Medicine has a dual obligation concerning the environment: (I) to supp
ly laboratory and clinical research to document harmful effects on the
environment, and (2) to encourage changes in the environment to reduc
e or eliminate adverse health effects. This article presents Individua
l and group actions for the improvement of the environment. The Americ
an Academy of Otolaryngology-Head and Neck Surgery has developed a med
ical office pledge, ''The Greening of Our Office for Improvement of Ou
r Environment.'' Physicians are encouraged to agree to certain princip
les for environmental improvement.