Shortages of anesthesiologists, certified-registered nurse anesthetists and other anesthesia providers have complicated surgical access over the last decade.
The shortage is generally understood to be a supply-and-demand issue, with surgical demand across the U.S. rising faster than the number of new medical students who can replace retiring physicians.
Xi Luo, MD, a clinical associate professor of anesthesiology and pain management at UT Southwestern in Dallas, recently joined Becker’s to discuss the factors he identifies as driving the shortage as well as how healthcare providers can address the obstacles it creates at their practice.
Editor’s note: This response has been lightly edited for clarity and length.
Question: What would it look like to ‘overcome’ the anesthesia provider shortage?
Dr. Xi Luo: The anesthesia workforce shortage is driven by both intrinsic and extrinsic factors.
Intrinsic factors include an aging workforce, earlier-than-expected retirements, and rising burnout. Extrinsic factors include rapid expansion of ambulatory surgery centers, increased procedural volume, and growing anesthesia demand driven by broader screening guidelines — particularly in procedural specialties such as gastroenterology. Advances in surgical technology, increasing case complexity, and policy changes such as the gradual elimination of the inpatient-only list have further amplified demand.
Given these realities, “overcoming” the shortage does not mean returning to prior staffing norms. Instead, success will require strategic redesign of how anesthesia services are deployed within health systems. This includes thoughtful consolidation of coverage models, optimization of block utilization, and aligning anesthesia resources with sites that generate the highest clinical and operational value.
In parallel, systems will need to reconsider sedation models. Expanded use of proceduralist-directed moderate sedation, when clinically appropriate, may become increasingly necessary — particularly as reimbursement pressures, payer policies, and pharmaceutical innovation continue to evolve. Advances in sedative agents and monitoring technology may allow safer expansion of moderate sedation pathways without compromising patient outcomes.
Ultimately, overcoming the workforce shortage will require system-level efficiency, cultural resilience, and flexibility, rather than relying solely on workforce expansion to meet growing demand.
Another food for thought as well is, expansion of ASC space not only affects anesthesia workforce, but it also affects surgical specialty workforce as well. With an expanded physical footprint for case coverage without modification of an inpatient coverage model, it will only be logical to conclude it could lead to surgical specialist recruitment and retention issues as well.
