Anesthesiology's biggest controversies

Four anesthesia leaders joined Becker's to discuss the biggest controversies in the industry today. 

Editor's note: This response was edited lightly for brevity and clarity. 

Adam Spiegel. CEO of NorthStar Anesthesia (Irving, Texas). One of the more challenging trends we've seen in many markets is that hospitals are increasingly trying to win back volume lost to ASCs during COVID-19 by increasing their surgical capacity. They have done this at the expense of running efficiently. We've seen our hospital partners increase surgical capacity (number of rooms they are staffing with anesthesia care) by 15 percent nationally since 2019, yet volumes at those centers have decreased by more than 2 percent. This trend creates an unnecessary demand for anesthesia providers, making an already challenging workforce issue much worse.

Javier Marull, MD. Anesthesiologists at UT Southwestern Medical Center (Dallas). The most controversial trends in anesthesiology are the buyouts of physician practices by management companies. These companies have turned anesthesia practices into businesses. 

Anthony Lawson, MD. CMO of Quantum Anesthesia Services (Chicago). Medicare says ultrasound guided regional anesthesia is now the standard of care, yet CMS, as of January 2023, will not reimburse for the ultrasound guidance in regional anesthesia. The average U.S. machine costs $25,000 without the bells and whistles. No longer is it safe to do the blocks without U.S. guidance. This is a cost incurred by the anesthesiologists for which CMS refuses to remunerate.

David Beardsley, MD. Anesthesiologist at Maria Parham Medical Center (Henderson, N.C.).  Labor shortages, increasing complexity of aging population, new technologies/medications, COVID-19, illegal drug epidemic and unrealistic expectations for end-of-life care.

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