Anesthesia staffing shortages show no sign of easing, and health systems are aware that no single fix exists. Industry leaders told Becker’s that, instead, they are rethinking everything from scheduling and compensation to culture and workforce pipelines to stabilize coverage.
The takeaway: success now depends on how well systems align staffing with real demand, invest in clinicians’ time and well-being and build models flexible enough to adapt to a rapidly changing workforce.
Question: What anesthesia staffing strategies are delivering real results in your organization right now?
Editor’s note: These responses have been lightly edited for clarity and length.
Moeed Azam, MD. Head of Innovation at U.S. Anesthesia Partners (Dallas): To work well, any staffing strategy must recognize that one size does not fit all; there should be flexibility for each local practice to adjust to local market conditions, expectations and clinical demands in order to find solutions that align well with the patients and facilities they serve.
For us, each practice is distinct. Several practices have introduced workweek and call flexibility, have deployed various strategies such as modified/shared FTE roles, and yes, physician autonomy with partnership tracks can still be successful and often aligns goals.
Patrick Booth, DNP, CRNA. University of Maryland Capital Region Medical Center (Lake Arbor): Anesthesia staffing strategies that deliver real results optimize utilization of CRNAs. CRNAs are able to perform their own regional anesthesia, cover obstetrics providing spinals and epidurals, as well as administer their own general anesthetics independently.
When outdated and inefficient staffing strategies are utilized such as medical direction with restrictive hospital bylaws, CRNA utilization and efficiency goes down. Facilities that utilize this result in less than ideal workplace anesthesia department cultures, which correlates to poor CRNA recruitment and retention. The number of physician anesthesiologists administering their own anesthesia is quite low, contributing to the anesthesia workforce shortages. Successful groups are able to use providers interchangeably at multiple service locations including surgery centers, non-OR anesthesia locations, endoscopy, obstetrics, etc to meet the demand with strong provider supply regardless of training, MD or CRNA.
Scott Bowers. Vice President of the Anesthesiology Institute at Allegheny Health Network (Pittsburgh): In markets where compensation and benefits are competitive between different organizations, it’s the details that set you apart from the others. Things like culture, schedules, scope of practice and care team collaboration are all keys to retaining staff.
The more creative you can be in anesthesiologist-CRNA team building, the more trust you can develop amongst your clinicians and the more present and transparent administrative leaders can be in the clinical setting, the stronger your reputation becomes in the market. This all rolls up to faith in the organization by your existing team and intrigue by those outside the practice.
Stephen Estime, MD. Associate Chair in the Department of Anesthesiology & Critical Care at University of Chicago Medicine: Anesthesia staffing remains challenging across many U.S. regions due to a mismatch between physician supply and growing demand. Addressing this requires balancing flexibility, competitive compensation and long-term talent development. We’ve shifted to more flexible staffing models with a mix of shift options, part-time, evening, weekend and as-needed, to better align coverage with when work is actually occurring, particularly later in the day when variability is highest. This has reduced same-day schedule changes and last-minute coverage needs. We also consistently benchmark compensation against local and regional markets to remain competitive.
In the longer term, building a resilient workforce requires intentional investment in the pipeline. We engage medical students, residents and fellows early, understand their career priorities and design roles that reflect those preferences. This creates a more durable staffing model and ensures we’re not just reacting to current shortages but preparing for future demand. Ultimately, anesthesia staffing will remain dynamic, and success will depend on staying adaptable to both evolving hospital needs and physician workforce priorities.
Joseph Hall, CRNA. Upper Cumberland Anesthesia Associates (Cookeville, Tenn.): Anesthesia staffing is much more than just recruiting. I see so many failing on the most important aspect in the anesthesia staffing algorithm, and that is retention. The big three puzzle pieces in anesthesia recruiting are salary, benefits and work-life balance. You must have one of the three pieces or a good blend of the two in order to recruit.
However, I would argue that high retention requires a global commitment to work-life balance. Anesthesia providers these days absolutely want a set schedule, a stop time and go-home time. They do not want to miss appointments, anniversaries or family activities. Anesthesia providers want to work in a healthy, cohesive, team-focused environment. High morale, work-focused friendships and strong peer-focused leadership are all essential for retention and an overall sense of a positive work-life balance.
Narasimhan Jagannathan, MD. Division Chief of Anesthesiology at Phoenix Children’s: One strategy delivering meaningful results for us has been tightly aligning anesthesia staffing with real-time procedural demand, rather than relying on locum tenens or external coverage. By prioritizing a core group of employed, pediatric-focused anesthesiologists, we’ve been able to maintain consistency in care delivery and more closely manage quality and safety outcomes.
We’ve complemented this with a subspecialty team model for higher-complexity cases, aligning provider expertise with specific surgical populations. This has reduced variability, improved team familiarity and supported more consistent perioperative outcomes.
Ryan McDonald, MSN, CRNA. Director of Anesthesia at Prosser (Wash.) Memorial Hospital: Prosser Memorial Health, located in rural Washington, has experienced tremendous growth, which necessitated a change to our anesthesia coverage. What was once reasonable for a CRNA to provide 24 hours of coverage with the following day off for recuperation, is no longer sustainable. Excellent data demonstrates that abusing the circadian rhythm is no good for multiple dimensions (e.g., physical health, mental health, career longevity, safety, etc.). We have rebuilt our schedule to place a CRNA in a solid week of nocturnal coverage, which allows a modicum of circadian settling and decreased fatigue.
