Dr. Anthony Szema is used to seeing patients with red eyes and runny noses. But in the past couple of years, the New York-based allergist has been faced with an onslaught of patients complaining their symptoms are starting earlier and hitting harder than ever before.
Szema believes climate change is a culprit in the extended severe allergy seasons. And he is one of a small number of physicians who are beginning to talk to their patients about it.
"I don't go on a soapbox making a scientific case, but by the time patients come to my office, they pretty much understand something is going on," he said. "They want to know why they are wheezing, why they have watery eyes and why their throats are swelling up. They understand the pollen season is worse this year."
"I give multiple etiologies," he said, referring to the causes of illness, "but climate change is one of them."
As scientists solidify the links between climate change and health issues like tropical ailments that infect Americans on the backs of whipping winds and warming ocean tides, top medical associations are becoming a high-profile lobbying force for climate regulations.
Prolonged allergy seasons, re-emerging illnesses and more extreme weather events are spurred on by climate change and will systematically affect human health, they argue.
Now, health advocates say physicians like Szema need to study up on the environment and bring conversations about the fingerprints of climate change right down to the doctor-patient level.
Most individual doctors remain reluctant to speak out on climate-health links. But top medical associations leapt into the fray this past year as U.S. EPA's climate regulations became a target of GOP-led attacks in Congress.
Medical associations join the fight for regulations
The American Medical Association and American Lung Association, for example, were part of a coalition that coordinated a defense for reining in the emissions from smokestacks and tailpipes. Their argument: Protect human health.
For that fight, they offered up a cadre of experts to speak out on the connections between greenhouse gas emissions and higher rates of asthma or other serious illnesses. Some health advocates see this as a preview of what is to come.
"The challenge for groups like the American Thoracic Society is that we are professional organizations designed to talk to ourselves. We are not well-structured to effectively communicate with the public on issues as large as this. We can certainly publish opinion pieces in our journals that make the case, but we don't have a direct line to The Washington Post or The Wall Street Journal," said Gary Ewart, director of government relations at the American Thoracic Society.
At the moment, he added, primary care physicians are also not well-positioned to squeeze talks about climate change and associated threats into 10-minute patient visits.
"In most patient encounters, you need to get the family history, and most of our physicians are seeing patients with complex problems and prescribing drugs and other lifestyle interventions ... doing that in a 10- to 15-minute discussion is a lot to cover," he said.
But Dr. Georges Benjamin, executive director of the American Public Health Association, said doctors still have a special responsibility to read up on these issues, verify the facts for themselves and help inform their communities and policymakers.
"Every physician has a role in prevention, and if we can help improve the environment, why shouldn't we?" he said. "If we saw a river was infected, we would tell our patients that they shouldn't drink the water from that river or bathe in that river, and I hope they would do work as good citizens to make sure whatever was polluting that river was taken care of."