Climate change and professional responsibility: a cross-sectional survey among German general practitioners

BACKGROUND: Climate change increasingly affects population health and healthcare systems. While normative frameworks emphasize physicians' societal role in climate protection, empirical evidence on how general practitioners perceive and address climate- and environment-related issues in daily clinical practice remains somewhat limited and not yet fully consistent across studies. METHODS: We conducted a nationwide cross-sectional online survey among general practitioners (N = 500; 38.2% female) in Germany. The questionnaire assessed attitudes toward climate protection, attribution of responsibility for climate- and environment-related practice in healthcare, and the frequency of addressing climate- and environment-related issues in practice by patients and practitioners. Data were analyzed using descriptive statistics, group comparisons, and correlation analyses. RESULTS: A majority of respondents (65.8%) considered climate- and environment-related issues relevant to their professional role and endorsed physicians' function as societal role models. Agreement regarding individual responsibility within clinical practice was comparatively moderate (22.6%), with responsibility more frequently attributed to institutional (29.1%) and policy levels (49.2%). Attitudes toward environmental responsibility were largely consistent across subgroups defined by federal state, community size, practice type, and professional experience, while female general practitioners reported higher levels of environmental concern (M = 3.94 vs. M = 3.43; p < .001), indicating a small to moderate effect. Climate- and environment-related issues were reported to arise regularly in general practice, initiated by both physicians and patients (monthly or more often in physicians 68.4% versus patients 59.2%; never in physicians 12.4% versus patients 12.6%). DISCUSSION AND CONCLUSIONS: The findings suggest that German general practitioners broadly acknowledge the relevance of climate- and environment-related issues to their professional role and are open to integrating such considerations into clinical context. At the same time, ambivalence regarding individual responsibility highlights the need for clearer normative orientation. Integrating climate- and environment-related considerations into professional standards, clinical guidelines, and medical education may help provide such orientation and support physicians in navigating ethical tensions.