Amid a growing anesthesia workforce shortage, stakeholders across the industry are pondering how to build a more sustainable and effective pipeline of providers.
Eight anesthesia leaders connected with Becker’s to discuss their most urgent priorities for combating the shortage, from workforce collaboration to expansion of training programs.
Question: What are the most urgent priorities to stabilize the anesthesia workforce?
Editor’s note: Responses have been lightly edited for clarity and length.
Chris Campanotta, CRNA at Anesthesiologists Associated (Birmingham, Ala.): Challenge practice models from a national perspective. There is enough volume out there for everyone to prosper. Anesthesiologists need to stop playing games, trying to do everything they can to limit CRNAs to push AAs and make them interchangeable when they just are not. CRNAs need to decide if they are going to be a clinician or a shift worker because they cannot have it both ways (and advance the practice).
Institutions, groups and facilities are stuck in outdated models of compensation, so they are unable to flex depending on their needs, and are left playing catch up. Since everything seems market- and return-driven, all actions become reactionary (CHECKERS) instead of proactive (CHESS).
Angie Edwards, MD. Associate Professor of Anesthesiology and Section Head for Perioperative Medicine at Wake Forest University School of Medicine (Winston-Salem, N.C.): We need to increase the number of anesthesiologist training/residency programs in the U.S. to accommodate this shortage of physicians, and we need to lessen the cost of medical education (more to this perhaps in another column).
We have too few anesthesiology residency training sites to develop well-trained anesthesiologists to safeguard patient care (in hospitals and outside at NORA sites). The current rate of retiring anesthesiologists will quickly outpace the number of new graduates ready to enter the general population workforce. Medical training takes a long time — four years of medical school, four years of residency, +/- fellowship. This is what distinguishes anesthesiologists as physician scientists best suited to care for a wide variety of patients in unique patient-centric ways. Not every patient is the same. Individual patient care requires a highly skilled physician to draft a patient-centered, safe approach and ensure ideal outcomes. Quality of recovery is dependent upon the anesthesia plan put forth by anesthesiologist physicians. This cannot be achieved through an algorithmic approach, which is where most nursing programs begin. We need to expand the number of anesthesiology residencies and incentivize graduates of these programs to enter the workforce following residency.
Antonio Hernandez Conte, MD. Former President of the California Society of Anesthesiologists: Most states are working hard to expand both anesthesiologist and nurse anesthetist training programs to keep up with the anesthesia workforce shortage.
Many anesthesia training programs now require financing from community hospitals and health systems to ensure that these programs can expand, given that federal funding is limited or non-existent. However, more efforts at the national level need to be made to allow certified anesthesiologist assistants to practice in ALL 50 states. Currently, 22 states, plus D.C. and Guam, plus the Veterans Administration System, allow CAAs to practice. However, legislative and licensure roadblocks continue to occur in many states. Allowing CAA practice via physician delegatory authority is a cost-effective way to introduce CAAs without the huge burden of creating a new licensure board. CAA pilot programs can also be started in states to rapidly credential and bring in CAAs to major hospitals and health systems, particularly in rural areas. CAAs are a safe, proven anesthesia workforce that complements the existing anesthesiologist-led care team model. There is simply no excuse for not allowing CAAs to practice in every state.
Don Harmeyer, CRNA. Staff Nurse Anesthetist at the University of Vermont Medical Center (Burlington, Vt.): When I completed my anesthesia training and after six years in Denver and Pittsburgh ICUs, the job opportunities for both CRNAs and physician anesthesiologists were bleak. Many training programs shriveled in numbers or even closed. At the University of Vermont, our physician anesthesiologist training program decreased to just one resident and nearly ceased to exist. Today, the nation has shifted in the other direction. The aging demographic of both providers and the American population, despite being predictable, has been ignored. The most urgent priority is for the ASA and the AANA to come to the table and determine a path forward for both providers to work in parallel and put an end to the political differences. This is the only choice if the needs of the American population are going to be met. The ASA has proposed the introduction of “sedationists” to be filled by other physicians. The reality of this is that if you do not manage airways on a regular basis, you will not be capable of doing so when a procedure goes beyond the needs of basic “sedation.”
