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The DEGAM guideline "Protection against over- and underprovision - deciding together" was introduced in June 2019 and is regularly updated. The article provides a condensed and revised introduction to the guideline in order to raise awareness about the problem of over- and underprovision. Definitions of over- and underprovision are given, and the causes, dimensions, and possible solutions of both phenomena are explained. The guideline offers recommendations for avoiding over- and underprovision based on other DEGAM guidelines and the National Supply Guideline. The article deals with the influence of the industry on medical research and the resulting guideline recommendations. It emphasizes that a reasonable and responsible use of the technical means of medicine should be aimed at in order to avoid under-, over-, and malprovision. Primary care organized health systems are considered more effective in improving the quality of life for people with chronic health problems. Evidence-based medicine is presented as a method for making the best possible decisions in individual cases, taking into account patient preferences and existing clinical research. It emphasizes that the patient's will is an important factor in medical decisions. Reflection and improvement of one's own work are seen as part of the professionalism of physicians in order to correct over- and underprovision. The article emphasizes the importance of process quality in healthcare and makes it clear that guidelines cannot replace medical judgment and individual decisions. Clinical quality management can help structure decision-making processes better and reduce errors. Furthermore, the need for a climate-neutral society is emphasized in order to sustain people's health in the long term. The healthcare system accounts for about 5% of Germany's total CO2 emissions, with medical products and the transportation of patients and staff contributing to the emissions, especially. It is emphasized that over- and underprovision should be avoided in order to reduce unnecessary emissions and conserve resources. The book "Climate Crisis and Health: On the Risks of a Human-Made Dynamics for Body and Soul" by Scherer M, Berghold J, and Hierdeis H addresses the impact of the climate crisis on health. It argues that a primary care system is necessary to improve healthcare, as outlined in a position paper by DEGAM. It also emphasizes that medical guidelines should take into account the time doctors need to adequately treat patients. [Extracted from the article]

Anesthetic gases are potent greenhouse gases, which are currently released into the atmosphere where they remain for many years. Strategies to reduce the carbon footprint in anesthesiology without compromising patient safety are urgently needed. Since 2020 several departments of anesthesiology have installed anesthetic gas capture systems with which anesthetic gases can be collected. This article aims to describe the anesthetic gas capture system CONTRAfluran™ and to give an overview of the first experiences in four departments of anesthesiology working with the new device in the daily clinical routine. The CONTRAfluran™ system presents a new concept in the surgical setting that has the potential to reduce the carbon footprint in anesthesiology; however, in order to accurately estimate CO2 equivalent savings, more information concerning the reprocessing and data on the pharmacokinetics of anesthetic gases are needed. Application of the CONTRAfluran™ system in daily clinical routine is feasible when anesthesiologists are aware of specific issues. In order to minimize the carbon footprint, it remains essential to implement the specific recommendations in the position paper of the German Society of Anaesthesiology and Intensive Care medicine (DGAI) and the Professional Association of German Anaesthesiologists (BDA) on ecological sustainability in anesthesiology and intensive care medicine and to support further research. [ABSTRACT FROM AUTHOR]

The section report Quality Promotion 2022 of the Journal for General Medicine (ZFA) covers various topics. One focus is on climate protection in continuing education in the field of general medicine. The Continuing Education Section, together with the Climate Change Working Group, has created a continuing education paper on the topic "Continuing Education and Climate Protection: Organizers, Participants, and Attendees in Ecological Responsibility." DEGAM has also published its own statement on two AWMF papers on the topics of continuing education, research, and guideline work. Another topic of the report is the DEGAM remembrance project "The Empty Consultation Room," which deals with the ideological influence on medical consultation rooms during the National Socialist era. A workshop on creating My Simple Show clips as a new channel for disseminating guidelines will also be offered at the DEGAM Congress in Greifswald. The Quality Promotion Section will merge with the adjacent topic area of guidelines as part of the restructuring of DEGAM. [Extracted from the article]