Feature | Radiology Business | July 10, 2024 | By Christine Book

Promoting the Planet’s Health: Sustainability in Radiology 

Promoting the Planet’s Health: Sustainability in Radiology 

Reed Omary, MD

Across the healthcare industry, and, notably, throughout the radiology community in just the past few years, the focus on the impact of medical imaging on the environment has intensified. Raising awareness and identifying solutions to advancing healthcare sustainability has been a top priority for Reed A. Omary, MD, MS, who served from 2012-2023 as Radiology Chair at Vanderbilt University Medical Center (VUMC) and continues as a professor and institutional leader. During his year-long sabbatical, he has generated both attention and momentum at VUMC, with members of both the Radiological Society of North America (RSNA) and American College of Radiology (ACR) and vendors. This interview provides valuable insight into what can be done to improve the health of patients, healthcare organizations’ bottom lines, and the planet. 

ITN: We know there are measurable impacts on the environment created by radiology every day. What should we know about how significant a toll this takes?

OMARY: I think it’s really important that we as physicians — as radiology techs, as nurses, frankly, anyone in the healthcare industry, whether you’re taking care of patients, or you’re providing supplies or medical devices for those patients — recognize our calling is to serve patients in the communities surrounding our health systems. What’s clear is that the pollution that we are emitting from healthcare and from radiology directly impacts the patients that we serve. My 12-year-old daughter did not have asthma. But when wildfires happened in Canada about a year ago, and all of that pollution came down from Canada to Nashville, she ended up needing to go see her pediatrician and went on a steroid inhaler and medication. So, this isn’t just an abstract concept, it can affect us, our families and worst of all our children.

ITN: How has the radiology community received these messages, even just since your RSNA22 plenary session which shed a spotlight on sustainability? 

OMARY: I think radiology is amongst the absolute most innovative specialties historically. And because of that, it’s been a fairly quick turnaround for embedding sustainability in our practices. Just as radiology is the leading specialty in terms of embedding artificial intelligence (AI), we have a knack for thinking about the future, and for thinking about how we can modify our practices to benefit those who need us. Whether it’s at the Radiological Society of North America or the American College of Radiology annual meetings, really all the main medical societies in radiology are addressing the status of our climate, the status of our planet’s health.

ITN: When you began your sabbatical about a year ago, your goals were threefold: to motivate healthcare to decarbonize; to adopt sustainable practices; and to promote planetary health. How’s that all going? 

OMARY: Well, it’s been going incredibly well. This past year has been one of the most, if not the single most, fulfilling year of my life. I’ve had the chance to meet with over 300 people around the world. This started off really as an innovation challenge for me. I wanted to understand: What were the needs of our patients? Our health systems? Our communities? So, I started off like any good innovation project, and focused on asking questions. What I ended up discovering was that everyone is concerned about their own health, the health of their children or their parents. 

So, a lot of the opportunity we have to make a difference is to think about ourselves as in the field of radiology, as not just taking care of the individual patient or family that needs us, but of our entire communities. And when we think in those terms, we recognize that taking care of the planet is actually the same thing as taking care of our patients in terms of improving their health.

ITN: What steps can healthcare facilities, institutions, individuals, radiologists and vendors take? What do we need to know about what to do next? 

OMARY: The first thing I would offer is to be aware that this is in our lane. When our health systems spew pollution out in burning of medical waste, or from all of the carbon pollution, it directly impacts those patients that we serve. So recognizing that, first of all, that this is part of what we do, I think is essential. 

Then it’s important to recognize that instead of this crisis, we have this opportunity to make an enormous difference using some tools that we’ve never considered. Thinking about sustainable practices is really just another way of thinking about ways we can better take care of our patients. It’s also a way to save costs for our health systems. We now know that 40% of hospitals nationwide are actually losing money. It’s a way to inspire our workforce — to come together to think about taking care of our individual patients, our communities, and our planet is all part of the regular work that we do.

ITN: As you’re working with colleagues at ACR and RSNA, can you speak to what those organizations are doing as a whole? What do we need to understand in order to take collective action? 

OMARY: I would say most people aren’t aware of how much pollution we emit in healthcare. If healthcare were a nation, it would actually be the fifth largest carbon polluter in the in the world. Right now in the United States, healthcare releases eight and a half percent of the carbon pollution. When we think about this worldwide, it’s four and a half percent. To put this in context, that’s more than aviation and shipping combined. 

We in healthcare have mostly considered ourselves off the hook until the last few years, because we do good work. So why should we worry about it? But actually, we need to worry about it because it’s part of the work that we already do. We take care of patients, so why would we want to contribute to their harm through the pollution that we admit. 

