U.S. medical organizations and climate change advocacy: a review of public facing websites.

BACKGROUND: Climate change poses a risk of health catastrophes and must be expeditiously addressed across the health care sector. Physicians are considered trustworthy and are well positioned to discuss climate change with patients. A unified strategy by all U.S. medical societies is essential to effectively mitigate their carbon footprint and address health concerns. METHODS: We conducted a review of the public facing websites of member organizations of the AMA House of Delegates and the AMA, which were scored based on inclusion of content related to climate change in position statements or policies, task forces or committees, patient education materials, practice recommendations and any official society publications. Membership in the Medical Society Consortium on Climate and Health or participation in the organization My Green Doctor were recorded as indicators of a commitment to providing educational resources about mitigation and adaptation to climate change. The availability of a virtual option for annual meetings, as a potential means to reduce the carbon footprint of attendees, was trended from 2021 to 2022. RESULTS: Fifty out of 111 U.S. medical organizations (45%) had at least one metric with a reference to climate change and sixty-one organizations (55%) had no evidence of such website content. Out of 111 websites, only 20% (N = 22) had position statements or policies pertaining to climate change, 11% (N = 12) had committees or task forces dealing with climate change, 8% (N = 9) provided patient education resources on climate change, 21% (N = 23) included green practice recommendations and 45% (N = 50) had an article in an official society publication addressing climate change. Only 14% (N = 15) were listed as member societies of the Medical Consortium on Climate Change and 2% (N = 2) were participating organizations with My Green Doctor. CONCLUSIONS: Viewed through the lens of medical society websites, there was a wide variation in efforts to address climate change. The high performing organizations can serve as a guide for other societies to help mitigate and adapt to the climate emergency.

Tularemia.

Tularemia is a complex clinical disorder caused by the ubiquitous intracellular parasite Francisella tularensis, which has many mammalian and insect hosts. The peak observed incidence of tularemia occurred in 1939, and most present-day clinicians have never seen a case of this disease. Tularemia manifests several different clinical syndromes, depending on the portal of entry. F. tularensis has been used in biological warfare experimentation and it has been weaponized and stockpiled in the past by the United States and other countries. It is classified as a category A critical biological agent by the Centers for Disease Control and Prevention. This article reviews the history, clinical features, diagnostic evaluation, and treatment of this organism with an emphasis placed on its potential role as an agent of biological warfare.