Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A reasoned response to the PPE debacle

Robert Frolichstein, MD
Conditions
May 9, 2020
Share
Tweet
Share

The lack of adequate supplies of PPE is deplorable, inconceivable.  This has been made abundantly clear through both social media and traditional media.  Post after post on various social media outlets have exposed the appalling shortages and, at times, blame and attack those that are obliged to provide us the PPE. Those posts, in part, have spurned movements among nonmedical personnel to donate and make masks.  Heartwarming, and it feels good to have widespread sympathy for our plight.

Thinking rationally, it is unlikely that those actions will solve this problem on a widespread scale. Hospitals and other organizations have entire teams of experts that deal with supply chains daily.  Terrible mistakes were made with horrific consequences. The mistakes were in the design of the system. The process of just-in-time ordering from group purchasing organizations is designed from a financial perspective.  It makes perfect sense to those making the decisions.  We use X amount of PPE every week (the burn rate), and if the supply of PPE matches the burn rate, there is no warehousing and warehouse management needed, and thus costs per unit of PPE go down. Now, faced with a burn rate of many multiples of X, the supply chain can not meet the demand.  This process is reproduced all the way back to the manufacturing and importing of PPE. There is no surplus in the system.  That was the mistake.  Based on affective decision-making principles, should we conclude that these organizations are now incapable of ramping up acquisition and maximizing supply and that we can do it better? Or should we do our part to raise awareness, coordinate donations, and then rely on the hospitals and organizations to manage the supply?

Again, the lack of PPE is appalling.  We are asked, expected, to care for patients in uncertain times with what is felt to be inadequate protection.  The lack of equipment should be made known to the industry and to the public to pressure industry leaders to ramp up supply.  That has happened.  The time for changing the system to prevent this from occurring again is in the future. Now it is time to step back and balance the emotion with the reason. Will continuing to emotionally appeal for more PPE or attack the organizations whose duty it is to supply it help? Rationally, does it make sense that our hospitals and supply chains do not want us to have the necessary PPE? Is it more likely that the conservation strategies (which emotionally seem ridiculous) are necessary to prevent running out of supplies completely? Using the affective decision making model, let us ask: How much more does and N95 mask protect us than does a surgical mask and contact precautions?  The answer is incredibly complex and depends upon so many variables including droplet size, chances of infection after exposure to an unknown amount of viral particles, air currents in the room, time in the room – the list goes on and on.  My job as a scientist and a leader is to postulate that an N95 mask reduces my chance of becoming ill more than a surgical mask, but likely by a very small amount.  So we must weigh this slight increase in benefit with the desire (emotion) to eliminate all risk while understanding the supply chain issues. So a strategy to conserve equipment and protect us must be developed based on reason balanced with the fear of becoming ill.

My job as a physician leader is to form my opinion about PPE based on a balance of emotion and what is rational.  This is perhaps the most difficult decision we will make because the emotion is so strong as we literally put our lives on the line.  We have done a fantastic job of raising awareness of the issue of inadequate PPE.  It has primed the system to now obtain as much PPE as possible.  It will soon be time to start having rational conversations when emotion is lower about how to prevent this scenario in the future.

Robert Frolichstein is an emergency medicine physician.

Image credit: Shutterstock.com

Prev

How to liberate doctors from EMRs

May 9, 2020 Kevin 3
…
Next

My living will during COVID-19

May 9, 2020 Kevin 1
…

Tagged as: COVID, Infectious Disease

Post navigation

< Previous Post
How to liberate doctors from EMRs
Next Post >
My living will during COVID-19

ADVERTISEMENT

More by Robert Frolichstein, MD

  • Is there opportunity for physicians in the pandemic?

    Robert Frolichstein, MD
  • Combining emotion and reason in decision making

    Robert Frolichstein, MD

Related Posts

  • An outdated law is limiting our coronavirus response

    Leah Hampson Yoke, PA-C
  • Why travel bans in response to Omicron are harmful

    Michelle Verghese
  • A modest proposal in response to eliminating the individual mandate

    Jonathan Kohler, MD
  • The burden of the badge: an MD student’s response to the FIGS controversy

    Palak Patel
  • A response to unemployment during the COVID pandemic: Medicare for all   

    Mallika Sabharwal, MD
  • Does Chicago needs a rapid response to food sanitation and safety?

    Janice Phillips, PhD, RN and John Mazzeo, PhD

More in Conditions

  • Clinical ghosts and why they haunt our exam rooms

    Kara Wada, MD
  • High blood pressure’s hidden impact on kidney health in older adults

    Edmond Kubi Appiah, MPH
  • How declining MMR vaccination rates put future generations at risk

    Ambika Sharma, Onyi Oligbo, and Katrina Green, MD
  • How one unforgettable ER patient taught a nurse about resilience

    Kristen Cline, BSN, RN
  • Why regular exercise is the best prescription for lifelong health

    George F. Smith, MD
  • When the weight won’t budge: the hidden physiology of grief, stress, and set point

    Sarah White, APRN
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...