Individual actions can mitigate the medical supply chain crisis

By Naveed Saleh, MD, MS

Published January 31, 2022

Key Takeaways

Supply-chain issues are currently causing shortages of drugs and medical equipment, such as crutches.
Individual physicians can protect themselves against supply chain inefficiencies and shortages.
Engaging hospital administrators and the public can help raise local alarms for shortages.

For the past 2 years, supply-chain issues have dominated the news coverage, and we appear to be far from a satisfactory resolution. As a result, supply-chain management has become a focus of hospital and other business administrators, as current shortages of drugs and things like crutches replace the dearth of PPE that occurred at the beginning of the pandemic.

Mitigation of the supply chain crisis is typically outside the scope of individual clinicians, but there are ways to protect against future shortages of PPE and other necessities. Recent data indicated that approximately 99% of the 73 health systems surveyed reported issues with procurement, so a look at physician-specific solutions is warranted.

What happened?

An article published in Harvard Business Review reports that everything began with efforts to make the supply chain efficient, leaner, and globalized. This goal, however, came at the cost of resilience—all healthcare institutions were drawing on a fragile global supply, which was immediately stressed at the start of the COVID-19 pandemic. Indeed, any “black swan” event could stress this supply chain and result in disruptions.

In response to international stressors, homegrown producers, domestic manufacturers, and community groups began to produce PPE and other medical necessities. This stateside network of DIY makers and commercial manufacturers were linked by digital platforms and operated at a community level.

Under routine conditions, hospitals or smaller facilities work together with a group purchasing organization, which contracts a few larger distributors. These distributors buy from wholesalers or contract from manufacturers to produce what is needed.

Products from overseas are shipped to regional distribution hubs and are delivered periodically to individual healthcare facilities. These institutions keep a supply on hand that can sustain days to weeks of routine operation.

In times of local emergencies, supplies are shuffled among individual hospitals. With COVID-19, all healthcare institutions across the world needed the same supplies, which strained and broke the system.

Soon exorbitant prices became the norm, with gowns rising in price by 2000% and N95 masks rising by more than 6000%. We also saw healthcare workers making their own face shields and gowns.

Although local suppliers were able to shore up supply availability—and the crisis would have been much worse without such efforts—many institutions struggled to take advantage of these new suppliers. Issues with access included problems with distant corporate offices, inflexible funding rules, and onerous vendor approval processes.

On a management level, the author of the HBR article suggested the following interventions to obviate supply-chain issues in the future:

Identify a single point of contact at the healthcare center for coordinating with alternative suppliers.
Locate alternative suppliers before they’re needed.
Decrease restrictions that limit the ability of institutions to purchase supplies.
Hold disaster preparation drills to test supplier distribution and to identify alternative suppliers.
Document and vet supplies for quality assurance.

What can you do?

Most physicians are not administrators or are not involved in the logistics or machinations of the supply chain. Nevertheless, there are things the clinician can do to protect against future shortages.

"Physicians should not be at risk of having their employment terminated, or be otherwise disciplined, for speaking out...on conditions and practices related to care of COVID-19 patients, including lack of personal protection equipment."

— ACP

For example, the American College of Physicians (ACP) stresses that as a means of health protection, physicians should expect their healthcare institutions to provide adequate PPE. Physicians should also be free to bring their own PPE to protect themselves and others when these items are in short supply. It may behoove you to have a stash of PPE for you and your colleagues.

In cases of a perceived threat to supplies needed to protect your patients and your own, raise the alarm and advocate for better practices.

“Physicians should not be at risk of having their employment terminated, or be otherwise disciplined, for speaking out in a professional manner, within their healthcare systems or publicly, on conditions and practices related to care of COVID-19 patients (including lack of personal protection equipment) that the physician has direct knowledge of and believes is in conflict with the health and safety of patients and clinicians,” according to the ACP.

The ACP also supports the right for a physician to go public and disseminate their legitimate concerns about supply with the news media or on social media “to achieve needed change for the health and safety of patients and clinicians, both within the health care facility and more broadly.”

What this means for you

COVID-19 exposed notable shortcomings in the supply chain. As a provider, you can protect yourself against the threat of future exigencies by stockpiling your own PPE, raising concern over lack of PPE and other supplies, and engaging the hospital administration, the media, and the public about risks to supply without fear of reproach or reprimand.

Sources

2021 State of Healthcare Performance Data. Kaufman Hall.
Hannah D. One Way to Build More Resilient Medical Supply Chains in the U.S. Harvard Business Review.
Protecting Patient and Physician Health and Safety During the COVID-19 Pandemic. ACP