During an interactive session at Becker's 29th Annual ASC Meeting: The Business and Operations of ASCs, Peter H. Doerner, Executive Vice President and Chief Development Officer for North American Partners in Anesthesia (NAPA), led a group of ASC healthcare leaders in discussion about the challenges faced by the healthcare industry due to a shortage of anesthesia clinicians.
This new reality is attributed in part to a lack of new medical residencies, an increase in demand for anesthesia services in outpatient settings, and a drop in actively employed anesthesia providers due to retirement or career changes. More than 2,872 anesthesiologists left the workforce from 2021 to 2022. The shortage has led to supply-and-demand pressures of increased clinical compensation for providers and has also resulted in some providers reducing their working hours.
The discussion also highlighted the need for additional nurse anesthetist training programs nationwide and the potential for clinical locations to serve as rotation sites for these students. The session also touched on the need for strategies to mitigate costs and the impact of the shortage on certain service lines.
Editor’s note: Quotes have been edited for length and clarity.
Key takeaways:
1. The anesthesia staffing shortage is a significant challenge in the healthcare industry and will continue to be for years to come.
Peter Doerner: “There are additional CRNA schools popping up across many markets in the US, but even so, there's a material shortfall of anesthesia providers in the coming years—for CRNAs, about 9,000 over the next eight to nine years, and physician anesthesiologists, nearly 10,000 over the next six to seven years.”
2. The shortage is pressuring availability of service lines and the need for increased communication between hospitals and ASCs.
PD: “Many hospitals have said, ‘We are no longer doing GI, eyes, or certain urology cases.’ That begs the question: ‘Where do [these patients] go for surgical care?’ They're going to go to our outpatient centers. These are strategic changes that we've seen over the last year in terms of adjusting service scope to meet this shift of demand with limited clinical labor.”
Anthony Principe, Vice President, Business Development, NAPA: “We're seeing a shift of complex cases away from the hospital and into the ASC. This increases the need for more planning and discussion between hospital and ASC treatment.”
3. The shift from hospitals to ASCs is increasing the need for CRNAs with advanced training.
AP: “If there is a higher volume of complex cases in ASC, and you traditionally have a higher balance of CRNAs there, now you have the question from your surgeons: ‘Is this CRNA skilled enough to cover this case?' So that concern needs to be addressed as well.”
4. Strategies to mitigate costs and address the shortage include increasing the number of CRNA training programs and adjusting service scope expectations.
CEO of a pain management medical practice based in the Southeast: “We need to start developing more CRNA training programs. It needs to be a national focus to increase those training programs. If we did this nationally, we would certainly have a wider pool of CRNAs to choose from.”
5. However, outpatient facilities are sometimes not the best training ground for new nurses.
Vice President of Operations for a surgery center development firm based in the Southeast: “Anesthesia residencies in the ASC setting are often not the most appropriate because we're focused so heavily on efficiency. We don't allow students to train there because our primary goal is to be efficient and move the cases through.”