When ‘Do No Harm’ Goes Global

By Betsy Piland
March 21, 2026 | VOLUME 4, ISSUE 1

Emergency medicine physician Amy Collins, MD, wasn’t expecting a career-defining moment to come in the elementary school pickup line.

But there she was, car idling, texting, and listening to music, when her son climbed in and told her what he’d learned that day about climate change and its impact on polar bears and penguins. Then he asked her to pinky swear she would do something about it.

That evening, the Collins family watched An Inconvenient Truth and committed to making changes at home: doing energy efficiency audits, line-drying laundry, composting, and growing a vegetable garden.

But during her shifts in the emergency department, Dr. Collins grew increasingly unsettled. “I started to feel very uncomfortable when I walked into the emergency department for a shift, really wondering why I was leaving my environmental conscience at the door,” she said.

She’d heard that recycling programs were illegal in hospitals, but a quick online search informed her that not only was recycling legal but the health care sector had a serious environmental footprint, which she saw as an opportunity to help reduce it.

One significant career pivot later, Dr. Collins now is Medical Director of Health Care Without Harm, a global nonprofit working to use its influence to create a sustainable, equitable, and healthy world.

It began with a thermometer

One of Health Care Without Harm’s first campaigns targeted mercury, a potent neurotoxin present in thermometers, blood pressure-monitoring devices, and chemical agents common in health care settings. Dr. Collins said that the campaign began with a thermometer swap at Beth Israel Deaconess Medical Center in Boston, where more than 1,000 mercury thermometers were replaced with digital alternatives. The effort grew into a national campaign to remove mercury from the US health care sector, ultimately contributing to a global treaty in which countries agreed to phase mercury out of health care sector worldwide.

“I think it really shows that this work can be scaled,” Dr. Collins said. “It can start small.”

That early success established a model that the organization has built on across sectors, including waste, sustainable food, energy, buildings, and transportation. Its current strategic plan, running through 2028, focuses on climate-smart health care organized around three pillars: mitigation, resilience, and equity.

Health Care Without Harm now works with more than 70,000 hospitals and health systems in 86 countries.

Mobilizing the clinical workforce

Dr. Collins is clear about what advocacy around this issue requires. “The health care sector is not going to be able to meet its climate goals without engaging and mobilizing the entire clinical workforce,” she said. But she is equally clear that engagement doesn’t require anyone to make a complete career change. “There’s a role for everyone,” she said.

For health professionals just getting started, she recommends first connecting with the health care sustainability community—getting educated, then sharing that knowledge with others. From there, Dr. Collins encourages clinicians to assess what their own institutions are doing. Has a sustainability commitment been made? Who are potential allies internally? What are peer organizations doing? What climate or emissions goals exist at the state or community level? “Then you can start figuring out what your action is going to be,” she said, “and it’s different for everyone.”

When the conversation moves to hospital or facility leadership, specificity matters. “Be really clear about what the ask is. Don’t just say, ‘How can we do something about climate?’ Go in and say, ‘I would like you to join Practice Greenhealth.’ Ask them to sign a pledge to reduce emissions or appoint a director of sustainability.” She also encourages clinicians to understand the business case for sustainable health care, which could make or break implementing sustainability efforts when it comes to the C-suite.

A role for every clinician

Dr. Collins discovered an underused opportunity for advocacy: the residency interview. “Medical students often think, ‘I’m just a medical student,’ but they have a lot of power,” Dr. Collins said.

She encourages candidates to ask programs directly what their institutions are doing on and around sustainability and whether they’ve made a climate commitment. The questions send a signal that resonates. In fact, a residency program director recently told her that roughly 10% of their candidates had raised the issue during residency interviews, and it prompted him to consider whether his program needed to respond.

“If we’re going to be competitive, we need to be prepared to support trainees’ interest in climate and sustainability,” the program director had told Dr. Collins.

Advocacy vs leadership

Because many interpret advocacy in the legislative policy context, Dr. Collins prefers the word “leadership” over “advocacy.” Leadership, she explained, captures the broader range of ways health professionals can take action. That includes efforts within the four walls of a health care facility—clinical decision-making, research, education, media engagement, resilience planning, and policy advocacy. In that broader sense, health professionals’ credibility, clinical expertise, and institutional influence make them essential to the work.

The path that took Dr. Collins from that school pickup line to her current role was a long but fulfilling one. Leaving clinical medicine was difficult; it had been her identity for years. But a colleague had offered the perspective that helped her decide: “A lot of people can be emergency medicine physicians, but not many people can do what you do.”

For clinicians wondering where to begin, her guidance is practical: Connect with others already doing the work, with one option being Health Care Without Harm’s Climate Smart Collective, a network of health professionals working in this space. Dr. Collins shared that the organization’s annual sustainability conference, CleanMed, offers fellowships and awards to help support students and trainees.

Whatever your leadership and advocacy path may be, she encourages medical professionals to use the influence they already have. “At this time of the climate crisis, health professionals’ greatest opportunity is to encourage their leaders to make a commitment to emission reduction and climate resilience planning.”

LEARN MORE ABOUT HEALTH CARE WITHOUT HARM »