The anesthesia staffing crunch hitting gastroenterology is not just about headcount; it’s about timing, coverage and payer pushback colliding.
In GI suites and other non-operating room anesthesia settings, procedure demand has become “volatile and front-loaded,” creating a daily mismatch between how staffing is designed and how cases actually arrive, Megan Friedman, DO, chair and medical director at Los Angeles-based Pacific Coast Anesthesia Consultants, told Becker’s.
“Anesthesia staffing models are still built around six daily blocks and historical averages, but we see consistent surges early in the day and then late add-ons and short-notice case stacking, especially in these NORA areas, that outstrip scheduled anesthesia coverage,” she said. “That’s followed by midday lulls where providers are staffed but underutilized.”
Fixing the problem requires a scheduling mindset shift, she said, particularly one that plans for early surges and anticipates late add-ons and short-notice cases as the norm in NORA, rather than the exception.
At the same time, payer pressure is narrowing which GI cases get anesthesia support at all, Dr. Friedman said, pointing to denials for routine GI procedures and heightened scrutiny around anesthesia utilization.
Clinicians say the staffing gap is already translating into access constraints. Seth Gross, MD, clinical chief of gastroenterology and hepatology at New York City-based NYU Langone Health, told Becker’s in 2025 that shortages of both CRNAs and anesthesiologists are limiting patient access, even as reimbursement for anesthesia services fails to keep pace with rising operating costs.
The demand side is also intensifying. Gastroenterology is contending with increased colonoscopy volume after the American Cancer Society and GI societies updated colorectal cancer screening guidelines to start at age 45 instead of 50. This shift added an estimated 19 million individuals to the screening-eligible pool.
“ASCs need to recruit more anesthesiologists and nurse anesthetists due to increased demand for colonoscopies,” Benjamin Levy, MD, gastroenterologist and clinical associate of medicine at University of Chicago Medicine, told Becker’s. “Furthermore, the U.S. is experiencing a relative shortage of anesthesiologists and CRNAs due to preferences for propofol during GI endoscopy, increased surgical volume, in general at ASCs, the baby boomer generation aging, and an aging workforce. In gastroenterology, we are working hard to increase colorectal cancer screening rates nationally to remove polyps before they turn into cancer, so we need additional gastroenterologists and anesthesiologists to help this effort.”