Now we’re seeing all the major radiology societies are establishing committees, task forces, and publishing papers in their journals. What we’re seeing is this accelerated adoption of sustainability as an opportunity that extends across the entire field of radiology. It’s like innovation, you really shouldn’t put innovation off in the corner because you can innovate your entire product line, or you can innovate in all the ways we educate, all the ways we take care of patients. So that’s what has become apparent in the field of radiology. It really is an exciting time to be in our field. 

ITN: We’ve noticed progress being made on many fronts. What can you share on specific projects at Vanderbilt or across the country?

OMARY: We at Vanderbilt, in partnership with Philips, conducted a lifecycle assessment of all of the emissions that our diagnostic radiology department contributed. This is a tool where we go back and look at the emissions, the pollution that’s generated in the actual construction and manufacturing of all the equipment and supplies we use, and then consider their use over a 10-year period. We found that MRI alone contributes half of our overall carbon pollution. We also found there are new methods that fall under a concept of circularity, which is to try and refurbish equipment, so that we can extend the life, reduce costs, provide the same degree of quality and also reduce our pollution. 

So it’s a win, win, win.

ITN: What do you see happening in the future in this area of  radiology sustainability? And what are your recommendations? 

OMARY: For radiology, I think the more we can start embedding this in our practices, the more affect we will have. So, what does that mean? For example, if you’re thinking about what new scanner to order, think about purchasing refurbished, or think about purchasing a scanner without the usual amount of helium, for instance, for an MRI scanner. Also, when ordering products, try to see whether the cost is the same, and try to think about ordering products with a smaller environmental footprint. 

I think it’s critical that we not think of sustainability as an add-on. We need to think of sustainability the way it actually is, which is quality. Patients trust us to think about their best interests. Everything that we do in the field of radiology and medicine contributes to the overall health of the patients and communities that we serve. So let’s just say: This is an opportunity, let’s take it, let’s run with it. 

The second thing that I would say from a healthcare perspective is that we have opportunities to save enormous sums of money for our health systems right now. Some of the most prominent health systems in the nation are actually losing money. I want to emphasize this: Thinking about sustainability, and ways to reduce our environmental impact to reduce waste, is a perfect way to reduce expenses. Why wouldn’t a healthcare facility try to save $5 to $10 million a year by looking at its entire operations and thinking: How might we go to more cheaper sources of renewable energy? How might we reduce the waste that that comes from our food services? How might we reduce the waste that comes from our needless overuse of plastic, and medical devices that are single use? All of these have the opportunity to save money. And so when health systems say, “We’re really strapped for cash, and we’re really strapped because we don’t have enough of a workforce …” I’d say, just invert it. Consider whether you are actually thinking about sources of reducing waste, and well, if you’re not, that’s on them. Sometimes we may need to upgrade our healthcare system leaders because they don’t understand that.

Watch the VIDEO: One on One ... with Reed A. Omary, MD, MS: Promoting the Planet’s Health: Sustainability in Radiology 


Reed A. Omary, MD, MS

•Chair, Radiology Department (2012-2023)

•The Carol D. and Henry P. Pendergrass Professor in the Department of Radiology 

•Vanderbilt University Medical Center (VUMC), Nashville, Tenn.

•25 years of experience as practicing interventional radiologist, NIH-funded scientist and educator.

•In June 2023, Omary stepped away from VUMC Radiology Chair to pursue a sabbatical focused on climate change and sustainable healthcare.

•Founder, The Greenwell Project ~ a sustainable healthcare non-profit (www.greenwellproject.org).

•Author, The Green Leap ~ a blog about making healthcare sustainable.

VUMC Roles and Initiatives

•Chair of Radiology from 2012 - 2023

•Chair of the Board for the Vanderbilt
Medical Group

•Founder, VUMC Medical Innovators
Development Program

•Co-leader, strategic planning for VUMC
workforce of over 30,000 professionals

Organizations and Leadership
•Society of Chairs of Academic Radiology Departments (SCARD) President-elect

•Association of University Radiologists (AUR) Past-president

•American College of Radiology (ACR)

•Radiological Society of North America (RSNA)

Education and Experience

•Vanderbilt University Medical Center

•Northwestern University Feinberg School of Medicine 

•University of New Mexico - Internship in internal medicine

•University of Virginia - Residency in diagnostic radiology while obtaining his master’s in epidemiology

•Northwestern - Fellow in cardiovascular and interventional radiology; director of the Interventional Radiology Research Laboratory and director of Research for the Department of Radiology

•University of Wisconsin School of Medicine and Public Health - Assistant Professor 

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