This article is part of the National Commission on Climate and Workforce Health’s series “Climate Prescription.”

Written by Dr. Leah B. Topper, a family medicine physician and Climate & Health Science Policy Fellow at the University of Colorado School of Medicine, the series translates the latest research on climate-driven health risks into practical insights for employers, HR leaders, and workplace health professionals.

Long before I ever set foot in a clinic, someone taught me a technique that has stuck with me throughout the years. It was a couple of years after college, at a communications workshop that borrowed one of improv's founding principles: "yes, and." In improv, you accept what your scene partner gives you, and then you build on it. The application to communicating is similar – instead of saying "no, but," you say "yes, and here's my perspective." In the years since that workshop, I've applied this technique to personal conversations, to professional deliberations, and now to the field of climate and health more broadly.

How I Interact With the Planet

My relationship to our planet's health exists across several overlapping spheres of influence. On a personal level, this understanding shows up in daily choices such as thrifting used clothes instead of buying new and preferring a plant-forward diet. It looks a little different professionally, in decisions like what single-use supplies I use or avoid in the clinic. 

I also find it in individual patient interactions: sitting across from someone who tells me their medication makes them more dehydrated in the heat, then building a plan together for what to do next time. The same forces play out at the population level, in entire neighborhoods and families affected by the same drought here in North Carolina, or the same heat wave we had this past month. From there, the effects keep expanding to health systems, other industries entirely, city and state regulations, and federal policy.

Through my one-year Climate & Health Science Policy Fellowship, I was placed with Health Action Alliance, which broadened my understanding of my own role within the climate and health space. Writing my monthly column, Climate Prescription, deliberately forced me to move between these layers. For example, in my piece on extreme heat, I connected what I see in an exam room to what steps employers can take. In my piece on air quality, I traced a line from a single patient of mine still living with lung damage from years of coal mining, through population-level research on pollution and heart disease, to concrete tips employers and workers can each take to protect their health.

Yes, And

That's where "yes, and" stops being a workshop icebreaker and becomes essential to solving our climate crisis. The climate and health crisis does not respect the boundaries we've built around our professions. I can counsel a patient on managing their asthma during a bad air quality day, but I am never going to be there with them at the worksite. What this year showed me is that the edge of one field is exactly where another field needs to say "yes, and." 

Occupational health can pick up where clinical counseling leaves off. HR and operations can start where occupational health reaches its limit. Employers, researchers, nonprofits, and policymakers each hold a piece the others don't. Solving this crisis means refusing to say "not my job" and instead asking, "okay, and what can I add from where I sit?"

Underlying this collaborative approach is the urgency of the situation. Climate change is a human-caused problem, and it is ours to fix starting yesterday. It is not a future generation's task, and the solutions are not confined to any single field, sector, or job title. We don't have to wait for the perfect coordinated plan across every level before we start. We can start in the space we're already standing in, whether that's a clinic, a boardroom, a factory floor, a policy desk, and say "yes, and" to whoever is standing in the next one over.

This past year was a valuable opportunity to collaborate across fields outside of my typical medical sphere. As I move on from this fellowship year, I plan to continue my climate health efforts in my clinical practice of medicine, through advocacy within the healthcare system, and by continuing to pursue a better future for a planet one “yes, and” at a time.