The anesthesia labor market is tighter than it has been in decades, making it increasingly difficult for ASCs to secure reliable coverage.
By 2026, the U.S. is projected to face a shortage of 6,300 anesthesiologists, according to a 2024 white paper from Medicus Healthcare Solutions. Today, there are more than 7,700 people for every one anesthesiologist, and the workforce is aging — over 56% of anesthesiologists are older than 55, and more than 17% are nearing retirement.
In this high-demand environment, one of the biggest mistakes ASCs can make is relying on a constant cycle of replacing anesthesia providers and “succumbing to a ‘revolving door’ of anesthesia groups,” according to Vijay Sudheendra, MD, president of Narragansett Bay Anesthesia in Providence, R.I.
According to Dr. Sudheendra, many ASC leaders believe changing anesthesia providers “will resolve financial or operational issues,” but the frequent turnover leads to “greater dysfunction, OR closures and canceled surgeries due to inadequate anesthesia coverage.”
ASCs may repeatedly switch anesthesia groups in hopes of improving cost-efficiency or care quality. But the resulting instability can undermine surgeon and staff morale, harm the patient experience and damage the ASC’s reputation.
Some centers are finding success by focusing on provider retention and fostering long-term relationships. Rosemont, Ill.-based Ambulatory Anesthesia Care, for instance, recruits and retains high-quality providers by balancing autonomy with a strong sense of team.
“I think that there’s a lot of physicians and healthcare workers in general that are trying to gain back some autonomy, some control, some freedom,” CEO Scott Mayer told Becker’s. “The consolidators just keep getting bigger, whether it comes to platforms or health systems, it’s definitely becoming more corporate. That’s forced a lot of [providers] — especially on the anesthesia side — to be their own independent contractors.”
To attract and retain anesthesiologists in this environment, ASCs must meet evolving provider expectations, including compensation, flexibility and clinical autonomy.
“What we’re really trying to do is empower our staff and our people to feel like not only they have a voice, but that there’s clinical autonomy, that there’s flexibility, so that they see that they’re part of of this migration and this movement to a future value-based care model of lower cost savings, higher satisfaction and increased access to care,” Mr. Mayer said. “We’ve got to be intentional with our individuals. We’ve got to show that we really want the best for this organization in many different ways and for them as people as well.”
Another key to retaining sustainable anesthesia partnerships is building strong, communicative relationships. Regular, structured dialogue is often overlooked but critical, according to Jeffrey Tieder, MSN, CRNA, clinical assistant professor at the University of Tennessee at Chattanooga.
“ASC leaders and anesthesia providers must work collaboratively to define appropriate patient selection criteria, ensuring alignment on which patients are safe and suitable for the outpatient setting,” he said. “Without clear boundaries, anesthesia teams may face last-minute surprises or unsafe situations, leading to case cancellations or unexpected transfers to the hospital — outcomes that are frustrating, costly and potentially damaging to the ASC’s reputation. Continued dialogue around case complexity, comorbidities and escalation protocols is essential to minimize disruption and ensure a smooth, efficient workflow that prioritizes patient safety.”
Some ASCs are responding to the labor shortage by directly employing anesthesiologists and offering more competitive compensation and benefits packages.
Andrew Lovewell, CEO of Columbia (Mo.) Orthopedic Group, told Becker’s his practice now employs the anesthesiologists who provide services at COG’s ASC.
“We are short on anesthesia personnel, key business office functions and surgical technicians. Our shortages compound as payers make the process significantly more complicated to get paid for services,” he said. “Finding qualified anesthesia personnel that embrace the high volume orthopedic ASC is a challenge as well.”
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