Friday, March 2, 2007

Feet to the Fire: Responding to Dr. Godlee

Filed under: Medgadget Exclusive

Over the last few weeks, we've taken BMJ editor Dr. Fiona Godlee to task for her recent piece, Reducing the Carbon Footprint of Medical Conferences. We noted the irony of Dr. Godlee urging doctors to lead by example and reduce the environmental impact of medical conferences when, in fact, she travels by air to conferences quite often. We set up an interactive map where readers can follow Dr. Godlee's travels and report their own sightings.

And, most importantly, we asked Dr. Godlee about steps she and BMJ are planning to take, to reduce their carbon emissions: are they willing to put their footprint where their mouth is?

Well, Dr. Godlee was good enough to respond to our missive (comment #3 in this thread) -- some of which is exceprted below.

... my business travel is rather more extensive than you have so far managed to document; indeed were it not so I might be charged with failing to do my job. But I'm grateful to you for taking the trouble to track my carbon footprint and for keeping me on my toes about this. If I can help with further information, please let me know. To your charge of hypocrisy I am tempted to hold my hand up and say that this is a fair cop. But on the basis of what I have written I don't think the charge stands. In our recent editorial, Ian Roberts and I said:

1. Climate change is important
2. Air travel contributes to it
3. Much air travel is unnecessary
4. We should try to reduce it and some are already doing so.

You don't argue with any of these substantive points. Of course I fully acknowledge the need for anyone writing about climate change to lead by personal example. Individual behaviour change is one of the four elements of the newly formed Health Climate Council's strategy (see What can we do about climate change? BMJ 2006;333:983-984). I have a long way to go to meaningfully reduce my own contribution, but I'm working on it and doing what I can to encourage others in the same direction. Inspired by your intervention I'll update my climate blog on bmj.com so anyone interested can judge how well or badly I'm doing. The BMJ Group is also taking seriously the need to lead on this, with increased investment in online conferencing and online learning...


(The emphasis is ours). We're pleased with this dialogue, but it seems to some extent we're talking past each other. From our perspective as writers for the Internet Journal of Emerging Medical Technology, our environmental impact is insignificant compared to the forests that have been consumed to deliver BMJ across the world (and you can't beat our price). Also, we regularly feature telemedicine breakthroughs that allow for remote monitoring and diagnosis -- spreading knowledge without spreading emissions from travel. Furthermore, Medgadget's editorial team includes Soviet emigres, who too often heard speeches from the party leadership, hypocritically forcing the masses to sacrifice. When a globe-trotting editor of a pulp publication tells us we should cut down on our activities, it rubs us the wrong way.

Dr. Godlee has been writing on this issue for sixteen years. But she still cites vague Health Climate Council strategies and touts announcements about increased investments in teleconferencing. We were much more impressed with her (or her colleague's) decision to drop out of an all-expense paid Australian presentation due to its environmental impact. We'd be more impressed if BMJ cut its members travel budget, and passed the savings directly into teleconference technology. More importantly, since deforestation's contribution to global warming outweighs that of air travel, we'd love to hear some announcements about BMJ phasing out their costly, wasteful paper products, and joining us in the realm of web-only publications.

In her response, Dr. Godlee proceeded to ask about us -- who funds us, how are our carbon footprints, and "perhaps most importantly of all given the fact that you are a technology site, what practical advice can you give publishers and others in health care about how they can most effectively transform an entrenched medical culture built on face to face meetings and global interaction?"

That's fair, so let's be clear: We are a group of students, researchers and physicians who subscribe to the HON code in our web-only publication. We are sponsored by advertisers displayed above the logo and along the ride side of your screen; no political groups or lobbyists are secretly funding our activities.

As far as our individual carbon footprints -- half of us don't own cars. Most of us live in small apartments, and take public transit (or walk!) to work. Some of us even have compact fluorescents in their sockets, and write from energy-star rated computers. We're no angels, but then again, we're not lecturing our peers on how to live.

Dr. Godlee asked us for advice in transforming an entrenched culture of medicine, based on face-to-face meetings and printed journals. Our experience is that scolding never promotes change; action and evidence do. BMJ's actions are still their infancy. And as for evidence, why not employ technology like Access Grid, which has been available for years (Nature subscription req'd) and has demonstrated its value in a variety of settings.

Look, as far as models of weather go, non-linear phenomena are beyond the scope of our knowledge (and, probably, beyond hers as well). But we believe in the stewardship of our environment -- we'll support anyone who makes an honest and practical attempt at lowering their personal pollution output, and we'll promote technologies that use less energy, create less interference, and create fewer tertiary effects.

What we can't abide is doubletalk. Dr. Godlee wants to use her pulpit to advocate for change -- well, good for her. But instead of scolding and urging others to sacrifice, she should use her position as head of an esteemed scienfitic journal to promote research on the wastefulness of conferences and paper journals, and steer the British Medical Journal clear of those practices. Evidence and action change behavior, not editorials.

We'd like to thank Dr. Godlee for taking the time to respond to us, and for her good-natured interpretation of our coverage. We look forward to the revival of her climate blog, and for news about BMJ's initiatives to reduce waste and emissions.

