Physician specialist shortages, and predicted shortages, are plaguing health systems nationwide, including ASCs. One major shortage especially affecting ASCs is a shortage of anesthesiologists.
Clinics like the Billings (Mont.) Clinic were seeing a shortage of 35 or more full-time anesthesiologists late last year in the wake of the COVID-19 pandemic.
Additionally, the U.S. is seeing an ongoing shortage of certain types of anesthesia, with estimated resupply dates continually being pushed back.
Here is what four ASC leaders have told Becker's about anesthesia shortages and the importance of anesthesiologists for ASCs:
"The anesthesia staffing shortages are not easily solved, particularly as reimbursement shrinks in many markets. Many ASCs are swallowing the bitter pill that they now have to supplement anesthesia pay with stipends or guaranteed day rates to keep sufficient staff. Discord between scope of practice among CRNAs and MDs does not help the matter. However, there are major staff shortages even in states where the working relationship between MDs and CRNAs is very good." – George Dickstein, MD, gastroenterologist at Boston Endoscopy Center
"I think the biggest threat towards ASCs in 2023 is staffing, especially qualified, experienced staffing in all areas of an ASC, including business office, pre-op, OR (both nursing and surgical technicians), post-anesthesia care unit and recovery nurses. In addition, sterile processing technicians. Each of these areas require a certain set of skills that are acquired and honed over time. There is increased competition, and in fact it is hard to compete with large health systems/hospitals. I am also finding that ASCs are competing in the same region against one another for the available staffing pool." – Michael Powers, administrator of Children's West Surgery Center (Knoxville, Tenn.)
"Staffing is definitely a top challenge. Other ones that come to mind are anesthesia: supply, demand of resources and people. Anesthesia has really been a challenge, especially in more rural and remote markets. That's led to coverage issues; in some cases we haven't been able to keep all the operating rooms up and running. It has led to expense issues where we've had to provide some financial guarantees to anesthesiologists in return for coverage. And just overall inflation. Everything is more expensive. Even though reimbursement has technically gone up, so has the expense side. That puts a lot of strain on the profitability of ASCs. You have to manage costs more effectively than before. You have to have a really strong financial plan that not only focuses on cost control, but also growth. Ultimately, you have to be able to have growth through strong physician recruiting, retention, having service lines and other strategies. Being affiliated with a big health system has been effective in driving growth." – Aric Burke, president and CEO of Atlas Healthcare Partners.
"The shift toward outpatient procedures is driven by advancements in medical technology, improvements in anesthesia and pain management techniques and the desire to reduce healthcare costs. This trend is expected to continue, providing opportunities for ASCs to expand their service offerings." – Ali Ghalayini, administrator at Munster (Ind.) Surgery Center