From the buzz around artificial intelligence to the persistent squeeze on reimbursement, eight leaders joined Becker’s to discuss the trends they’re tired of hearing about.
Question: What’s one anesthesia trend you’re sick of hearing about?
Editor’s note: Responses have been lightly edited for clarity and length.
George Anatsein, MD. Director of Anesthesiology at White Plains (N.Y.) Hospital: Locums work as being liberating. Demonstrating how interchangeable anesthesiology clinicians are is doing long term harm to the profession. Additionally, I truly believe you get the best patient outcomes with teams who work together frequently, and over long periods of time, this is because unexpected untoward events in the operating room require tight coordination and communication. This type of quality is hard to capture with metrics and data. Over my career there have been several “saves” because I knew the capability limits of a particular surgeon, or where a hard to find and rarely used piece of equipment was located, or that an operation booked as a simple procedure was going to be a much more lengthy and complex white knuckle ride because of prior experience at that same facility.
Robert Ebener, DO. Anesthesiologist in Jacksonville, Fla. Well I’m certainly sick of hearing about our Medicare reimbursement problem, which has existed since the 1990s. But, we need to keep the issue front and center if we want to keep the hope alive for change.
Megan Friedman, DO. Director of Pacific Coast Anesthesia Consultants (Los Angeles): I’m sick of hearing that cutting anesthesia costs is the key to operational efficiency. Anesthesia service lines are constantly told to “be more efficient,” as if that alone will fix broader operational issues. Yes, timeliness and quick turnovers matter — but they’re just one small piece of a much larger puzzle, and often not the root cause of inefficiencies.
Real perioperative success — whether in hospitals or surgery centers — comes from smart scheduling, balanced case distribution, appropriate staffing, strategic utilization and recruiting the right surgeon mix with a sustainable payer profile. Hospitals invest heavily in technology and infrastructure, yet high-quality anesthesia staffing is often treated as an afterthought.
Anesthesia isn’t just a cost — it’s a foundational clinical service that touches nearly every patient and department: ORs, imaging, cath lab, endoscopy, labor and delivery and every procedural space across inpatient and ambulatory care. It can’t be cut or replaced without consequences.
Our goals are aligned with hospital and surgical leadership. When hospitals thrive — through volume, efficiency and payer mix — so do anesthesia services. It’s not us versus them. Sustainable performance requires collaboration, not finger-pointing. If systems want lasting, meaningful solutions, they need to stop squeezing anesthesia and start addressing the full picture of surgical services and operational strategy.
Antonio Hernandez-Conte, MD. Immediate Past President of California Society of Anesthesiologists: It is truly disheartening to hear about commercial payers that are continually squeezing anesthesiology practices by lowering payments, creating billing obstacles and/or failing to pay physicians after winning No Surprises Act arbitration payment disputes, while at the same time knowing that these same health insurance companies are recording massive profits year after year.
Narasimhan Jagannathan, MD. Division Chief of Anesthesiology at Phoenix Children’s: The constant hype around AI replacing anesthesia providers. While AI can enhance monitoring and workflow, it’s nowhere close to replacing the nuanced judgment and hands-on expertise required in real-time critical care.
Daniel King, CRNA. Board Director of the American Association of Nurse Anesthesiology: Too much of the current conversation around anesthesia workforce solutions is being dominated by ineffective proposals — whether it’s the introduction of anesthesiologist assistants or the allure of costly, futuristic technology. While innovation has a place for enhancements in our evolving field, nothing can fully replace the clinical judgment, adaptability, safety and trust that CRNAs provide every day.
Anesthesiologist assistants are trained to assist. CRNAs are educated and prepared to autonomously deliver the full spectrum of anesthesia care. Labeling AAs as a “workforce solution” is not only misleading — it’s fiscally irresponsible. Their introduction adds yet another layer of cost to an already overburdened healthcare system without expanding access to care.
Rather than chasing expensive machines or creating new provider roles with limited utility, the real solution lies in removing practice barriers and fully empowering CRNAs to work at the top of their education and license. Let’s stop being distracted by shiny objects and start addressing the systemic issues that affect patient care today.
Rick Middleton, CRNA. Director of Anesthesia Services at UNC Wayne (Goldsboro, N.C.): The social media cry, “Know your worth” is exhausting. We CRNAs know our worth, some of us more than others. Not all of us are or want to operate to our fullest scope – and that’s ok. I am a proponent of enabling those CRNAs that do, though, to bill for procedures performed that can be directly paid to those practitioners who have chosen to operate a higher level than others. I believe this would go a long way toward pushing CRNAs to practice to their fullest scope. It is mandatory though, that CRNAs understand all those issues I discussed above related to billing and revenue.
Jeff Tieder, CRNA. Clinical Assistant Professor of the Nurse Anesthesia Concentration at The University of Tennessee at Chattanooga: In nearly every national conversation about the anesthesia workforce, we hear it again: “the looming physician shortage.” It’s presented as the primary threat to patient access and the reason to train more anesthesiologists.
But this one-dimensional narrative ignores a critical truth: CRNAs have long delivered safe, effective, and cost-efficient care—independently and across every clinical setting.
Yet CRNA voices are routinely excluded from policy discussions. Outdated scope-of-practice laws and reimbursement inequities remain unaddressed, despite clear evidence that lifting these barriers would immediately expand access and strengthen the workforce.
Instead, the focus remains physician-centric, with calls to expand less scalable and more costly roles like anesthesiologist assistants—while the CRNAs doing the work today are overlooked.
It’s time to shift the conversation. If we want real, lasting solutions to the anesthesia workforce crisis, we must fully recognize and utilize the skilled professionals already meeting the moment: CRNAs.
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