The anesthesia workforce shortage is not new news to ASCs and physicians – the projected shortage of anesthesiologists by 2036 will hit 6,300, and by 2033, the U.S. is projected to face a shortage of about 12,500 CRNAs, nearly 22% of the current workforce.
Sean Gipson started worrying about anesthesia staffing years before most of his peers did. Mr. Gipson, an ASC administrator in the Dallas-Fort Worth area with a background in hospital administration, told Becker’s he began building relationships with CRNAs and physician assistants five to seven years ago, well before the current wave of hospital stipends made headlines.
“I started really five to seven years ago seeing the strain building on anesthesia,” Mr. Gipson said. “At that point I understood that, just like with PAs, we’d better start creating a pool of providers we have a relationship with — people I can eventually hire as employees, but who start off as PRN so we get a relationship going.”
Mr. Gipson’s timeline lines up with a workforce problem he says is now compounding. He estimated the anesthesia field will see an additional 20% shrinkage over the next five years as older providers retire, on top of low enrollment in anesthesia training programs over the past five years.
“There’s going to be, in the next five years, an additional 20% shrinkage because of the age of the providers that’ll be retiring out in the anesthesia world,” he said.
He added that “even in the last five years the enrollment for anesthesia has been very low,” with prospective clinicians choosing the CRNA route instead, or leaving the field for something else entirely.
According to data from the Bureau of Labor Statistics, the states with the fewest anesthesiologists per capita include Nevada, New Mexico, Pennsylvania and Louisiana. Arizona, California, Vermont and Massachusetts have the lowest number of CRNAs. Some states have employment estimates not released by the BLS. Other reports have Idaho ranking at 5 anesthesiologists per 100,000 people; South Dakota at 9; Mississippi at 10; North Carolina at 11.
Eight states do not have anesthesia residency programs: Alaska, Delaware, Hawaii, Idaho, Montana, North Dakota, South Dakota and Wyoming. Several of these overlap with the lowest-per-capita states, meaning they face the worst current shortage and have no infrastructure to grow their own supply
By 2033, the U.S. is projected to face a shortage of about 12,500 CRNAs, nearly 22% of the current workforce. Demand remains high, with the Bureau of Labor Statistics projecting 38% growth in the field by 2032.
Mr. Gipson’s response has been to restructure how cases are staffed rather than simply compete harder for physician anesthesiologists. Major cases are scheduled early in the day, run by the physician side of the anesthesia team, with time built in for PACU recovery. Lower-acuity procedures such as carpal tunnel releases and injections are handled by CRNAs, with a supervising physician nearby.
“The smaller procedures — the carpal tunnels, the injections — can be run by the CRNAs, and they have their provider right here in case something gets muddy,” Mr. Gipson said.
Mr. Gipson pointed to a second, less obvious consequence of an aging anesthesia workforce: a reluctance among some older providers to adopt electronic documentation, which he said has created real patient safety exposure through pharmacy audits and transcription errors between paper charting and the EMR.
“It tends to be the older population that isn’t as tech savvy,” he said, describing weekly pharmacy audits that repeatedly flagged discrepancies from anesthesia’s paper-based documentation before his organization moved fully electronic.
According to Mr. Gipson, ASCs waiting to feel the supply crunch before acting will already be too late, since building a reliable bench of CRNAs and physician anesthesiologists takes years of relationship-building, not a single hiring push.
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