For Clinicians | Appropriate Medical Preparation 

The Clinical Category We’ve Been Practicing Without a Name

By Dr. Jamie Wilkey, PharmD — Director of Clinical Strategy, Jase
Medically reviewed by Kristen Carpenter, PA-C — Clinical Advisory Board Member

Patients have been asking us a version of the same question for years. “What’s reasonable to have on hand,…… just in case?” Most of us don’t have a clean answer.

• The toddler spiking a fever past 11pm after the only instacare in town just closed. 
• The UTI that announces itself Friday at 6pm with a weekend ahead.
• Pink eye Sunday morning with school Monday. 
• Strep in a rural county where the nearest ER is three hours away and urgent care closed at 6. 
• The pharmacy that’s open but out of stock on the antibiotic the prescriber just called in
• The cruise-ship UTI on night three. 
• A traveler’s fever in a hotel in a country where nobody at the front desk speaks English. 
• A national pharmacy chain offline for two days after a ransomware attack. 
• A maintenance refill backordered the week of a long-planned trip. 

Different sizes of disruption, same shape underneath: a moment when primary care isn’t reachable, and the patient doesn’t have what they need on the shelf.

Our patients have been living in this middle for years without a word for it. We are giving it one: appropriate medical preparation. A clinically grounded buffer to primary care, not around it.  Common, predictable medical disruption that ends with an avoidable ER bill, a missed dose, a ruined vacation, or just a really bad week.

Between full healthcare and full prepper

Right now, patients are choosing between two answers. Full healthcare, available when you’re close to the doctor and the pharmacy and the schedule is cooperating. Or full prepper, where the assumption is help isn’t coming. Neither was built for the life they actually live. The institutional advice in between (FEMA’s 72-hour kit, the written medication list every family is told to clear) is what everyone’s told to have, but in practice almost no family does.¹

Patients are hungry for something better. Access. Travel. Geography. Timing that doesn’t fit a normal clinic schedule. The things that go wrong on a Friday night don’t wait for Monday morning. When healthcare doesn’t fill the gap, patients fill it themselves, often from dubious sources online, because they need a real answer and someone has to give them one.

The disruption doesn’t even need to be exotic to be miserable. My brother-in-law spent an hour and a half in a seemingly neverending line at 9pm on a Friday at the only 24-hour pharmacy in his county (and at 750K+ people, it’s not a small, rural podunk county). Just Friday at 9pm, not even a holiday weekend. The whole evening was gone for something he should’ve been able to have on his own shelf ahead of time.

Survival medicine has its place for the long-term disruptions where help really isn’t coming. But for the disruptions that fill most families’ calendars, the question isn’t whether help is coming. It’s whether the family already has what they need on the shelf, before the wait causes major inconvenience and perhaps deterioration in their condition. That’s what we’re building into: a clinical bridge that meets patients where they are, instead of asking them to work around healthcare hours that aren’t always in their best interest.

What’s actively short in summer 2026

In Q1 2026, ASHP counted 223 active national drug shortages, the second consecutive quarter the count has risen⁵. The mix isn’t the headlines you might remember.

ADHD stimulants: amphetamine mixed salts (IR and XR), lisdexamfetamine, and methylphenidate ER are in their fourth year of active shortage. Specific strengths of amphetamine XR had release dates as recently as mid-May and early-June 2026.

Sterile injectable chemotherapy: vinblastine, methotrexate, and cisplatin are all currently short. Vinblastine is the most-shorted oncology drug, reported in shortage at 57% of surveyed centers⁶.

Injectable opioids: morphine sulfate (on the FDA shortage list since 2017) and fentanyl citrate (since 2012) remain chronically short. Acute pain, surgical anesthesia, palliative care.

Estradiol and progesterone: added to the shortage list in January and February 2026. Demand is up; manufacturing capacity hasn’t caught up.

The guidelines that haven’t been written

Naming the category is half the work. The other half is writing the clinical guidelines that define it: what patients can safely have on hand before a clinical event arrives, and how to use it well when it does. Clinicians love guidelines and frameworks, and the ones for this category have not been written yet. We are building them.

Appropriate medical preparation is, in no way, a replacement for primary care. Chronic conditions and the long-term continuity that primary care exists to provide belong in the exam room. We are here for the moments primary care isn’t, not for the moments primary care is. The line is sharp and we hold it.