This run of nocturnal shifts ends with three days of recuperation time and returns to a very busy day-shift rotation. This is seemingly unique for a critical access hospital and has received praise from partners and hospital administration.
Michael Nurok, MD, PhD. Professor and Co-Chair in the Department of Anesthesiology at Cedars-Sinai Medical Center (Los Angeles): The most helpful conversations I’ve had with potential recruits have focused on aligning institutional mission, the vision for our department and the personal values and career ideals of the candidates themselves. Simply offering clinicians a place to show up, anesthetize patients and earn a paycheck is a recipe to a revolving door propelled by market rates. Giving clinicians the opportunity to develop careers they find meaningful and that align with institutional needs, is the key to creating a stable workforce that adds value to healthcare and the communities we serve.
Amit Prabhakar, MD. Chief of Anesthesiology at Emory University Hospital Midtown and Winship at Emory Midtown (Atlanta): Organizations stabilizing anesthesia coverage aren’t relying on a single solution; they’re combining flexible workforce models, smarter scheduling and tighter OR alignment. Underpinning this is a focus on psychologically safe cultures where clinicians feel heard and supported, which directly drives retention, engagement and patient care.
At the same time, leading programs optimize perioperative operations to improve efficiency and financial performance through better block utilization, reduced downtime and increased OR throughput. What sets them apart is reinvesting those gains back into the anesthesia team through more competitive compensation and greater control over time, including reduced call burden, flexible scheduling and protected time off. This combination of operational discipline, strong culture and intentional reinvestment is what’s sustaining anesthesia coverage today.
Eric Reilly, DO. Assistant Professor of Anesthesiology at Corewell Health (Royal Oak, Mich.): Our anesthesiologist and CRNA teams meet daily with OR leadership and schedulers to align staffing, case mix and equipment needs, often planning up to a week in advance. This forward-looking approach allows us to build more accurate daily schedules and ensure appropriate call coverage, reducing last-minute disruptions. Clinically, we utilize a medical direction care-team model that blends anesthesiologists, residents and CRNAs. We safely adjust assignments and provide relief based on real-time demands, which helps us stay responsive to the variability of each day.
A key driver of success has been strong internal leadership. Our anesthesiologist, resident and CRNA leaders are fully in-house, deeply familiar with our system and empowered with a high level of trust and autonomy. That combination of structure and support has made a meaningful difference. Ultimately, when our anesthesia teams feel organized, supported and heard, it translates directly into better experiences for both our patients and our surgical colleagues.
Gerald Rosen, MD. Anesthesiology Residency Program Director at Mount Sinai Medical Center of Florida (Miami Beach): Mount Sinai Medical Center’s division of anesthesia utilizes a care team model to balance daily coverage needs with the educational requirements of our residents and SRNAs.
Our recent transition to hospital employment has further strengthened this strategy, aligning our incentives with hospital leadership to create collaborative staffing solutions as our anesthesia services expand. By prioritizing a high-quality culture and working environment, we have achieved excellent recruitment results that allow us to fully maximize both our clinical and academic staffing models. With this solid footing under us, we can now focus on a more detailed staffing approach to each OR, each day, as opposed to a blanket coverage model.
Luis Tollinche, MD. Chair and Professor in the Department of Anesthesiology at MetroHealth Medical Center (Cleveland): What’s delivering real results for us is a deliberate shift away from treating anesthesia staffing as a commodity, and instead, positioning our department as a differentiated clinical and operational partner, with intentional investment in what makes us distinct—subspecialty expertise, perioperative leadership, flexible physician-led team design and a strong culture.
By emphasizing these unique strengths, we move out of a crowded competitive space and establish our department as a fundamentally different product rather than just another staffing solution
Brian Walford, MSNA, APRN, CRNA. Golden Crescent Anesthesia (Victoria, Texas): We believe culture is the ultimate staffing strategy. Our primary focus is on creating and protecting an environment of mutual respect where every provider feels heard and valued. We’ve found that prioritizing job satisfaction is the most effective way to drive higher retention and long-term stability.
Crucial to this is a commitment to ‘quality over speed’ in recruitment. Even when a vacancy creates immediate pressure, we take the time to find the right CRNA who fits our culture rather than simply hiring the first available candidate. This approach requires a leadership team willing to invest both personal time and financial resources to bridge the gaps themselves, ensuring we never compromise our standards for the sake of a quick fix.
Jake Yellen, CRNA. Owner of United Sedation (Albany, N.Y.): As an ASC anesthesia staffing and management company, what I’ve found that works best for staffing is working together with my ASC partners to finalize a surgeon block schedule 30 to 90 days in advance. From there, we calculate surgeons’ minimum volume for each day, so that the anesthesia revenue can, at minimum, break even on the CRNAs needed per day, while guaranteeing 8 hours pay per CRNA per day.
CRNAs are looking for the lifestyle of the ASC; no nights, weekends, holidays or call, but also want the security of the 8 hour guarantee. It’s a win all the way around.
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