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Most surgeons equate environmentalism with the softer sciences related more to personal philosophy than with anything connected to the harder science and business of healing patients. Only after we can get beyond the jokes about “saving whales” and “hugging trees” and “going green,” can we truly appreciate environmentalism in surgery for what it is: a smart, efficient, and cost effective way to do business in 2016. In the past decade, and especially in the wake of the Affordable Care Act, there has been national emphasis on improving the quality of health care delivery and increasing transparency while decreasing cost. 1 Ironically, this is happening at a time when rapidly evolving technology is making health care more and more expensive. 2 By evaluating the current system and eliminating waste and unnecessary expense, providers and health care systems can achieve that balance between quality and …