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replies: 3 comments
Open comments are not moderated, although abusive and vulgar remarks may be deleted. Opinions expressed do not necessarily reflect the views of Medgadget.com. Please consult our disclaimer.

Dr. Godlee, or Fiona as I call her, is a privileged pampered princess who enjoys dishing it out from a position of moral superiority. When confronted on the merits, she is somewhat out of her natural element. I certainly appreciate your honesty and willingness to shine a spotlight behind the spotlight.


Posted by: Boris
on March 3, 2007 10:18 AM GMT

I don't s'pose anyone watched the programme on Channel 4 last night? About climate change, and the mis-information that successive western governments and large multi-nationals have promulgated? As I never quite viewed myself as a leftie radical, more of a right-wing housewife (note: houseWIFE, not house-person, home-maker - even more puke-making than any of the others, or even the more current domestic-goddess - plain ole housewife will do just fine) - the point being that 30 years ago, the debate began about climate change. Except it was concerning the earth cooling down, not getting warmer. The programme noted cyclical events (not over thousands of years, although it did that too) over the past few hundred years or so, and interestingly, when the earth got warmer, carbon emissions were lower, not higher as those in the know would have us believe. The argument was not to prove the opposite to that occurring now, but to demonstrate that global warming has nothing to do with CO2 at all. It is the sun and its prevalence of hotspots which affects the level of cloud(s) in earth's atmosphere; thereby cooling the earth down or warming it up, as the case may be.

In short, the scientists who were questioned were all at the top of their profession and each and every one stated that there is a link between the sun's rays and climate change and that there is no link at all, between global warming and CO2 emissions. They noted that with all the natural gasses in earth's atmosphere anyway, even now, carbon emissions only make up 0.54% of all emissions of any kind - so one could ask why there is even a debate taking place, with so much emphasis on carbon emiissions.

The programme also said that any models being used for "proof" by gov't's etc., is based on there being something like an increase of 1% in carbon emissions each year from hereonin, when the science says that the actual percentage is 0.49%.

The programme beautifully illustrated that once politicians grab hold of an idea, no matter how innocent that idea is upon conception, once politicians put $$$$ behind an idea, then that's where the moeny goes - into reasearch. Except it is a bit like funding research into the habits of goats! Who would do such a daft thing - unless, of course there was big bucks to be made? It is indeed a terrible travesty that we in the west, nay, those who wield power, have permitted the use of misleading and in some cases, false science, merely to back up some rather erroneous claims, that happen to suit their purposes, which is presumably to tax the wotsits off the rest of us, with the epithet that we are saving the planet.

The most worrying part of the programme - and I am still trying to digest this 12 hours on - is that the effect of this drive towards a reduction of carbon emissions is not so much harming us in the west, who, by world standards are pretty well off, but is seriously undermining the efforts of African nations in their efforts to progress. A conference took place in Nairobi recently, endorsed by the UN?? / IPCC (a climate political group) whereby the messge was that in order to do one's bit, one must use solar panels! Solar panels?? In Africa? This is insane, and yes, funny too. A doctor's surgery was shown that had solar panels on the roof; except the dr. could only use the electric light OR the fridge, not both at the same time.

Like I say, I never viewed myself as a leftie but my goodness, I felt like one after watching that programme. So, basically, the message is this: carry on jetting all around the world because there is no reason why this should not happen. The planet is no better or worse for it. Apart from which cows dicharging gas is significantly higher than all of man's activities.

The final straw was that those who do speak out, the scientists who do possess substative data are silenced and ostracised by their peers, and worse, gain the attention of the radical elements of society who view them (the scientists) as being in the pay of the multi-nationals, which is also untrue.

I hope others will seek to promote the science as a testament to the truth, rather than endorsing misconceptions which remain unchallenged.


Posted by: Elizabeth Marsh
on March 9, 2007 01:36 AM GMT

Another example of why carbon utilitarianism gets us nowhere. I see not justification for the blithe assertion that printed copies of a journal result in more carbon than a web version. Once printed, and distributed, a paper copy requires little energy to view. A website consumes energy constantly. Indeed, a small web server consumes about 12 KWh/day, but much of that is generate heat, which must then be pumped out of the room the server is in, itself consuming lets say another 6KWh/day. Then we must add in a share of the network hardware in the datacenter, the cost of transmitting the signal across the world, the costs incurred by the staff who work in such places etc. etc. Not to mention a tiny share of the vast energy sunk into laying the fibres, launching the satellites and so forth. Obviously, the total calculation would be enormously complex. Then we need to factor in the cost of all the client side computers, the energy cost of PDAs that are thrown away after a few years when better ones come out and so forth.

This must be compared to the energy cost of felling trees, making paper, making ink, printing, transporting it, perhaps the cost of transporting it as waste and landfilling it.

Can someone point me to some reasonable attempt to show which consumes the most energy? Until they can, I don't see that one is worse than the other. And this calculation doesn't even begin to take account of tertiary matters such as the real value of the journal. I'm sure we'd agree that a web journal that has no influence on anyone, was rarely read and never cited was a complete waste of energy (in all senses!).

J


Posted by: J
on July 4, 2007 07:17 AM GMT

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