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How She Leads

How She Leads: Kathy Gerwig, Kaiser Permanente

<p>The health care company&rsquo;s sustainability exec discusses the relationship between health care and the environment, from farmers markets to landfill diversion.</p>

How She Leads is a regular feature on GreenBiz spotlighting the career paths of women who have moved into influential roles in sustainable business.

Kathy Gerwig is vice president of employee safety, health and wellness, and environmental stewardship officer for Kaiser Permanente. In this role, she is responsible for developing, organizing and managing the organization's nationwide environmental initiative. Under her leadership, Kaiser Permanente has become widely recognized as an environmental leader in the health-care sector. Kathy has testified twice to Congress on the need for federal chemical policy reform, and has appeared at numerous hearings on environmental issues. Gerwig is also Kaiser Permanente's national leader for employee safety, health and wellness.

Kaiser Permanente was founded in 1945 and is one of the nation's largest not-for-profit health plans, serving 9.1 million members. Kaiser Permanente's creation resulted from the challenge of providing Americans medical care during the Great Depression and World War II, when most people could not afford to go to a doctor.

Here, she talks about how the health-care industry can make a positive difference on the environment.

Maya Albanese: How and when did your career begin to focus on sustainability?

Kathy Gerwig: My educational background is environmental sciences, and my first job out of college was with a small non-profit working on air quality issues in California.

Albanese: Have you always worked in the health-care industry?

Gerwig: No, I had a whole career for quite some time working for nonprofits doing environmental work. I became a consultant on environmental issues and Kaiser Permanente was one of my clients. After working with them for a while, they brought me on full-time to work on these issues.

Albanese: Was there an "a-ha moment" that inspired you to work in environmental stewardship?

Gerwig: My family moved to Santa Barbara where the horrible oil spill of 1969 occurred. At that point, it was the largest ever oil spill of its kind. After doing beach cleanups, restoration and all the work that comes after such a catastrophe, I learned what environmental devastation looks like. I saw what was lost and regained, and thought about how disasters like this one could be avoided in the future through better environmental policy.

Albanese: What did you study and how is it relevant to your current work?

Gerwig: I went to San Francisco State for my bachelor's in Geography and Environmental Studies, and then got an MBA from Pepperdine University. It gave me the environmental science plus business background necessary to work in a large company.

Albanese: How does your position fit into the corporate structure?

Gerwig: I am the environmental stewardship officer, which other companies may call chief sustainability officer, and I report to Dr. Ray Baxter, senior vice president of community benefit, research and health policy. Dr. Baxter reports directly to the chairman and CEO, and I regularly report to the board on our activities. We deliberately moved environmental stewardship into this structure in 2007, because we know that community health is one and the same with patient health.

Albanese: What would you say are your top three responsibilities in this role?

Gerwig: Developing a strategic approach to reducing environmental contributors to disease; understanding Kaiser Permanente's own impact on the environment and how we can mitigate that impact; and partnering with others both internally and externally to improve the environmental performance of the entire health-care sector.

Albanese: Do you have a team that works with you on these initiatives?

Gerwig: We have an environmental stewardship council that includes an executive committee chaired by Dr. Ray Baxter. We have an environmental stewardship working group with about 30 people on it, and everyone has some accountability for environmental performance within the organization. We have a lean team at the national level, but we've embedded environmental stewardship within our operations across the country. For example, the people responsible for building our medical facilities are accountable to doing it in a green way. When the program began, passionate volunteers worked on environmental stewardship, but today, we have formal work plans with measurable environmental objectives.

Albanese: Where is Kaiser's environmental footprint the largest?

Gerwig: Similar to all healthcare organizations, our greenhouse gas emissions are large, because many of our operations are open 24/7 and are really energy intensive. And like all hospitals, we need to process a lot of waste. It's been estimated that more than 6,600 tons of waste are produced every day by hospitals in this country. We have an excellent landfill diversion rate, but we are constantly working on this, because it's a huge part of our footprint. Along with climate impact and waste, we also focus on using safe chemicals in products, sustainable food and water conservation.

Albanese: What are some examples of how medical facilities and equipment can be more sustainable?

