A Noodle Shop Without Noodles

David Epstein, MD, MS, FAAP discusses the experience of limited resources in medical practice and how it affects medical care.

The other night, we were going out to eat dinner at a restaurant that specialized in soup and noodles.

When we arrived, the staff mentioned that they ran out of noodles! It’s not such a good look for a noodle shop to not have any noodles. It is like Starbucks without coffee, Kentucky Fried Chicken without chicken, or a pediatric urgent care without medical supplies.
Wait…a pediatric urgent care without medical supplies? That’s absurd! But, that is exactly what happened during the height of the pandemic. Some supplies were hard to come by. There were limited numbers of all kinds of gloves (regular and sterile), masks, gowns, and other supplies that we never would have thought would limit our practice of medicine. The noodle shop jogged my memory of how the practice of medicine was affected by supply chain issues and I felt empathy for that noodle shop.


During my medical training and practice, I can’t remember when rationing care or having a shortage of supplies was ever an issue.

Of course, I had heard about these types of things in other countries around the world, but I had never experienced it myself. The idea of adjusting our medical management or not being able to administer medical care because of these issues was not a problem that I ever had to confront.
At one point, there was a problem with obtaining intravenous fluid bags to help with fluid resuscitation for kids with dehydration, lidocaine solution to help anesthetize wounds for laceration repairs, and a shortage of supplies for COVID-19 PCR test kits (before rapid COVID-19 testing was so readily available). Our reference laboratory quickly ran out of COVID-19 PCR test kits because it was overwhelmed with the demand for testing. We were able to create our own testing kits with a special swab, saline medium, and specimen container. But, these supplies were soon hard to come by as well.
As I reflect upon how medical care was affected by limited supplies and resources during the pandemic, I can’t help but realize that this is more common around the world under normal circumstances.
While the practice of medicine is more than just medications, supplies, and diagnostic tests, these elements are critical to performing the best and most current standards of care in medicine. Resource limitations can change medical practice, like any other business or service industry. So, while a noodle shop can still serve plain soup if they run out of noodles, the dining experience is just not the same.
Have you ever experienced resource limitations in medicine or another business? How did you manage these limitations?


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