Patients' perspectives on ecologically sustainable health care in general practice: an experimental vignette and...

Health care contributes substantially to climate change. GPs want to implement sustainable health care but are hesitant, worried that this may jeopardise their doctor-patient relationship. However, whether this concern is valid should be urgently assessed.

To explore patients' perspectives on sustainable health care in general practice.

In 2022 and 2023, we performed an online study with Dutch adults using experimental vignettes and a questionnaire.

The vignettes described GP appointments for three health complaints with randomly allocated treatment advice, varying in sustainability and explanation, but with comparable health outcomes. The questionnaire assessed participants' perspectives on sustainable health care in general practice. We analysed the vignettes using mixed-design analysis of variance (ANOVA) and the questionnaire using descriptive statistics and correlations.

In total, 801 participants completed the vignettes, and 397 the questionnaire. We found no difference on satisfaction with a doctor's visit (P values >0.24) when comparing a sustainable and a less-sustainable treatment option. The effect of explicitly mentioning sustainability differed per health complaint (dyspnoea: no difference; knee pain: mean difference [MD] = 0.31, P = 0.002; erythema: MD = -0.23, P = 0.003). In the questionnaire, participants reported positive expectations, and trust in the GP and treatment when delivering sustainable health care, but were more neutral about the GP's role.

We found no indication that sustainable treatment advice leads to lower satisfaction with GP care. The effect of explicitly mentioning sustainability was minimal and differed per health complaint. When directly asked, participants were mainly positive about sustainable health care. These results could encourage GPs to introduce sustainable treatment advice, without worrying about negatively influencing patient satisfaction.