Harmonizing environmental and economic forces in urologic care

Increases in wealth, scientific knowledge, and resources have contributed to unprecedented improvements in overall and urologic health over the past century. However, anthropogenic greenhouse gas emissions driving these advancements are a primary driver of climate change, including a substantial share contributed from the healthcare industry itself. Reducing resource-intensive processes in urologic care has been proposed to support environmental sustainability but these initiatives could conflict with economic forces that drive progress in biomedical innovation. Paradoxically, such strategies may also have unintended consequences for human health by slowing the pipeline or scientific discovery or delivery of treatment. A balanced approach can prioritize the elimination of low-value services in order to enhance care value while simultaneously reducing environmental waste and resource consumption. In this review, we examine strategies that seek to align environmental and economic forces in urologic care delivery within a market-influenced healthcare system.

Strategies to reduce low-value urologic care, including decreased reliance on single-use items, reducing use of the operating room when feasible, and judicious use of resource-intensive research methods, have potentially favorable environmental impacts. A maturing body of research has examined ways in which reductions in low-value services can be incorporated into clinical practice without compromising quality, safety, and patient outcomes.

Sustainability efforts in urology can be aligned with economic realities to be effective and scalable. Strategies that reduce environmental impact should consider cost, local market, and incentives within existing healthcare systems. Aligning ecological responsibility with economic value ensures that sustainable practices can be adopted without slowing clinical progress.