Jason Manella, MD. Director of Anesthesia Operations at Endeavor Health (Chicago): The current number of anesthesia providers graduating into the workforce each year is unable to keep up with the necessary demand required of anesthesia in OR and non-OR settings. At Endeavor Health, one of our key strategies to stabilize the anesthesia workforce and meet these demands is through our School of Nurse Anesthesia and CRNAs. SONA has been around for nearly 100 years and we plan to double the class size in the coming years. Endeavor Health executive leadership understands the benefit of training an anesthesia workforce and is investing heavily to ensure SONA’s continued success. Additionally, our department has fostered a work culture that has led to extremely high retention and allows CRNAs to work up to their full potential and scope of practice.
Allyn Miller, CRNA, MSN. Regional Director of Anesthesia Operations of Community Health Systems (Franklin, Tenn.): To stabilize the anesthesia workforce, some of the most urgent priorities lie in leveraging data science and AI to drive smarter workforce planning, optimize resource allocation, and support clinical decision-making.
We must invest in advanced workforce analytics and predictive modeling. Data tools can forecast anesthesia staffing needs by analyzing trends in surgical volume, provider availability, case complexity, and geographic distribution. AI models can also anticipate retirement patterns, burnout risks, and regional gaps in coverage, enabling more proactive recruitment and resource deployment. These insights can guide policy and operational decisions at the facility, system, and national levels.
AI-enabled scheduling and OR optimization platforms should be integrated across more health systems. These tools use machine learning to improve case scheduling, minimize downtime, and match anesthesia staffing to real-time demand. By aligning anesthesia resources with daily procedural fluctuations, these systems reduce inefficiencies and help prevent provider overwork, a key driver of burnout and attrition.
Data-driven education planning can help target training investments. AI can identify where anesthesia provider shortages are most acute and which communities are underserved. These insights should be used to direct funding toward education pipelines, such as CRNA and anesthesiology residency slots, in areas with projected long-term need. Additionally, AI tools can evaluate the impact of various workforce policies (e.g., independent CRNA practice, rural stipends), helping legislators and system leaders prioritize the most effective interventions.
Real-time dashboarding and geospatial mapping of anesthesia coverage gaps can help state and regional health authorities coordinate staffing on a larger scale. These visual tools would ensure that resources are directed to the areas where the population’s health risk is greatest.
AI can support clinical decision-making and documentation, easing providers’ administrative load. By automating routine charting tasks and offering intraoperative decision support, AI can help restore clinical focus and reduce burnout, improving job satisfaction and retention.
Stabilizing the anesthesia workforce requires integrating data science and AI across education, operations, and policy. These tools can move us from reactive crisis management to proactive, data-informed workforce planning, ensuring anesthesia services remain accessible, efficient and sustainable nationwide.
Erin Pukenas, MD. Vice Chair and Associate Professor of the Department of Anesthesiology at Cooper University Health Care (Camden, N.J.): The most urgent priorities to stabilize the anesthesia workforce are to optimize care delivery models, retain current providers and expand training. At our medical school, we have made changes to the curriculum to promote earlier exposure to the specialty of anesthesiology, which has led to a fourfold increase in the number of our graduates pursuing anesthesia as a career. We’re also exploring precision education models to accelerate entry into the workforce.
Mark Zapp, MD. Anesthesiologist at Fleming Island (Fla.) Surgery Center: Priorities to stabilize the workforce:
- Increase anesthesia residencies.
- Increase RVU reimbursement for anesthesia services.
- Revise the No Surprises Act, which significantly decreases anesthesia reimbursement in favor of insurance companies.
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