Procurement is often discussed in terms of savings, efficiency and resilience. Yet in healthcare, the most consequential procurement decisions are not financial – they’re clinical. Choices about medical products shape hospital workflows and contribute to patient safety and better outcomes. They also drive broader system sustainability and can help mitigate the impact of geopolitical pressures affecting the healthcare supply chain.  

Despite conjecture to the contrary, clinicians are meaningfully involved our country’s largest healthcare sourcing initiatives. For hundreds of Canadian hospitals, procurement is not simply a transactional function, but a key contributor to the quality and continuity of care.

Supply disruptions, global tariffs and other pressures have all exposed the limitations of procurement models that prioritize unit cost over clinical usability and outcomes. That’s why embedding clinical expertise into the sourcing process and the programs that help hospitals manage supply disruptions is not an optional enhancement – it’s a necessary safeguard.

Clinical Insight as a Foundation

Clinicians are trained to evaluate products differently than procurement professionals – and bring an essential lens to the process. They assess not only whether an item meets specifications, but how it performs under real-world conditions: its ease of use, its interaction with other equipment and its impact on patient comfort and safety. Clinicians also know which products are viable alternatives in the event of a disruption. 

This approach challenges a long-standing assumption that lowest cost represents best value. In healthcare, that notion often fails to account for downstream consequences of inferior products being selected for their lower unit cost. These can include longer lengths of stay for patients, increased readmission rates, less efficient care delivery and increased training requirements – all of which consume clinical time and organizational resources.

Structuring Clinical Participation

Effective clinical engagement requires structure and support. The well-established model used by MMC takes the form of working groups comprising clinicians from hospitals participating in the RFP. They review and refine specifications and score vendor submissions. When necessary, such as in the adoption of new products, clinical evaluations are conducted in situ to ensure medical/surgical products meet hospital requirements. 

For hospital-based clinicians, the approach is effective. “Mohawk Medbuy’s Clinical team takes on the pre-work of doing background research and drafting initial clinical specifications for our review,” according to Glyn Boatswain, Chief Nursing and Allied Professionals Executive at Scarborough Health Network. “That saves significant time for SHN clinicians.” This division of labour acknowledges both the value of clinical judgment and the realities of clinical workloads.

The argument for clinical involvement becomes even stronger during periods of supply instability. Between April 2024 and March 2025, more than four thousand manufacturer supply disruptions affected contracted medical, surgical and pharmaceutical products across Canadian hospitals. In these situations, which often arise with little notice, the immediate questions start with whether a substitute exists and quickly move to whether the alternative is clinically appropriate.

Clinically informed disruption management typically involves assessing patient risk, identifying acceptable alternatives and supporting practice changes when no true equivalent is available. This work relies heavily on clinical judgment, shared experiential knowledge and open communication across organizations and professions. Proactive clinical work to pre-identify substitute products expedites the transition to alternates in the event of a short-term backorder or geopolitical issues that necessitate wholescale changes in country of origin and supply routes. 

During a major shortage of 0.2-micron filters in 2025, clinicians from multiple disciplines and jurisdictions participated in structured communities of practice established by MMC to address both immediate clinical concerns and broader system impacts. Such collaborative forums illustrate how procurement challenges can be channeled into opportunities for shared learning.

Pharmacy as a Parallel Case

The importance of clinical leadership in procurement is perhaps most clearly established in pharmacy services, where professional standards explicitly link product selection to patient safety. Pharmacists routinely evaluate handling requirements, labeling clarity and formulary alignment –factors that are inseparable from procurement decisions.

Supply disruptions in pharmaceuticals underscore this connection. During a critical glucagon shortage in 2023, coordinated clinical engagement and access to MMC’s aggregated hospital utilization data supported contingency planning and equitable allocation while supply was constrained. The episode reinforced a core lesson: procurement does not end with a contract award. Ongoing clinical oversight is essential when conditions change.

Beyond Cost: Reframing Value

At its core, clinician engagement in procurement is central to defining value. Savings achieved at the item level may be offset by inefficiencies, errors or delays in care delivery. Conversely, products that better align with clinical practice often offer far greater savings through shorter lengths of stay, streamlined workflows and safer patient experiences – even if their unit cost is higher.

Procurement professionals, clinicians and system leaders all have a role in navigating these realities in the face of operational and ethical pressures that define today’s healthcare environment. As our health systems confront uncertainty from geopolitical dynamics, workforce challenges and evolving standards of care, it’s heartening to know that Canada’s largest sourcing initiatives are being conducted with clinical expertise at their core. That’s not simply good practice. It is a testament to how patient-focused procurement is central to patient-centred care.

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