5 Observations on Anesthesia in ASCs From Syed Ishaq of Somnia Anesthesia

Syed Ishaq, vice president for business development at Somnia Anesthesia Services in New Rochelle, N.Y., offers five observations on anesthesia in ASCs.

1. Why anesthesiologists are in shortage. The number of new anesthesiologists has not grown. At the same time, due to advances in anaesthesiology and technology, more and more procedures requiring anesthesia are moving out of hospitals and into surgery centers and physicians' offices. This is impacting supply and demand—demand for procedures isn't going down at hospitals and other facilities, while the existing supply of anesthesiologists now has to be spread across more sites.

2. For certain clinicians, working at an ASC is preferable to working at a hospital. Where clinicians prefer to work depends on their personal priorities. If they want more regular, corporate-type hours (no call or weekends), they probably want to work for an ASC. However, if they also want to meet a certain salary level, then they need to be sure the facility has the case volume to fill the days, a situation that which can make recruiting for ASCs more difficult. Although working at a hospital means longer hours (call and weekends) it also offers a wider variety of complex cases for clinicians who are interested in honing certain skill sets.

3. Case guarantees becoming more common. This situation really points to anesthesia providers being able to meet their salary needs which in turn ties to volume. It also relates to the surgeons in that some may prefer to work only in the mornings, leaving afternoons free and no cases for the anesthesia provider. It's a balancing act. So in order for it to be attractive to the anesthesia provider, the ASC may be asked to guarantee a certain number of cases that will ensure the provider meets his/her salary target.

4. Working with large anesthesia groups can get complicated. Typically, large groups are at hospitals and also will contract with nearby ASCs. That can spread providers thinly. For example, when people from the group are on vacation or in emergency surgery, they are unavailable to be scheduled at the ASC. At the same time, surgeons at the ASC may be used to seeing certain faces from the group who are not available so the anesthesia providers need to fill in with someone new, who may not be familiar with the ASC's facility and staff. On occasion, this has the potential to affect the ASC's efficiency and, possibly, its quality.

5. Small groups also pose challenges. A group of two or three anesthesiologists dedicated to a single facility can present coverage issues. For instance, it may be difficult to find a fill-in when one of them goes on vacation and this may cause disruption. Also, small groups are typically unable to provide a quality assurance program, because they lack the infrastructure to support one, which is ever more important as reimbursements become outcome-based.

Learn more about Somnia Anesthesia Services.

Read more from Somnia Anesthesia Services:

- Propofol Shortage Effect on ASC Operations and Profitability: Q&A With Dr. Robert Goldstein of Somnia Anesthesia Services

Anesthesiologist Dr. Marc Koch Comments on Anesthesia Cost-Containment Study

White Paper on Driving Value in Anesthesia Services Now Available From Somnia Anesthesia Services

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