While the anesthesia workforce faces significant workforce pressures and financial challenges, including sinking reimbursement rates and a wave of retiring practitioners.
However, there are several developments promising a brighter future ahead in the specialty.
Physician leadership
Anesthesiologists may be increasingly well-positioned to step into leadership and administrative roles at medical centers and institutions, according to panelists during a session at the American Society of Anesthesiologists’ ADVANCE 2025 conference in Las Vegas.
Aalok Agarwala, MD, an anesthesiologist and associate chief medical officer at Boston-based Massachusetts General Hospital and Mass Eye and Ear, moderated the session. He noted that it has become “more common for anesthesiologists to seek greater leadership — not just at the practice or department level, but at the hospital level.”
“Our experience as clinical leaders, working closely with surgeons and nurses in the OR — that teamwork collaboration with direct patient care has been invaluable in adapting to the complexities of the C-suite,” Dr. Agarwala said.
New opioid-sparing techniques
Opioid-sparing protocols have become increasingly desired and commonplace in outpatient surgery, as heightened surgical volumes and patient preferences increase the demand for swifter recoveries.
Armen Voskeridjian, MD, the director of anesthesia services at Jefferson Surgery Center at the Navy Yard in Philadelphia, is on the cutting edge of opioid-sparing techniques. He recently conducted two studies on the effectiveness of adding dexamethasone, a steroid, to liposomal bupivacaine, a long-lasting local anesthetic.
Both studies produced highly promising results, with patients in the variable groups requiring almost zero narcotics during recovery from surgery.
“This is an incredible result,” Dr. Voskeridjian told Becker’s. “Considering most patients would finish their narcotic prescription of 20 pills, sometimes calling the surgeon’s office for a refill.”
There is a swath of similar research and new pain management techniques emerging in the specialty that aim to decrease or eliminate opioid use entirely.
“The recently FDA-approved suzetrigine is a non-opioid alternative approved for acute postoperative pain. Of course, nothing beats aggressive multimodal analgesia,” Eugene Viscusi, MD, a professor of anesthesiology and perioperative medicine at Thomas Jefferson University in Philadelphia, told Becker’s. “Since most ambulatory patients are generally healthier, they can benefit from the full range of standard non-opioid agents. Buprenorphine is finding its way into postoperative pain pathways too. It has a safety profile superior to standard opioids. The buprenorphine patch can be an effective option for ambulatory surgical patients.”
Improved work-life balance
The rise of outpatient surgery and growth of the ASC market has resulted in a cultural shift among anesthesia providers, as new outpatient settings are often able to offer more flexible scheduling options and more intimate, less bureaucratic work environments, Angela Durham, vice president of ancillary services at Franklin, Tenn.-based US Heart and Vascular told Becker’s.
Hospitals have tried to meet the moment by offering increasingly flexible schedules and other work-life benefits to anesthesia providers. This creates stiff competition for providers with ASCs, as hospitals can often offer higher compensation, but may be an encouraging factor for medical students weighing a future in the specialty.
“As the hospital began experiencing the competitive pressure of the ASC attracting anesthesia providers due to lower acuity patients and better working hours, they responded in kind, offering equally appealing schedules that allow providers to achieve their desired work/life balance plus high rates of compensation,” Ms. Durham said.
ASCs’ work environments may also be able to give anesthesia providers a greater sense of autonomy, improving the outlook for those entering the specialty.
“There are anesthesiologists unhappy with the hospital systems or burnt out, because of working conditions, call autonomy and are willing to work in an ASC,” Krishna Jain, MD, CMO at Chicago-based APEx Health Network, told Becker’s.
This also comes into play with the appeal of 1099 compensation, which some ASCs can offer CRNAs, Andrew Hicks, a CRNA for the cardiothoracic division of the Columbus-based Ohio State University College of Medicine told Becker’s.
Many CRNAs prefer 1099 compensation for its autonomy and financial benefits, yet are often forced to work through third-party staffing agencies to access these arrangements,” he said. “A practical solution would be for outpatient surgical centers and large healthcare systems to offer both 1099 and W-2 compensation options directly. This would not only attract a broader pool of qualified anesthesia providers but also reduce reliance on external agencies, improving consistency and quality of care.”