What it actually is: a clinically grounded model of preparation, built by a team of board-certified physicians, physician assistants, and pharmacists. Protocols are reviewed. Decisions are cross-checked. Medications are matched to common and predictable conditions where the clinical decision is well-understood. When something changes after the patient has the medication on the shelf, the team is reachable by call or email, no runaround. The work is structured around preparation, before symptoms arrive.

And it is not fear-based stockpiling dressed up in clinical language. The doomsday posture sold as health care is a different category. Ours stays in the lane of common, predictable conditions where the clinical evidence is settled.

The work the literature already supports

Any clinician in practice more than a few months has seen this conversation in a dozen different costumes. The patient calling Friday at 4:55pm…….the colleague who watched a UTI hijack a family’s vacation……the pharmacist taking the 9pm phone call asking about an antibiotic shortage with no known arrival date for the backordered amoxicillin² and the parents are really upset because the other pharmacy that can get it in is closed for the weekend……the provider who got the late-night text from a friend traveling abroad asking how he can get an antibiotic for strep overseas. We have been navigating this informally for years, one patient at a time, with no shared language and no defined framework.

The reason is partly that we were trained for a different system. Pharmacy school, medical school, PA school all assumed a closed loop: one patient, one prescriber, one chart, one local pharmacy that knew about all three. That loop is gone. Patients now have access to direct-to-consumer telehealth, mail-order chains, foreign pharmacies, cross-border purchasing, online communities, and TikTok dosing advice³. The job is harder than the one we trained for: guiding patients toward appropriate access in a landscape where access is everywhere and quality is uneven.

The frame for this kind of work already exists in the literature. The Patient Activation Measure⁴ has documented for two decades that clinical outcomes improve when patients are activated and prepared to participate in their own care. Appropriate medical preparation is clinician-supported patient activation, not patient autonomy alone. The category needs both halves; neither one works on its own.

Charting the gray area in public

Public knowledge gets better when clinicians chart the gray area in public, instead of leaving the internet to do it. Patients today can get almost anything they want from an online pharmacy. Without a clinical voice in that conversation, they will keep filling the gap themselves, more often and with less guidance. We’re choosing to do that work in the open.

What we are doing right now is defining what is safe to have on hand and what is not, and edging out the boundaries of the category as we go. We are confident doing this work. We are also finding it is more complex than it sounds. A UTI workup is straightforward. Building a complete framework for the range of conditions a reasonable family could face is a different scale of clinical work. Not impossible. Just hard to do well in the cracks of an office visit. If you are doing this work for your own patients, we champion that. If you would rather refer or follow along, both options are here. You can refer at Jase.com, or follow our work as we share how we are thinking about it.

What we are sharing going forward: how we make clinical decisions, where we draw the lines, what the evidence supports, what we’re still working through. The category is new. The protocols are being written at the highest clinical standard we know. We want medical professionals at the table while we build, not after.

Building this in the open

This article is one of many we are writing. The category needs a clinical framework, written and revised in public, and we are starting that work here. Each week we will be sharing a piece of it: a condition we are working through, a protocol, a decision we made and why, a question we are still chewing on, and current news stories and how they relate to appropriate medical preparation.

If this is interesting to you….follow along! We are publishing a few times a week, having a lot of fun building this in the open, and we would love to have you join us. 

Sources

1. FEMA. 2023 National Household Survey on Disaster Preparedness: Key Findings. Federal Emergency Management Agency, Individual and Community Preparedness Division, 2023. https://community.fema.gov/PreparednessConnect/s/article/Results-from-the-2023-National-Household-Survey-on-Disaster-Preparedness
2. Brewster RCL, Khazanchi R, Butler A, O’Meara D, Bagchi D, Michelson KA. The 2022-2023 Amoxicillin Shortage and Acute Otitis Media Treatment. Pediatrics. 2023;152(3):e2023062482. https://pmc.ncbi.nlm.nih.gov/articles/PMC10895544/
3. Trilliant Health. Telehealth Demand: An Update Four Years After the Onset of the COVID-19 Pandemic. Trilliant Health Market Research, 2024. https://www.trillianthealth.com/market-research/studies/telehealth-demand-an-update-four-years-after-the-onset-of-the-covid-19-pandemic
4. Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure (PAM): Conceptualizing and Measuring Activation in Patients and Consumers. Health Services Research. 2004;39(4 Pt 1):1005-1026. https://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2004.00269.x