuels to heat pumps. For example, heat pumps are a low-carbon heating technology with the potential to deliver large-scale reductions in carbon emissions from building heat 1. They are also highly efficient, delivering three to five units of heat for each unit of electricity needed to run them 1. In addition, heat pumps have become an increasingly effective way for buildings to decarbonize due to operating, equipment, and installation costs becoming more competitive in certain markets 2.

Is there anything else you would like me to find for you?

Yes, it’s really hard to find good solid economic data to detail the cost of conversion, especially when you include cost of removal of old gas burners, sourcing the replacement heat pumps, and labour costs. I don’t really care if what you give me is not applicable to our local circumstances, but anything that you can find that addresses these will be helpful. What can you find for hospitals or similar size buildings such as hotels?

I’m sorry, but I couldn’t find any specific information on the cost of converting hospitals or hotels from fossil fuels to heat pumps. However, an article by McKinsey states that electric heat pumps have become an increasingly effective way for buildings to decarbonize due to operating, equipment, and installation costs becoming more competitive in certain markets ¹.

Would you like me to search for something else?

At this point I bailed and went to good ol’ Google to see what I might have missed:

This-

Appreciating the Value of Sustainability in Health Care

and this-

https://www.hfmmagazine.com/articles/4562-decarbonizing-health-care-facilities

“Non-communicable disease”. Let’s retire this phrase. Isn’t it counterproductive to Public Health?

Sitting here on the tail end of another awesome ASLM conference https://www.lifestylemedicine.org.au/conference/program/, I find myself again reacting to public health concept “Communicable disease” (spread by infectious agents) vs “Non-communicable” disease as I find it binary, polarised, disempowering and counterproductive to our efforts to live healthier.

I react because of the possible implications of the latter term. If something is “non-communicable” then we aren’t spreading, encouraging, allowing, promoting this condition are we? The factors causing the epidemic of type 2 diabetes are mainly non communicable, no?

“No” I argue. But do you agree? The way I see it, whenever we promote sweets as a reward for eating healthy food to children, or a Friday beer session as a reward for a hard week’s work, or a G and T as the deserved treat at the end of a stressful day, we are spreading the “you deserve this” meme. We are communicating and transmitting a message. We are trafficking in communicable harmful beliefs, and we are promoting all sorts of “non communicable” conditions.

Furthermore, so many of the conditions have a transmissible component through vertical and horizontal gut microbiome transmission (families share the gut microbiome, mothers pass down their microbiome (gut/skin) during childbirth. We are now well aware of the gut-brain, gut-nerve, gut-joint axes (amongst others) and the importance of a healthy mouth microbiome in preventing cardiovascular disease. We transmit our microbiomes, and we exchange bits of them with our pets.

Add to this the component of epigenetic signalling (which is partially genetically passed down, and partially modulated by the gut-biome) and suddenly we question whether we are really passive in perpetuating society’s chronic diseases.

And don’t get me started on how we transmit ideas that we are individuals with rights, rather than an interconnected colony of humans. The latter idea, intrinsic to the gentler cultures, is a weird concept to us Western Lifestylers.

Suffice it to say, I think we should broaden the term “communicable conditions” and thereby share a bit more responsibility for our part in promoting and transmitting the upstream determinants of lifestyle disease, starting with our language. (Owning up to my hypocrisy here.. I feel very certain about this, and that’s a problem… ). To me this is about more helpful ways of thinking about taking collective responsibility for our health and health inequality.

Thoughts?

If we are serious about suicide prevention… what about this conversation?

I find myself constantly despairing about the missed opportunities to change our ways of thinking in order to prevent mental illness and suicide.

I’m worried we are taking a less than optimally effective approach to suicide prevention.

I was reading about Australia’s “you can talk about suicide” launch.

I found no reference to shame in the document and that concerns me, as shame, I think, isn’t far from self-loathing if it’s not talked about, shared and normalised.

What about “How to have conversations which disclose and normalise the experience of shame, and self shaming internal dialogue?”

I don’t believe we can have an effective conversation about suicide until we are skilled up in having this conversation.

I think it’s not that hard, but the principles of the conversation are counter-cultural.. let’s start on that project ASAP rather than conversations which assume that depression or anxiety have an internal locus (diagnostic model) with a biochemical basis, on top of causal genetics and experiences and therefore respond to fortification or medication.

The diagnostic model is struggling to achieve great results in primary prevention. It’s had an OK effect on secondary prevention but I strongly believe that looking at the social construction of mental illness might be more fruitful.

Let’s start the conversation with the question “We all suffer from shame in some form or another. What would I need to do differently so that you and I/we all can talk about our shame and work together against its effects?”

What do you think?

“Mental Illness” and medical students with Anxiety/Depression

So today I heard on the radio that 3 point something percent of medical students are suffering from a severe form or mental illness, which was described as anxiety or depression. A brave young doctor spoke out about her own experience. You can find the information here .

What I want to say about this is simple, and I believe vital.

That we regard “anxiety/depression” as “mental illness” is part of the problem.

Continue reading “Mental Illness” and medical students with Anxiety/Depression

Do you do an emotional workout?

It’s 11am and I’ve already (unintentionally) done my emotional workout for the day. It started with a phone call where I learned about a senior doctor (supported by two colleagues) bullying medical students. (not in my town fortunately!) They berated the students, accusing them of arrogance, stupidity and weakness. The students were told “Know your place!” all because the students asked to be excused from an activity so they could study for their upcoming exams. Haven’t these doctors been reading the news?

ANGER– Which I have re-narrated as “passion for justice”. When will we turn our medical culture around? I felt ashamed of and angry with some members of my profession.

Then I read about the outpouring of generosity for the homeless student who wants to be a criminologist and is living in a tent under a bridge (It must be SOOO cold!) I shed a tear or two.

THANKFULNESS TO OTHERS for being so compassionate. I felt good to be a human.

Then I remembered all the work I had to do today! I had a little panic.

FEAR- I had a little chat with fear, thanking it for reminding me not to waste the whole day, and re-examined my expectations. I wouldn’t try to do so much. The panic was a little less overwhelming

Then I decided to head down to the local coffee shop for coffee and a croissant (yes I know it’s pro-inflammatory! and yes it might have been avoidance!) The new Florence and the Machine album was playing, the sun was streaming in, and some kind patrons were rescuing a terrified wandering little dog outside. I read a funny clip in the Herald Sun from a lavatory in Japan

LAUGHTER AND JOY

That’s it. Workout over. On with the working day!

Must get a physical workout in later!