Bridging Environmental Impact and Patient Outcomes; Comment on "A Review of the Applicability of Current Green Practices in Healthcare Facilities"

The intersection of healthcare sustainability and clinical practice presents complex challenges in implementing circular economy (CE) principles. This commentary examines Soares et al.'s review of green practices in healthcare facilities while identifying significant gaps in the current discourse. While healthcare facilities are adopting sustainability measures like renewable energy and efficiency improvements, the implementation faces significant operational challenges, particularly in embedding environmental considerations in the clinical decisionmaking and care delivery process. The analysis discusses that overdiagnosis and low-value care contribute substantially to healthcare's environmental footprint, exemplified through screening cases that demonstrate the delicate balance between clinical necessity and resource utilisation. We emphasize the need for context-specific approaches that acknowledge operational realities and stakeholder diversity within healthcare governance. We advocate for an integrated approach that places health outcomes at the center of climate initiatives, recognising that public health interventions must equally consider environmental impacts. Ultimately, we call for a paradigm shift that moves beyond siloed environmental initiatives toward systemic integration that complements rather than competes with clinical responsibilities.