we’re so used to ordering whatever tests we want for patients, though we do occasionally consider cost. for one of my patients we had a bit of a discussion whether this test was indicated, considering that there was a good chance we would not make any changes to his management. the attending, however, wanted the test, and so it was ordered along with another scan. it was a bit surprising to learn the next day that he would be unable to undergo these tests, not because of time or cost or efficacy, but simply because of a national shortage of technetium-99.
i guess the upside is that this forces us to really evaluate the necessity/utility of the tests we order.