Gerwig: It's hard to narrow it down to one, but a great example where everyone involved has won is the move from traditional X-ray systems to digital systems in radiology. This has improved the quality of patient care, making imaging clearer and easier to share, but it also prevents using all the toxic chemicals and mercury associated with film processing and production. And we've reduced the use of thousands of gallons of water every year. 

In another example, we adopted a policy last year that all our new buildings must be LEED Gold certified. LEED recently added a "LEED for Healthcare" standard, and we opened our first LEED Gold hospital in the Portland, Ore., area last year. The incremental cost of achieving LEED Gold certification was less than 1 percent of the total cost of the project, and the payback is almost immediate in terms of energy savings. So, we learned a great lesson. If you start with a sustainable approach at the outset, you are making a smart business choice.

Albanese: How is the health-care industry affecting climate change?

Gerwig: The health-care sector is a huge energy hog, and we need to combat that. We need to address the sources of energy that we use and have a positive impact on climate change. Kaiser Permanente has a goal to reduce all of its GHG emissions by 30 percent by 2020. It's an absolute reduction from our 2008 emissions, so regardless of our expected growth in energy needs, our GHG emissions will drop.

Albanese: How is climate change going to affect health care?

Gerwig: You can certainly see health effects from climate change. Diseases such as malaria and dengue fever are spreading. Air pollution has caused an increase in asthma and respiratory illnesses. Heat waves and severe weather patterns have caused flooding and forced hospitals to close. Superstorm Sandy caused several hospitals to completely lose power and evacuate people.

Albanese: Hospitals are notorious for food quality. How is Kaiser working to provide better food?

Gerwig: Part of our success in this area is that we view healthy eating and food quality as part of the health of our patients. The definition of healthy food must include the responsibility of the product and its supply chain in addition to it being high quality and healthy. Across all of our facilities, we are increasing the amount of food that is locally and sustainably grown. Today, approximately 18 percent of our food purchases are local or sustainable food, and our goal is to get to 20 percent by 2015. In addition, we are transitioning to poultry products that are 100 percent antibiotic-free and dairy products that don't contain any added hormones. Nearly all of our facilities have on-site farmers markets that sell produce that is local and in-season. This has really changed the whole perspective that people have about what it means to be in a hospital. People see the farmers and fresh food and they can see how good health and disease prevention is related to eating healthy and sustainable food.

Albanese: What is one obstacle you have overcome in your work?

Gerwig: One obstacle we've overcome is the myth that going green costs more money. We have measurable ways to show the benefit of sustainability that would meet any CFO's criteria about what a healthy investment is. We look at cost more holistically. Sure, it's an extra cost to have farmers markets at our facilities, but you can't even begin to quantify all the benefits that go back to the patients and local community by providing access to fresh and sustainable food. And what is the overall cost of ownership of a toxic product versus a sustainable one? With devices containing mercury, we need to include the cost of disposing of them as hazardous waste in the total cost of ownership.

Albanese: What is an ongoing challenge that you face?

Gerwig: Procurement of sustainable products remains a challenge. There are suppliers that are not keeping up with demand for more sustainable materials. Some suppliers have made big transitions, but there are so many products that we've targeted to find environmentally preferable alternatives that just don't exist yet.

Albanese: What are the biggest social challenges that the health-care industry must face?

Gerwig: I would have to add the obesity epidemic in this country to the major challenges, and what that means from an environmental perspective.

Albanese: What is an accomplishment at Kaiser that you are particularly proud of?

Gerwig: We've made huge strides in every one of our priority areas, so picking one is like asking to pick a favorite child. But I'm particularly proud that Kaiser Permanente has embedded environmental stewardship throughout the entire organization. It's not just part of a corporate office of accountability. It is truly part of our mission.

Albanese: What advice would you give professionals aspiring to work in a role like yours?

Gerwig: Passion for the environment is typically what brings people to a job like mine, but to be successful, you need to come up with innovative and practical solutions. It's fairly easy to get people to agree that something needs to be changed, but it's harder to get people to agree on how and when it can be accomplished.

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