ASC and anesthesia leaders are turning to creative solutions amid the growing anesthesia provider shortage.
According to a 2024 Medicus white paper, there will be a projected shortage of 6,300 anesthesiologists by 2036. There are currently 51,492 active anesthesiologists in the U.S. Of those, 56.9% are 55 years or older and more than 17% are nearing retirement.
At Becker's 30th Annual Business and Operations of ASCs Meeting in Chicago, two healthcare leaders shared strategies to address the shortage, focusing on workforce adaptations, flexible workflows and recruitment tactics.
Adapt to the workforce
The anesthesia workforce is in a transformative period, with professionals from at least three generations working side by side, said Gary Haynes, MD, PhD, chair of anesthesiology at Tulane University School of Medicine in New Orleans.
Recent medical school graduates have "very different expectations" regarding workload and often face high debt burdens, which impact their career decisions in ways that were less common in the past, Dr. Haynes said.
Stan Plavin, MD, an anesthesiologist and owner of Oral Surgery Anesthesia Associates in Atlanta, echoed this, noting that the workforce today operates differently.
"Our society is not driven by the same sort of level of engagement professionally that it used to be," he said.
To bridge these generational differences, Dr. Plavin emphasized the importance of offering a "value proposition" that encourages providers to excel while feeling satisfied professionally. This could involve implementing revenue guarantee models, profit sharing, ownership opportunities, addressing scheduling inefficiencies and exploring alternative business models.
Flexible workflows
In response to the shortage, Dr. Haynes' team at Tulane has adopted flexible call schedules across multiple hospitals.
"We've played with our call schedules and gone to — instead of one night or one night on call the next day off — we'd go into a night float system for a week at a time, which helped mitigate our current situation," he said. "We talk a lot about physician wellness and I think it's easier for physicians to be on call and do it a week at a time, giving them more free time during the day and then a week off afterwards for mental and physical reasons."
This setup not only allows for better mental and physical health but also offers providers the option to take extra shifts during their post-call week if desired. While this solution may feel like "rearranging deck chairs" rather than a fix, Dr. Haynes said, it has proved effective in maintaining operations during the shortage.
Strong communication
Effective communication between anesthesia teams and ASC or hospital leadership is essential.
"I always made a point of having a meeting with the hospital administrator at least once a month, if not more frequent, as well as meetings with the CEO," Dr. Haynes said. "The thing that's made the most difference is developing a tighter relationship with operating room nurse managers and working together to understand each other's concerns and to sit down and actually look at schedules a week or two out anticipating what the problems were going to be."
Creative recruitment
Developing creative recruitment strategies is critical to maintaining coverage, Dr. Plavin said.
"We're treading water right now," he said, adding that finding sustainable solutions that meet the needs of both patients and providers has been challenging.
As a business owner, Dr. Plavin has found success by offering flexible scheduling, lifestyle perks, performance-based bonuses and a supportive work environment aligned with providers’ goals.
He has also tailored his recruiting efforts to appeal to candidates of similar age, fostering better alignment of professional intentions and lifestyle expectations.
Advantages of ASCs
ASCs offer advantages for anesthesia providers, from fixed hours to reduced exposure to hospital environments.
"ASCs do a great job in solving a lot of patient problems. Because what are hospitals? They're a place where everyone who's sick goes, and so it's a big petri dish for everybody and not the most efficient place, either," Dr. Haynes said. "[ASCs] have fixed hours, you don't have call schedules. You've got something that fits the lifestyle and lends itself to better wellness for CRNAs, for anesthesiologists, for everybody who works in them."
Dr. Plavin agreed, adding that ASCs also enhance provider wellness and longevity in the field.
However, he noted that some facilities may need to adjust expectations around revenue, possibly even subsidizing anesthesia care to attract and retain providers.
"I think the facilities are starting to realize that they're not going to make money off of us, but in fact they may even have to subsidize our care," he said. "A lot of times those facilities that are somewhat antiquated and not really where they need to be, it's difficult for a practitioner to feel confident and comfortable in their skills."