Going green
In Practice
By Victoria Houghton, managing editor, July 1, 2019
Dermatology World talks to Sandra Marchese Johnson, MD, from Johnson Dermatology in Fort Smith, Arkansas, about the green practice that she and her husband, Brad Johnson, MD, opened in 2006.
Dermatology World: Tell me about your practice.
Dr. Sandra Johnson: My husband and I built our medical facility and opened our practice in 2006. We have three board-certified dermatologists — which includes my husband and myself — a board-certified dermatopathologist, a physician assistant, and two nurse practitioners. On average, we see about 3,500 patients per month.
Dermatology World: Why did you decide to seek LEED certification for your facility?
Dr. Johnson: My husband was a physics major in college, and he really wanted to make a statement with our new practice. When we started, we wanted to be earth-conscious in our new building — I wanted to use geothermal and have a small carbon footprint on the environment. Our architect and our builder went to high school with my husband and both are LEED-accredited and were really excited about these green initiatives in our new practice. They kept those aspects in mind when we started to develop the plans. Just as we got to the building stage, we realized that if we just added a few more points, we could go for LEED certification, so we decided to take it a step further and try to get certification. We were the first medical clinic in the state of Arkansas to be LEED certified.
Dermatology World: Can you describe some of the key LEED characteristics of your practice and why you chose them?
Dr. Johnson: We knew what big items we wanted, and our architect and builder helped us decide which smaller items would make sense to add. We decided that we wanted to design a building to look like a barn. The architect designed a silo on the side of the barn to collect rain water and we use that rain water to flush the toilets. It was a pretty design element but also a functional one. My son, who was 10 at the time, and I really liked this flooring that looked like hardwood flooring at a showroom, but it was recycled vinyl planks, so we chose that and that brought us another LEED point. You also get a lot of credit for using local supplies. It was easy for us to get our stone locally so there weren’t a lot of transportation costs when bringing the stone to our place. Also, supporting local is important to us, so it made sense.
Dermatology World: From soup to nuts, how long did it take to build your LEED-certified facility?
Dr. Johnson: It took about 18 months to design and build. Adding the LEED certification did not add a lot of time to our construction timeline.
Dermatology World: Building a LEED-certified building can be more costly than building a non-LEED facility, but in the long run, is there the potential for cost savings?
Dr. Johnson: There’s a high price tag to get that LEED certification. Since we’d already made all of those decisions in the building that we wanted anyway, to be greener, we thought it was worth paying that extra fee to get this certification. It would kind of be like doing your residency without taking your boards. You might as well get the certification.
If you want to get the most return on your investment, going for the LEED certification probably doesn’t make good financial sense. If you want to make a statement as a dermatologist who’s environmentally conscious, that’s a non-tangible benefit that you really can’t measure. When we were building, we knew we wanted to build as energy- and earth-conscious as possible. Doing those things really did not add more expense but really has saved us a lot in costs. We more than tripled our building size, but less than doubled our electric bill. They did a lot of design elements to save on electricity, such as using motion sensors, so the lights go off if you’re not in the room. We have geothermal energy and all our heat and air units are on timers.
Dermatology World: Are you still looking for ways to be “greener” in your practice?
Dr. Johnson: We are! We recycle. For example, we melt down our sharps whenever we can and put them in the regular trash rather than contributing to the medical waste. We also use electronic medical records, as most people do. There is still a lot of waste of paper and we are looking for ways to decrease the use of paper at our clinic. Using the patient portal is helping us a lot with that. Some patients are reluctant to use it. However, it has been a really good environmental feature and offers a cost-savings to us. In general, being green is something that continues to be important to us.
Dermatology World: If a physician — who already has a practice or works in an institution and can’t build from the ground up — wants to go green, what tips would you offer?
Dr. Johnson: Be aware of your paper use. See if you can put your outlets, lighting, heat, and air on a timer. If possible, investing in a smart thermostat is a good idea. Don’t heat or cool an empty building. Also, living the example more than just saying you support green efforts is one thing physicians can do. Walk to places instead of driving. Recycle your utensils in the office. I use real plates and silverware instead of paper plates and products, and we wash those to decrease the amount of trash.
Dermatology World: How has having a LEED-certified building affected your patients?
Dr. Johnson: I think for most of our patients, it’s a really good way to communicate and start a dialogue. We also built a clinic that I think is very pleasing to the eye. It feels very homey with that barn feel. Driving up to it, you feel comfortable and I think that’s created a sense of calmness for our patients. People appreciate the fact that they can go to a nice medical facility and it doesn’t cost any more money, and they know that we’re invested in the community and also invested in our patients.
