Today I got an in-service on a new product and my Program Director informed me that since we were moving to a new system for ordering supplies and charging them, it was about to become darn near impossible to get new products. I remember back in the early 1990’s I worked for 2 years to get a multilayer wrap on the formulary as an alternative to Unna’s boots. The wound center at my old hospital was the largest user of dressings in the hospital system, but I was never allowed on the “Skin Committee.” They didn’t trust a doctor to be able to provide an independent assessment of products so the inpatient nurses and the administrators got to decide what products were used in the OUTPATIENT clinic. However, I actually care a lot about cost effectiveness and would love to have told them how I could have saved money with different product choices. Making it harder to get products does not mean that we have less wasted resources. There needs to be a better way to decide what products to use in both the inpatient and outpatient settings AND how to pick the right product for the right patient.  Just making it HARDER to get new products does not make us more cost efficient.  

Caroline Fife, MD
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