How Physicians Are Navigating a Fragile Supply Chain to Reduce the Impact on their Practices

This expansive network enables the group practice to overstock supplies where needed, which Dr. Brown acknowledges also puts a strain on the supply chain. “We can no longer run a ‘just in time’ inventory,” he said. “We have to get supplies as they become available.”

A less expansive practice might require a different strategy. “Supplies are fairly streamlined here,” said Dr. Backous. “Most items are used very frequently and there would be utility in keeping additional stock, but storage space is at a premium. We do order items earlier when there’s a known shortage.” Dr. Blythe’s staff has increased its par level for all critical supplies. “I don’t want to suggest that we’re ‘hoarding,’ but that might be a fair characterization,” he said.

To guard against future catastrophic shortages caused by overstocking, distributors have had to put some practices on monthly or weekly allocation programs for certain items, which means they’re limited to a predetermined amount based on past usage. “We have to purchase the amount that we’re allocated for fear that we might lose allocation,” Dr. Brown explained. “If we need more of an item than is on allocation, we have to find substitute products, which can be costly.” Similarly, Dr. Dubin’s practice has had to increase inventory from two weeks’ worth to four to six weeks’ worth.

New inventory minimums translate to greater cash outgo, so minimizing waste is paramount. “In private practice we try not to waste anything ever,” said Dr. Blythe, “but that has become even more important during the supply chain struggles.” Otolaryngologists cited drugs used in surgery, injectables, and sutures as frequently prone to waste. Dr. Dubin said his office was going through sterilizing wipes so quickly that “we had to switch to a cleaning solution concentrate.”

With a normal supply chain, a two-week supply is reasonable, and I look forward to when that time comes again. —Marc Dubin, MD

To complicate matters, supply prices have risen, dramatically at times. “A box of gloves that cost us $8 before COVID now costs $30,” reported Dr. Brown. “Having to stock excessive amounts has led to overhead challenges within our practice, and during COVID we have also struggled with patient volume challenges. The combination of lower revenue and higher overhead partially tells the story of how COVID has challenged private practices.” He cautions colleagues about dealing with new companies, as “the supply shortage has brought out the schemers to prey on everyone.”

Ultimately, otolaryngologists can’t treat patients without having the necessary supplies, and that’s the bottom line, reminded Dr. Dubin. “I would rather pay more in the short term than lose a patient because they had to go somewhere else to get their ear tube put in,” he pointed out. “Meanwhile, we aren’t buying anything we aren’t going to use at some point, and if supply issues normalize, I’ll save money at the back end. With a normal supply chain, a two-week supply is reasonable, and I look forward to when that time comes again.” 

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Linda Kossoff is a freelance medical writer based in Woodland Hills, Calif.